Should You Take a GLP-1 Drug to Treat OSA?

‘I Have OSA — Could I Benefit From Taking a GLP-1?’

While Zepbound has been shown to help people with OSA, this injectable medication specifically works for only a certain group of patients.

May Be a Good Fit For

• Adults who have been clinically diagnosed with moderate to severe OSA who have obesity

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• Adults who have excess weight (overweight) and moderate to severe OSA, depending on the insurance
• Adults with moderate to severe OSA and obesity who have a hard time using the CPAP machine (For example, some people may have trouble falling asleep with a mask, while others might feel claustrophobic wearing the device.)

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• Adults with moderate to severe OSA who have additional diseases or conditions associated with obesity, such as high blood pressure and type 2 diabetes, where a tirzepatide could also provide other benefits

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May Not Be a Good Fit For

• Adults with mild OSA, as it has not been approved for this group

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• Adults who have structural issues that may be causing OSA, such as a small jaw or enlarged tonsils

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• Adults who are taking certain diabetes medications or birth control because the dosage may need to be adjusted while using this type of GLP-1 (Always discuss it with your doctor.)

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Not a Good Fit For

• People under 18 who have OSA, as children are not approved to take Zepbound (the only FDA-approved GLP-1 for OSA)

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• Adults who are pregnant, planning to become pregnant, or breastfeeding, which Zepbound is not approved for

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• Adults who have a history of pancreatitis or a condition that might increase their risk of developing medullary thyroid carcinoma, a very rare thyroid cancer

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• Patients with severe stomach or intestinal problems or active gallbladder disease

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How GLP-1 Drugs Can Help With OSA

“We have known for years that with substantial weight loss following surgical intervention, such as the gastric sleeve or gastric bypass surgery, that patients have improvement and sometimes resolution of their OSA,” Ashraf says. “These medications offer a pathway without surgery to have clinically meaningful reduction in sleep apnea severity, and in some cases, they may resolve the OSA entirely,” Ashraf adds.

Are GLP-1 Drugs a Replacement for Other OSA Treatments?

Despite the clear benefits of Zepbound for OSA, this GLP-1 drug isn’t a replacement for conventional OSA treatment, including the CPAP machine. “I think of these treatments as addressing different aspects of OSA,” says Tu. For example, a CPAP machine can help you have better sleep right away (thanks to helping keep your airways open, which allows you to breathe freely). However, a patient on a tirzepatide may need 6 to 12 months on the medication before doctors see meaningful improvement in OSA severity, says Ashraf.

“Sleepiness symptoms and sleep disruption will improve faster with starting a CPAP than with weight loss, so I usually recommend patients start CPAP first or CPAP with tirzepatide,” says Ashraf. “But if a patient is very hesitant to start CPAP, we can start with focusing on weight reduction first,” says Ashraf. Also, reassessment is key. “After significant weight loss, repeat sleep testing can help determine whether OSA severity or PAP requirements have changed,” says Tu.

“Oftentimes, side effects improve after a couple of weeks, but if they do not, I recommend stopping the medication,” says Ashraf.

Finally, using Zepbound is not a quick fix for OSA. “It is also important to know there is a high likelihood that weight will return if the medication is stopped, even after dietary and lifestyle changes have been implemented,” says Ashraf. “I advise patients that we expect them to be taking this medication or another similar medication possibly for the rest of their life,” Ashraf adds.