Antidiabetic Drug Tirzepatide Could Benefit Sleep Apnea Patients

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

The study is published in The New England Journal of Medicine.

Fighting the effects of sleep apnea

OSA affects millions of people globally. It is characterized by repeated episodes of irregular breathing during sleep, caused by complete or partial blockages 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 alleviate OSA.

The disorder can greatly impair the quality of sleep of those affected, causing sleepiness in the daytime. Reduced oxygen levels in the blood caused by OSA can also lead to more serious complications such as high blood pressure and heart disease.

The effects of OSA can be managed using continuous positive airway pressure (CPAP) machines that keep the airway open during sleep – but their effectiveness depends on how consistently they are used.

No drugs are approved for the treatment of OSA. However, glucagon-like peptide-1 (GLP-1) receptor agonists such as tirzepatide – which can lead to significant weight loss for those with obesity – may have the potential to alleviate OSA.

Drug treatment shows promise for reducing breathing interruptions

In the new study, researchers from 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 nearly 500 patients who took part in the study were first split into 2 groups – those who were undergoing CPAP treatment and those who were not. Each group was split into a 1:1 ratio, receiving injections of either 10 or 15 mg of tirzepatide, or a placebo, over 52 weeks.

Tirzepatide treatment significantly decreased the number of breathing interruptions experienced by the participants during sleep – a key measure of OSA severity – compared to placebo. Importantly, some participants in the tirzepatide groups reached a point where CPAP therapy might not be necessary.

The drug treatment also improved other OSA-related aspects like cardiovascular diseases factors and reduced body weight. The most common side effect reported was mild stomach issues.

A “new era” of sleep apnea management

“This new drug treatment offers a more accessible alternative for individuals who cannot tolerate or adhere to existing therapies,” explained senior author Atul Malhotra, a professor of medicine at UCSD School of Medicine and director of sleep medicine at UCSD Health. “We believe that the combination of CPAP therapy with weight loss will be optimal for improving cardiometabolic risk and symptoms.”

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

“It means we can offer an innovative solution, signifying hope and a new standard of care to provide relief to countless individuals and their families who have struggled with the limitations of existing treatments,” said Malhotra. “This breakthrough opens the door to a new era of OSA management for people diagnosed with obesity, potentially transforming how we approach and treat this pervasive condition on a global scale.”

Next steps for the research team will include conducting clinical trials to examine longer term effects of tirzepatide.

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

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