Tirzepatide: The diabetes drug transforming sleep apnea treatment

936 million people worldwide suffer from obstructive sleep apnea (OSA), a sleep disorder characterized by repeated episodes of irregular breathing during sleep [1]​. 

OSA not only disrupts sleep but also poses severe risks, including hypertension, cardiovascular disease, and metabolic disorders. 

Recent research has revealed an exciting breakthrough: tirzepatide, originally a type 2 diabetes drug, now demonstrates potential in treating sleep apnea.

About the study

In collaboration with international partners, University of California San Diego School of Medicine researchers conducted a study that could revolutionize the treatment of OSA. 

This study, published in the New England Journal of Medicine, demonstrated that tirzepatide significantly reduces the apnea-hypopnea index (AHI), a key indicator of sleep apnea severity, and improves overall health outcomes for those affected by both OSA and obesity ​[1].

What is tirzepatide?

Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist

It was initially approved for managing type 2 diabetes due to its effectiveness in controlling blood sugar levels and promoting weight loss. 

The potential of tirzepatide to address OSA stems from its ability to reduce body weight and improve metabolic health, which are crucial factors in the severity of sleep apnea [1], [2].

Key findings from the study

The study involved two phase 3, double-blind, randomized, controlled trials with 469 participants diagnosed with moderate-to-severe OSA and obesity. 

Participants were divided into two groups: 

  • One group received the maximum tolerated dose of tirzepatide (10 mg or 15 mg) 
  • The other received a placebo, both over 52 weeks [2].

Results 

  • Trial 1 showed a mean change in AHI at week 52 of −25.3 events per hour with tirzepatide, compared to −5.3 events per hour with placebo.
  • Trial 2 demonstrated a mean change in AHI at week 52 of −29.3 events per hour with tirzepatide, compared to −5.5 events per hour with placebo.
  • Significant improvements were also observed in secondary endpoints, including reductions in body weight, high-sensitivity C-reactive protein (hsCRP) concentration, hypoxic burden, and systolic blood pressure​​ [2].

For the first time, a medication demonstrates the potential to decrease the severity of sleep apnea effectively.

This mainly benefits patients who struggle with the current standard treatment, continuous positive airway pressure (CPAP) therapy, which many find uncomfortable and challenging to adhere to.

Patient experiences 

The study participants reported their sleep quality and overall well-being significantly improved.

Reduced sleep apnea events meant fewer interruptions at night, leading to better rest and increased daily energy. 

Additionally, the weight loss experienced by many participants contributed to enhanced physical health and reduced cardiovascular risks.

Expert opinions

Dr. Atul Malhotra, the study’s lead author and a professor of medicine at the UCSD School of Medicine, emphasizes the significance of these findings. 

He notes that the combination of CPAP therapy with weight loss could offer optimal improvement in cardiometabolic risk and symptoms. Tirzepatide’s ability to target specific underlying mechanisms of sleep apnea represents a significant advancement in the field​ [1].

While the results are promising, further research is required to examine the long-term effects of tirzepatide on sleep apnea. Ongoing clinical trials aim to explore its efficacy and safety over extended periods.

As a revolutionary treatment for obstructive sleep apnea, tirzepatide’s ability to significantly reduce AHI, promote weight loss, and improve overall health outcomes marks a new era in the management of this condition. 

Researchers are hopeful that tirzepatide will soon become a widely accepted treatment option, providing relief to millions of OSA patients worldwide.

[1] https://www.universityofcalifornia.edu/news/study-identifies-first-drug-therapy-sleep-apnea
[2] https://www.nejm.org/doi/full/10.1056/NEJMoa2404881

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