Diabetes Drug Identified as First Effective Medication for Sleep Apnea

Tirzepatide, a type 2 diabetes and weight loss medication, may be the first effective drug therapy for obstructive sleep apnea (OSA), a new study has found.

Obstructive sleep apnea (OSA) is a sleep-related disorder that affects nearly 936 million people worldwide. The only treatments currently available for the condition are devices like CPAP machines, which aid breathing during sleep. But that may soon change.

A new study, published in the New England Journal of Medicine, suggests that tirzepatide — which sells under the brand name Mounjaro and is currently approved for weight management in those with type 2 diabetes — may be an effective therapy for OSA.

OSA occurs when an individual suffers from a partial or complete upper airway blockage, resulting in irregular breathing during sleep. This causes a person to wake up during the night and disrupts sleep. OSA has been shown to reduce oxygen levels in the blood and has been associated with an increased risk of cardiovascular complications, including hypertension and heart disease. It is more common in individuals with obesity.

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As a result of the prevalence of OSA and its potential cardiovascular impacts — as well as the fact that many are reluctant to use CPAP machines while they sleep — scientists have been looking for alternatives.

This research was conducted using two Phase III, double-blinded, randomized, controlled trials involving 469 participants from nine different countries who had been diagnosed with clinical obesity and moderate-to-severe OSA. Some patients used CPAP machines, which help to maintain an open airway while an individual sleeps, and some didn’t.

Over a period of 52 weeks, participants were either given injections of 10 or 15 mg of tirzepatide, or a placebo.

At the end of the study period, researchers found that the drug significantly decreased the number of breathing interruptions participants experienced — a much greater reduction than in those who took the placebo. Some participants even improved to the point of not necessarily needing a CPAP machine.

Tirzepatide was also found to help other health issues associated with OSA, including improved body weight and reduced risk factors for cardiovascular diseases.

The authors say this new therapy option is needed because CPAP is currently the only option for patients with OSA and obesity — and it relies on consistency to be effective. However, not all individuals are willing to sleep with a mask on their faces.

“This new drug treatment offers a more accessible alternative for individuals who cannot tolerate or adhere to existing therapies,” said lead study author Atul Malhotra, M.D., a professor of medicine at the University of California San Diego School of Medicine and director of sleep medicine at UC San Diego Health, in a statement. “We believe that the combination of CPAP therapy with weight loss will be optimal for improving cardiometabolic risk and symptoms.”

The researchers say the drug can also target specific underlying mechanisms of OSA, which could potentially result in a more individualized and effective treatment.

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During the trials, the most common side effects participants experienced were mild stomach issues. Next, the researchers plan to analyze the long-term effects of tirzepatide.

Tirzepatide is also the active ingredient in Zepbound, a drug that was approved by the U.S. Food and Drug Administration (FDA) in 2023 for weight management in adults with a high body mass index (BMI) or obesity who also have one or more weight-related health conditions.

Both Zepbound and Mounjaro have seen major shortages recently as demand for these weight-loss medications has surged in recent months.

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