This was an unexpected effect.
Eli Lilly, the pharmaceutical company behind the anti-obesity drug Zepbound (tirzepatide), announced on April 17th that individuals with obesity experienced relief from obstructive sleep apnea—a condition characterized by interruptions in breathing during sleep—while using the medication.
The findings stem from two yearlong clinical trials involving over 400 adult patients with obstructive sleep apnea, a prevalent sleep-related breathing disorder affecting millions of Americans, often undiagnosed. In obstructive sleep apnea, the upper airway becomes obstructed, leading to brief pauses in breathing during sleep. This condition can result in daytime fatigue, headaches, increased cardiovascular disease risk, diabetes, and mental health changes.
While the results have not yet been published in a peer-reviewed journal, they are set to be presented at the American Diabetes Association’s 84th Scientific Sessions in June.
Christine Ren-Fielding, MD, division chief of bariatric surgery at NYU Langone, noted the significance of the findings, suggesting that the use of medications to promote weight loss could improve sleep apnea symptoms. Tirzepatide, marketed as Zepbound, gained FDA approval for chronic weight management in November 2023. It belongs to the GLP-1 receptor agonists drug class, targeting both GLP-1 and GIP hormones.
Participants in the studies had obesity and moderate-to-severe obstructive sleep apnea, characterized by 15 or more breathing interruptions per hour during sleep. Central sleep apnea participants were excluded, as it involves a malfunction in the brain’s signaling to the breathing muscles.
One study focused on participants unwilling or unable to use a continuous positive airway pressure (CPAP) machine, commonly prescribed for sleep apnea. Those receiving tirzepatide injections experienced a substantial reduction in apnea events compared to those on a placebo. The other study included CPAP users, with similar results favoring tirzepatide.
Participants in both studies also experienced around a 20% reduction in body weight. Unlike conventional sleep apnea treatments targeting symptoms, tirzepatide addresses the underlying cause by addressing airway blockages contributing to breathing pauses during sleep.
Dr. Ren-Fielding highlighted the link between weight gain and obstructive sleep apnea, noting that fat accumulation in the neck and tongue can obstruct airflow during sleep. Consequently, disrupted sleep patterns may lead to increased consumption of sugary or caffeinated products, contributing to further weight gain.
Marijane Hynes, MD, associate clinical professor of medicine at George Washington University, emphasized the role of weight loss in improving sleep apnea symptoms, with treatments like bariatric surgery showing promise in alleviating the condition.
Dr. Mir Ali, a bariatric surgeon, echoed the benefits of weight loss interventions, noting that maintaining weight loss can sustain improvements in sleep apnea, along with other comorbidities like diabetes and hypertension.
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