Summary:
Tirzepatide (Zepbound), a GLP-1 receptor agonist, has been FDA-approved for obstructive sleep apnea (OSA) in people with obesity, raising questions about whether it could help some patients reduce or eliminate the need for CPAP. While weight loss from the drug may improve airway function in weight-related OSA, experts caution that CPAP should not be discontinued without medical evaluation. Additionally, maintaining muscle mass through diet and exercise is essential, as stopping GLP-1 therapy often leads to weight regain, which could reverse improvements in sleep apnea.
Key Takeaways:
- Zepbound Becomes First Approved Medication for OSA in Obesity – The FDA has approved tirzepatide for obstructive sleep apnea in people with obesity, offering a new, non-device-based treatment option.
- Weight Loss May Reduce CPAP Dependence – Some patients with weight-related OSA may no longer need CPAP after significant weight loss, but experts stress that patients should continue CPAP until a doctor confirms improvement through follow-up testing.
- Lifestyle Changes Are Key for Long-Term Results – Since weight regain is common after stopping GLP-1 medications, maintaining a healthy diet, exercise, and muscle mass is essential for lasting improvements in sleep apnea and overall health.
For obstructive sleep apnea (OSA) patients who don’t enjoy sleeping with a CPAP, there’s possible relief, thanks to the US Food and Drug Administration’s recent approval of tirzepatide (Zepbound) for patients with moderate-to-severe OSA and obesity.
The drug is typically prescribed for type 2 diabetes and is among the class of drugs known as GLP-1 receptor agonists, meaning they work on hormones that control appetite and insulin levels and can help promote weight loss.
Sarah Zallek, MD, a neurologist and vice president and chief medical officer for OSF HealthCare St. Joseph Medical Center and medical director of OSF Sleep, calls the approval a significant and important development, pointing out that there have been few new developments for the treatment of OSA, and this is the first medication.
Could Zepbound Help Some OSA Patients Stop Using CPAP?
Could this let some people ditch their CPAP machines? Zallek says if their sleep apnea is caused by obesity, potentially yes. “So, if you’re wearing CPAP, and you have weight-related sleep apnea, weight loss is a great idea. The approval of Zepbound (tirzepatide) is a new avenue for us to look for treating overweight or obesity and to treat sleep apnea,” she says in a release.
Zallek says, for some people with weight-related OSA, losing about 10% or more of overall body weight can significantly reduce or eliminate the sleeping disorder. However, she warns that, with GLP-1 agonists, it’s important to maintain a healthy diet and exercise because the medication carries significant risk of muscle loss.
“It’s really important for people who are using GLP-1s to maintain adequate nutritional intake, particularly with high-quality protein, and maintain exercise so that they get muscle resistance exercise and build and maintain muscle,” she says in a release.
Treatment of sleep apnea with CPAP is still the gold standard. Zallek says if switching to Zepbound to address OSA, a doctor should continue to monitor weight loss and then test again to see if a person’s airway has opened up.
“Keep using that treatment until you successfully lose weight and get rid of the sleep apnea. It’s not time to stop the CPAP and switch to Zepbound, for example. To treat sleep apnea, it’s time to continue what you’re doing, approach weight loss, and then see if the sleep apnea has resolved,” she says in a release.
Lifestyle Changes Are Key for Long-Term Success
Studies have shown that people who have lost weight with GLP-1 drugs, tend to regain the weight once they quit taking the medication. This is because GLP-1s mimic natural hormones that regulate blood sugar, slow digestion, and make you feel full. So, Zallek stresses the need for lifestyle changes regardless of the approach to treating sleep apnea.
Zallek is board-certified in lifestyle medicine, which means she incorporates therapeutic lifestyle interventions to treat and reverse chronic conditions. That includes a whole-food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connections.
It’s possible other GLP-1 drug makers for Wegovy, Ozempic, or Mounjaro will seek similar approval for use as treatment of OSA. But Zallek says people also need to talk with their provider and weigh the side effects with the benefits. Some of the side effects of the GLP1s include nausea, vomiting, diarrhea, delayed gastric emptying, low blood sugar, fatigue, and more serious complications such as gallstone disease, and pancreatitis.
As they say in the ads, “Ask your doctor if it’s right for you.”
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