First Drug Treatment for Sleep Apnea Identified in New Study

Researchers at the University of California San Diego School of Medicine conducted an advanced study demonstrating the potential of tirzepatide, known to manage type 2 diabetes, as the first effective drug therapy for obstructive sleep apnea (OSA), a sleep-related disorder characterized by repeated episodes of irregular breathing due to complete or partial blockage of the upper airway.

The results, published in the

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New England Journal of Medicine, highlighted the treatment’s potential to improve the quality of life for millions around the world affected by obstructive sleep apnea.

Obstructive sleep apnea can result in reduced oxygen levels in the blood and can also be associated with an increased risk of cardiovascular complications, such as hypertension and heart disease. Recent studies suggested that the number of OSA patients worldwide is close to 936 million.

Tirzepatide is a novel medication primarily used to manage type 2 diabetes. It is a dual agonist that targets both the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. By activating these receptors, tirzepatide enhances insulin secretion, reduces glucagon levels, and slows gastric emptying, which helps regulate blood sugar levels. Additionally, tirzepatide has shown promising results in promoting weight loss, making it a potentially beneficial treatment for conditions associated with obesity.

In two Phase III, double-blinded, randomized controlled trials, 469 participants with clinical obesity and moderate-to-severe OSA were studied over 52 weeks to evaluate the effects of tirzepatide.

Participants, including some using continuous positive airway pressure (CPAP) therapy, were administered either 10 or 15 mg of tirzepatide by injection or a placebo.

The results demonstrated that tirzepatide significantly reduced the number of breathing interruptions during sleep, a crucial indicator of OSA severity, compared to the placebo group. Remarkably, some participants on tirzepatide reached a level of improvement where CPAP therapy might no longer be needed.

The drug also improved cardiovascular risk factors and body weight, highlighting the advantage of addressing both sleep apnea and obesity simultaneously.

“Historically, treating OSA meant using devices during sleep, like a CPAP machine, to alleviate breathing difficulties and symptoms. However, its effectiveness relies on consistent use. This new drug treatment offers a more accessible alternative for individuals who cannot tolerate or adhere to existing therapies. 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,” said Atul Malhotra who led the study.

Reference: Sanjay R. Patel, Entering a New Era in Sleep-Apnea Treatment, New England Journal of Medicine, 0, 0, (undefined). /doi/full/10.1056/NEJMe2407117