Do you know someone who snores a lot? While it might seem harmless, snoring is often a red flag for obstructive sleep apnea (OSA), a serious condition characterized by repetitive throat collapse during sleep, causing breath interruptions, low oxygen levels, and frequent awakenings. Affecting over 900 million people worldwide, with 40% experiencing moderate-to-severe symptoms, OSA not only disrupts sleep but also poses a significant risk for cardiovascular diseases.

Traditional treatment for OSA focuses on mechanical aids like positive airway pressure (PAP) therapy or lifestyle changes like weight loss. While PAP improves symptoms, its effectiveness is often limited by inconsistent patient adherence and does not significantly reduce cardiovascular events or mortality. Weight loss is another well-recognized treatment strategy for OSA and, unlike PAP, can significantly reduce the risk of cardiovascular events and mortality.

Researchers from the University of California San Diego have discovered that tirzepatide, a drug commonly used to treat diabetes by promoting weight loss, reducing blood pressure, and decreasing inflammation, could also significantly improve OSA. To investigate this, they evaluated tirzepatide’s safety and efficacy over 52 weeks in adults with moderate-to-severe OSA and obesity with participants randomly assigned to receive either tirzepatide or a placebo. Results showed that tirzepatide significantly reduced the apnea-hypopnea index – a measurement used to indicate the severity of sleep apnea – and improved measures of sleep impairment and cardiovascular risk factors compared to the placebo. Moreover, some participants who took the drug reached a point where CPAP therapy might no longer be necessary. The drug’s safety profile was consistent with previous trials, with mild-to-moderate gastrointestinal issues being the most commonly reported side effect.

This study is a significant milestone and indicates that a drug therapy addressing both sleep apnea and obesity is more beneficial than treating either condition individually. However, further research is needed to assess long-term cardiovascular outcomes and the drug’s effectiveness in a broader population. Nonetheless, tirzepatide offers a new approach for those struggling with OSA and obesity, potentially improving the quality of life for people affected by this widespread and debilitating condition.

This study was led by researchers at University of California San Diego, Macquarie University, Royal Alfred Hospital, University of Sydney, Charité University Hospital Berlin, University of Illinois, Brigham and Women’s Hospital, Harvard Medical School, University of Pennsylvania and Eli Lilly and Company with corresponding author Atul Malhotra. 

Managing Correspondent: Gurminder K. Paink 

Press article: Study identifies first drug therapy for sleep apnea (medicalxpress.org)

Original Journal Article: Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (New England Journal of Medicine)

Image Credit: Pexels/Ron Lach