Anti-diabetic drug tirzepatide may benefit sleep apnea patients

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Findings from a new clinical trial suggest that the anti-diabetic drug, tirzepatide, may be effective for obstructive sleep apnea (OSA). These data could potentially pave the way for improved quality of life for people affected by the sleep-related disorder.

This study was published in 2014. New England Journal of Medicine,

Fighting the effects of sleep apnea

OSA affects millions of people worldwide. It is characterized by recurrent episodes of irregular breathing during sleep, caused by complete or partial obstructions of the upper airway. OSA is most common in people who are overweight or obese, and weight loss is recognized as an effective approach to reducing OSA.

This disorder can greatly impair the quality of sleep of those affected, leading to daytime sleepiness. Low oxygen levels in the blood due to OSA can also lead to more serious complications such as high blood pressure and heart disease.

The effects of OSA can be managed by using continuous positive airway pressure (CPAP) machines, which keep the airways open during sleep — but their effectiveness depends on how consistently they're used.

There are no medications approved to treat OSA. However, glucagon-like peptide-1 (GLP-1) receptor agonists such as tirzepatide — which can cause significant weight loss for people with obesity — have the potential to alleviate OSA.

Drug treatment shows promise in reducing breathing problems

In the new study, researchers at the University of California San Diego (UCSD) School of Medicine led a phase 3 clinical trial to evaluate the effects of tirzepatide for people with clinical obesity and moderate to severe OSA.

The approximately 500 patients who participated in the study were first divided into 2 groups – those who were undergoing CPAP treatment and those who were not. Each group was divided in a 1:1 ratio to receive injections of 10 or 15 mg of tirzepatide or a placebo for up to 52 weeks.

Tirzepatide treatment significantly reduced the number of breathing interruptions participants experienced during sleep – a key measure of OSA severity – compared with placebo. Importantly, some participants in the tirzepatide groups reached a point where CPAP therapy may not be needed.

Drug treatment also improved other OSA-related aspects such as cardiovascular disease factors and reduced body weight. The most common side effects reported were mild stomach problems.

A “new era” of sleep apnea management

“This new drug treatment provides a more accessible option for individuals who cannot tolerate or adhere to existing treatments,” explained senior author Atul Malhotra, MD, professor of medicine at UCSD School of Medicine and director of Sleep Medicine at UCSD Health. “We believe that combining CPAP therapy with weight loss would be optimal for improving cardiometabolic risk and symptoms.”

“Tirzepatide may also target specific underlying mechanisms of sleep apnea, potentially leading to more personalized and effective treatments,” he added.

“This means we can offer an innovative solution that represents hope and a new standard of care, bringing relief to countless individuals and their families who have struggled with the limitations of existing treatments,” Malhotra said. “This breakthrough opens the door to a new era of OSA management for people with obesity, potentially transforming the way we address and treat this widespread condition globally.”

The research team's next steps will include conducting clinical trials to investigate the long-term effects of tirzepatide.

Reference: Malhotra Atul, Grunstein Ronald R., Fietz Ingo, et al. Tirzepatide for the treatment of obstructive sleep apnea and obesity. NEJMdoi: 10.1056/NEJMoa2404881

This article is a rewrite of a press release issued by UC San Diego Health. Content has been edited for length and content.