FAQ: Anti-Obesity Medications And Obstructive Sleep Apnea
Answers to questions you may have about anti-obesity or weight loss medications like GLP-1s, including Eli Lilly’s Zepbound® (tirzepatide), and obstructive sleep apnea (OSA).
A closer look at what the latest GLP-1 data could mean for those with OSA
Message from our Medical Doctor
FAQ: Obstructive Sleep Apnea and Obesity
Why is sleep health crucial?
Sleep stands as a fundamental cornerstone of holistic health, alongside physical activity, balanced diet, and emotional wellbeing. When an individual experiences inadequate sleep, it can undermine their ability to maintain overall wellness—affecting immune function, cognitive performance, metabolic balance, and increasing susceptibility to chronic conditions like type 2 diabetes and hypertension. Emerging research highlights sleep’s role in regulating hormonal balance, with improved sleep quality linked to enhanced metabolic efficiency and reduced inflammation.
It is estimated that over 1.2 billion adults worldwide aged 25–74 suffer from obstructive sleep apnea (OSA), with approximately 500 million of them living with moderate-to-severe forms of the condition.
Individuals with moderate-to-severe OSA have been found to face a 2.5-fold higher risk of cardiovascular events over a 10-year period, compared to 1.3-fold and 1.1-fold risks in those with mild OSA or no sleep-disordered breathing.
What is the link between obstructive sleep apnea and obesity?
- Excess body fat, especially around the neck
- Sedentary lifestyle
- Unhealthy dietary habits
- Chronic metabolic disorders
- Family history of sleep-related conditions
- Age-related changes in muscle tone
- Nasal structure abnormalities Obesity is a key risk factor for OSA. A large number of people with OSA have obesity, as excess fat tissue—particularly around the upper airway—can narrow the breathing passage and increase the likelihood of airway collapse during sleep. For many individuals, losing weight may help reduce the occurrence or severity of OSA symptoms.
FAQ: For Healthcare Professionals
Are anti-obesity medications such as GLP-1s approved for use in patients with obstructive sleep apnea?
Currently, only one anti-obesity medication—Zepbound® (tirzepatide)—has received FDA approval for treating moderate-to-severe obstructive sleep apnea in adults with obesity. Positive airway pressure (PAP) therapy, which includes continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) therapies, remains the most widely used, well-understood, and effective treatment for obstructive sleep apnea (OSA).
While anti-obesity medications, including GLP-1s, have proven effective for weight management in some people, there have been no research studies to date comparing the effectiveness of CPAP therapy and anti-obesity medications in treating OSA.
Clinical research shows that for patients with moderate-to-severe obesity-related OSA, combining CPAP therapy with weight loss yields better results than either treatment alone. The SURMOUNT-OSA trials support this approach, demonstrating that the combination of weight loss and CPAP is more beneficial than weight loss alone. In these trials, adults using tirzepatide achieved significant weight loss, and those using tirzepatide alongside PAP therapy saw even greater weight loss compared to the placebo group.
FAQ: For Primary Care Physicians
What dosan increased interest in anti-obesity medications such as GLP-1s mean for me?
Patients who come to you for advice on anti-obesity medications might also be suffering from symptoms like excessive daytime drowsiness, loud snoring, or interruptions in breathing while asleep. Making it a priority to discuss sleep health with every patient can aid in the early detection and treatment of sleep disorders. This is particularly vital for obese patients, as they face a greater likelihood of developing sleep disorders such as obstructive sleep apnea.
Although patients who respond well to anti-obesity medications, including GLP-1 therapies, may experience some alleviation of sleep-related difficulties or symptoms, it is crucial to stay vigilant about potential underlying or ongoing sleep problems. This is especially true once patients stop taking these medications and are faced with the long-term challenge of managing their weight.
When you identify a patient at risk, conducting a sleep screening or referring them to a sleep specialist can bring them closer to a proper diagnosis and treatment, enabling them to take control of their sleep health. Sleep screening tools are readily accessible and can be easily integrated into regular check-ups. Furthermore, your patients can visit our Sleep Assessment page for a free sleep assessment to gain a better understanding of their sleep health. A directory of sleep specialists is also available at https://sleepeducation.org/sleep-center/.
FAQ: For Sleep Specialists
How will recent evidence impact how we treat obstructive sleep apnea?
Patients with obstructive sleep apnea (OSA) may seek your advice on anti-obesity medication options. For patients with moderate-to-severe obesity-related OSA, research shows that combining continuous positive airway pressure (CPAP) therapy with weight loss yields better outcomes than either treatment alone.
Additionally, weight loss might enhance patients’ adherence to OSA treatment: A recent real-world study analysis found that OSA patients prescribed a GLP-1 medication showed significantly higher rates of initiating CPAP therapy and maintained more consistent CPAP supply replenishment over 1 and 2 years compared to those not using such medications.
While patients responding to anti-obesity medications like GLP-1 therapies may experience some improvement in sleep-related symptoms, it’s essential to monitor for potential underlying or recurring sleep issues—particularly after discontinuing these medications, when they face the long-term challenge of sustaining weight management.
How will the rise of anti-obesity medications like GLP-1s impact the number of people being screened or diagnosed with OSA?
Significant OSA affects over 30% of individuals with obesity, according to clinical observations. Experts anticipate that the growing use of these medications will increase patient engagement with healthcare providers, creating more opportunities to screen for sleep disorders and refer individuals for diagnostic sleep tests.
While weight loss may alleviate OSA severity in some cases, patients who do not achieve full remission or have persistent symptoms still require formal evaluation. Encouraging patients to undergo repeat sleep testing to reassess their condition will be a key part of OSA management. It remains crucial to educate patients that obesity is one of several risk factors for OSA, and that proper screening is essential to avoid misdiagnosis—especially since OSA often goes unrecognized.
FAQ: For HMEs
What will be the impact of anti-obesity medications on patients seeking CPAP therapy?
It’s estimated that up to 80% of patients with obstructive sleep apnea (OSA) remain undiagnosed. Experts believe that new anti-obesity medications will boost patient engagement with the healthcare system, creating more chances for patients to be screened for sleep disorders and start treatment when necessary.
Moreover, weight loss may enhance patients’ willingness to stick to OSA therapy. A recent analysis of real-world data showed that OSA patients who were prescribed GLP-1 medications were 10.8 percentage points more likely to start continuous positive airway pressure (CPAP) therapy than those without such prescriptions.
For patients with comorbid obesity, CPAP therapy—whether used alone or in combination with anti-obesity medications like GLP-1s for weight loss—can be more effective if they achieve healthy, sustainable weight loss.
Will anti-obesity medications such as GLP-1s and Eli Lilly’s Zepbound® (tirzepatide) impact existing CPAP therapy patients and resupply rates?
FAQ: For People Who May Be at Risk of Sleep Apnea
What should I do if I think I might have obstructive sleep apnea?
If you have concerns about your sleep patterns or often feel overly exhausted during the day, it’s advisable to discuss your symptoms with your doctor. Your doctor can help figure out if a sleep disorder like obstructive sleep apnea (OSA) could be stopping you from getting the quality sleep you require. If needed, your doctor might refer you to a sleep specialist, who can evaluate your nighttime sleep habits and symptoms such as snoring, sudden gasps for air while sleeping, and/or extreme daytime sleepiness.
How is obstructive sleep apnea treated?
Positive airway pressure (PAP) therapy—which includes continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) therapies—delivers a gentle flow of air into the lungs during sleep. It helps improve breathing patterns, reduce nighttime disruptions, and is widely recognized as the most commonly used, well-understood, and effective treatment for obstructive sleep apnea.
The term “apnea” refers to pauses in breathing lasting at least 10 seconds, while “hypopnea” describes partial airway blockages that cause shallower breathing than normal. A sleep test (conducted at home or in a lab) measures the apnea-hypopnea index (AHI), which tracks the average number of apnea and hypopnea events per hour. This index indicates the severity of sleep apnea, and a key goal of CPAP therapy is typically to lower AHI to a healthy range. Clinical data shows CPAP therapy effectively reduces AHI levels.
When used as prescribed, CPAP therapy may lead to improvements in mood, concentration, memory, daily productivity, and energy levels. Untreated obstructive sleep apnea is associated with increased risks of type 2 diabetes, cardiovascular issues, and depression.
For individuals with obesity, CPAP therapy may be more effective when combined with healthy, sustainable weight loss. In some cases, combining weight loss medications (such as GLP-1s) with CPAP therapy can enhance benefits. Research suggests that combining weight management strategies with CPAP therapy yields greater health improvements than either approach alone.
If you’re concerned about sleep quality or experience persistent daytime fatigue, consulting a doctor is advisable. They can help determine if a sleep disorder like OSA is affecting your ability to get quality sleep.
I heard there’s a new medication for obstructive sleep apnea. What is it?
On December 20, 2024, the U.S. Food and Drug Administration (FDA) approved Eli Lilly and Company’s Zepbound® (tirzepatide), a medication initially used for obesity treatment, for addressing moderate-to-severe obstructive sleep apnea in adults with obesity. (https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-obstructive-sleep-apnea)
If weight loss medications like GLP-1s help me lose weight, won’t that fix my sleep apnea problems and symptoms?
For some individuals, losing weight through medications like GLP-1s can reduce the risk or ease the severity of obstructive sleep apnea (OSA). However, while weight loss can play a role in managing OSA, CPAP therapy remains the most widely used, well-understood, and effective treatment for the condition. It is also the recommended first-line therapy for OSA according to guidelines established by sleep experts.
In many instances, combining weight loss medications (including GLP-1s) with CPAP therapy may yield the best results. Your doctor is best positioned to determine the optimal treatment plan for you, so it’s important to discuss any sleep-related concerns during conversations about weight management.
FAQ: For People Diagnosed With Obstructive Sleep Apnea
Can weight loss improve obstructive sleep apnea?
Obesity is a major risk factor for obstructive sleep apnea (OSA), with many people with OSA having obesity. OSA is also more common in older adults, men, and those with a higher body mass index (BMI).
For some people, losing weight can lower the risk of developing OSA or reduce its severity. Weight management is always recommended as a complementary treatment for obesity-related OSA. But obesity is not the only risk factor—OSA can affect people with a healthy weight too, and it’s linked to other health conditions like high blood pressure and heart disease.
For individuals with obesity, combining healthy, sustainable weight loss with CPAP therapy may make the treatment more effective. In some cases, using weight loss medications (such as GLP-1s) along with CPAP therapy can bring greater benefits. Studies have shown that combining weight loss efforts with CPAP therapy often leads to better health improvements than using either approach alone.
Zepbound® (tirzepatide) and its delivery device base are trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.