Could individuals suffering from obstructive sleep apnea (a medical condition where you have pauses in breathing for 10 seconds or more while sleeping) finally find relief?
Zepbound (tripeptide), a weight loss drug, was approved by the U.S. Food and Drug Administration on December 20, 2024, for a new use: treating moderate to severe obstructive sleep apnea (OSA) in overweight adults.
"Today's approval marks the first drug treatment option for certain patients with obstructive sleep apnea, says Sally Seymour, MD, director of the Division of Pulmonology, Allergy, and Critical Care in the FDA's Center for Drug Evaluation and Research. "This is a major step forward for patients with obstructive sleep apnea." 1.
Although obstructive sleep apnea (OSA) can affect anyone, it is more common in overweight adults.
OSA leads to pauses (or obstructions) in breathing while a person is sleeping, causing temporary airway collapse. Adults suffering from OSA might find themselves being suddenly jerked out of sleep when their brain says, Hey, I'm not getting enough air.
Obstructive sleep apnea (OSA) is often marked by loud, disruptive snoring which leads to interrupted and non-restorative sleep. At times, for more than one person.
People who live with OSA can struggle with maintaining their overall quality of life.
They wake up frustratingly exhausted and feel sluggish throughout the day. They're often at greater risk for heart complications, and poor mental health. Poor sleep from OSA can also lead to driving safety concerns. 2
Zepbound may offer relief.
Zepbound, in combination with a reduced diet and exercise, can treat individuals with obstructive sleep apnea, significantly improving their quality of life. 1
Eli Lilly and Company is the medical organization behind this discovery. They aim to use groundbreaking discoveries to improve global health.
They use biotechnology, chemistry, and genetic medicine to tackle diabetes, obesity, Alzheimer's, immune disorders, and cancers. 3
How Zepbound Works to Treat Sleep Apnea
Zepbound works by telling hormone receptors in your stomach called glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) to decrease appetite. As a result, you to eat less and lose weight.
Studies show that by decreasing weight, Zepbound also improves obstructive sleep apnea.
Zepbound (10 mg or 15 mg) was approved based on the SURMOUNT-OSA phase 3 trials. This trial measured how well Zepbound worked over a year to treat moderate-to-severe OSA in overweight adults.
The trial was made up of people who used positive airway pressure (PAP) therapy and those who did not.
Positive airway pressure therapy (PAP) uses a machine to blow controlled gusts of air into the mouth (or nose) and through the lungs. This controlled gust of air (or pressure) helps to keep the airways open, allowing you to breathe normally. 4.
Results of Individuals on Positive Airway Pressure (PAP) Therapy
In adults using positive airway pressure (PAP) therapy, Zepbound led to twenty-nine fewer breathing pauses per hour. The placebo (a treatment that looks like the original but doesn't have any medication) led to six.
After one year, 50% of adults on Zepbound with positive airway (PAP) therapy started having recovery or mild, non-bothersome OSA, compared to 14% on the placebo. 3
The adults on Zepbound and positive airway (PAP) therapy lost an average of 50 pounds (20%) of their body weight compared to (2%) on placebo.
Results of Individuals Not on Positive Airway Pressure (PAP) Therapy
In adults who were not using positive airway pressure (PAP) therapy, Zepbound was found to work five times better than the placebo, leading to twenty-five less breathing pauses per hour. The placebo led to five.
Similarly, 42% of adults on Zepbound started recovering, or only having mild, non-bothersome obstructive sleep apnea (OSA), compared to 16% on the placebo.
Not only did OSA symptoms improve, but adults on Zepound lost an average of 45 pounds (18%) of body weight compared to 4 pounds (2%) with those on the placebo.
Side Effects of Zepbound For Obstructive Sleep Apnea Treatment
Zepbound may cause serious side effects, including,
severe stomach problems
kidney problems
gallbladder problems
Swelling or irritation of the pancreas
serious allergic reactions
low blood sugar
changes in vision in type 2 diabetes patients
depression
deep sedation during surgery or procedures.
Other side effects include,
nausea
Liquid stools
vomiting
constipation
stomach pain
indigestion
injection site reactions
feeling tired
belching
hair loss
heartburn
Zepbound may also cause tumors in the thyroid, including thyroid cancer. Individuals are advised to look out for possible symptoms, such as a lump or swelling in the neck, a raspy voice, trouble swallowing, or difficulty breathing.
Future Implications of Obstructive Sleep Apnea Treatment
Along with an improvement in sleep apnea and weight loss, here are the future implications for Zepbound,
Reduced Dependence on Positive Airway Pressure (PAP) Therapy
Although PAP machines are portable, it's still annoying for people to bring them everywhere they go. It can also limit freedom of movement during sleep and negatively impact intimacy.
If Zepound is found effective, some people may be able to reduce their pressure setting or stop positive airway therapy altogether.
Heart and Metabolic (How The Body Turns Food Into Energy) Benefits
OSA is linked with other health conditions like high blood pressure, heart disease, and insulin resistance ( when the body does not respond to the hormone insulin like it should, making it hard for glucose, which give you energy, to get into your cells.)
Zepbound may help individuals not only relieve obstructive sleep apnea but also reduce the associated risk factors.
If people can get a head start on their health and have a sense of hope, it can help them develop a better quality of life.
Decreased Surgical Risk and Quicker Recovery Time
Patients with severe OSA who are overweight can face greater medical risk and longer postoperative recovery time. This is due to their already limited breathing when sleeping.
These patients need to be carefully monitored while in hospital. 5. Zepound may help people reduce their hospital stay and get home quicker.
Bottom Line
Zepbound can change the way OSA is treated, especially for overweight people who have trouble sticking to their CPAP schedule. If further research shows that it works, it could be used as an added treatment or even an alternative for some patients.
The long-term effects need to be further researched. There also needs to be consideration on whether or not the benefits outweigh the risks for certain populations.
References
FDA. (n.d.). FDA approves first medication for obstructive sleep apnea. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-obstructive-sleep-apnea (1)
Lilly. (2023, November 8). FDA approves Zepbound® (tirzepatide) – The first and only prescription treatment for chronic weight management that activates both GIP and GLP-1 pathways. Eli Lilly and Company. https://investor.lilly.com/news-releases/news-release-details/fda-approves-zepboundr-tirzepatide-first-and-only-prescription (3)
National Center for Biotechnology Information. (n.d.). Obstructive sleep apnea. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK459252/ (2)
Stanford Health Care. (n.d.). Positive airway pressure (PAP) therapies. https://stanfordhealthcare.org/medical-treatments/p/positive-airway-pressure-therapies.html (4)
Yildiz, M., Ofluoglu, C., Kuyrukluyildiz, U., & Tosun, E. (2012). Postoperative management of obstructive sleep apnea patients. Anesthesia, Essays and Researches, 6(1), 152–157. https://pmc.ncbi.nlm.nih.gov/articles/PMC3311420 (5)
Assessed and Endorsed by the MedReport Medical Review Board