Key Takeaways
- Two studies found that Zepbound, an anti-obesity medication, may effectively treat obstructive sleep apnea.
- Drug manufacturer Eli Lilly has applied to the FDA to market Zepbound for obstructive sleep apnea, with a decision expected by the end of the year.
- If approved, Zepbound would be the first drug for obstructive sleep apnea, offering an alternative to devices like CPAP machines.
Two new studies published in the New England Journal of Medicine suggest that Zepbound, the latest and most potent injectable anti-obesity medication approved by the FDA, may be an effective treatment for certain types of sleep apnea.
The results have prompted drug manufacturer Eli Lilly, who funded the studies, to apply to the FDA for permission to market the Zepbound for obstructive sleep apnea, according to a company spokesperson. The FDA could decide by the end of the year.
“A medication would be an important tool for some patients with sleep apnea, but likely best in combination therapy,” Karin Johnson, MD, medical director of the Baystate Health Regional Sleep Program in Springfield, Massachusetts, told Verywell.
If the FDA does give the nod to Zepbound for the treatment of obstructive sleep apnea, it will be the first drug to be approved for the condition. The use of a continuous positive airway pressure (CPAP) device is the most common and usually the most effective treatment. It relies on a mask that a patient wears over their nose and/or mouth during sleep to keep airways open.
“While there have been substantial improvements in devices to treat obstructive sleep apnea that offer more comfort and tolerance, there are patients that would prefer another option,” Johnson said.
What Is Sleep Apnea?
Sleep apnea is a potentially serious disorder during which breathing is disrupted during sleep. There are two main types of sleep apnea. The most common, called obstructive sleep apnea, occurs when the upper airway becomes fully or partly blocked during sleep, which can lead to drops in oxygen levels. Central sleep apnea, on the other hand, occurs when the control of breathing is altered during sleep, causing pauses in airflow. Common causes include heart failure and narcotic pain medications.
About 39 million Americans have sleep apnea, but only about 6 million have been diagnosed with the condition.
Sleep apnea can result in problems functioning properly during the day or sleeping well at night. If left untreated, it can lead to cardiovascular issues, diabetes, stroke, and dementia.
Why Zepbound Might Treat Apnea
Obesity can be a risk factor for obstructive sleep apnea because fat deposits in the upper respiratory tract can narrow the airway. Johnson said some patients who have had bariatric surgery or lost weight through diet and exercise have seen their sleep apnea resolve, so it makes sense that a weight loss medication might help, too.
“Obstructive sleep apnea is in part a weight-associated health problem,” David Kuhlmann, MD, a spokesperson for the American Academy of Sleep Medicine, told Verywell. “Excess weight can lead to increased collapsibility of the upper airway as well as reduced ventilatory capacity of the lungs. Weight loss is an essential part of the management of obstructive sleep apnea.”All of the participants in the two Eli Lilly studies had obesity. The first study compared weekly injections of Zepbound to a placebo in adults with moderate-to-severe obstructive sleep apnea and obesity who were not on CPAP. The second trial tested Zepbound in adults with the same conditions, but those patients were on CPAP therapy.
The study found that 43% of people in the first study and 51.5% of patients in the second who took the highest dose of Zepbound (15 milligrams) achieved “disease resolution,” meaning no or fewer sleep apnea episodes per hour and a resolution of their symptoms. That compares with 14.9% and 13.6% of patients who took a placebo in the two trials, respectively.
Some patients also had improved cardiovascular health based on blood pressure readings and reduced inflammation, measured by a blood test. Johnson said that while other anti-obesity drugs might be as effective for treating obstructive sleep apnea, the fact that other conditions improved even without the use of a CPAP device may have to do with the specific drug, not just the effects of weight loss, “and that will need to be studied.”
A Sleep Apnea Drug Will Take Time to Work—If It Works at All
Kuhlmann points out that weight loss medications “will only help the subset of patients where obstructive sleep apnea is predominantly caused by excess weight.” Other non-weight associated risk factors for obstructive sleep apnea include anatomic issues of the upper airway, problems with nasal breathing, and increased age.
“Treatment for obstructive sleep apnea will continue to be needed in these patients. Even in patients who do benefit from GLP-1s, they may continue to need [other treatment] depending on the severity of sleep-disordered breathing as well as their own preference,” Kuhlmann said.
Nathaniel Yuan, DO, a sleep specialist at UCLA Health, advises people being treated for sleep apnea against stopping their current treatment even if they take Zepbound or another GLP-1 medication for obesity or diabetes.
“Those who are on a CPAP for sleep apnea should continue the therapy. Reassessing the severity after significant weight change may help guide clinical decisions of possibly switching therapies for that individual,” he told Verywell.
It’s important to note that experiencing sleep apnea benefits from Zepbound will take time because weight loss takes time, Johnson said. CPAP devices, on the other hand, provide relief immediately.
A sleep apnea medication may also be a lifelong treatment.
“Just like patients who take injectable drugs for weight loss, patients taking the Zepbound for obstructive sleep apnea may have to take the drugs for life given the risk for rebound weight gain and worsening of sleep apnea after stopping.”
What This Means For You
The research is very early on whether Zepbound is effective for treating sleep apnea and the drug has not yet been approved for that use by the FDA. If you are using a device such as a CPAP machine to treat sleep apnea, don’t stop using it, even if you are taking an injectable anti-obesity medication like Zepbound.
