From the Guidelines
Zepbound (tirzepatide) is not specifically approved to treat obstructive sleep apnea (OSA), but it may help improve OSA symptoms indirectly through weight loss. As a GLP-1/GIP receptor agonist, Zepbound is FDA-approved for chronic weight management in adults with obesity or overweight with weight-related conditions. The medication is administered as a once-weekly subcutaneous injection, starting at 2.5 mg for the first 4 weeks, then gradually increasing to a target dose of 5 mg, 10 mg, or 15 mg based on response and tolerability. Since excess weight is a major risk factor for OSA, the significant weight loss achieved with Zepbound (typically 15-20% of body weight over time) can reduce fat deposits around the upper airway, decrease airway collapsibility, and improve breathing during sleep. However, patients with OSA should continue using their primary OSA treatments like CPAP therapy while taking Zepbound, as weight loss is a complementary approach rather than a replacement for standard OSA management, as recommended by the American College of Physicians 1.
Some key points to consider:
- The American College of Physicians recommends continuous positive airway pressure (CPAP) treatment as initial therapy for patients diagnosed with OSA 1.
- Mandibular advancement devices (MADs) can be considered as an alternative therapy to CPAP for patients with OSA who prefer MADs or have adverse effects associated with CPAP 1.
- Weight loss is an important aspect of OSA management, and Zepbound can help achieve significant weight loss, which can improve OSA symptoms 1.
- Common side effects of Zepbound include nausea, diarrhea, vomiting, and constipation, which typically improve over time.
It is essential to note that while Zepbound may help improve OSA symptoms indirectly through weight loss, it is not a replacement for standard OSA management, and patients should continue using their primary OSA treatments like CPAP therapy while taking Zepbound.
From the Research
Treatment of OSA
- Zepbound is not explicitly mentioned in the provided studies as a treatment for Obstructive Sleep Apnea (OSA).
- However, the studies discuss various treatments for OSA, including oral appliance therapy and continuous positive airway pressure (CPAP) therapy.
Oral Appliance Therapy
- Oral appliance therapy is a non-invasive treatment option for patients diagnosed with OSA 2.
- Mandibular advancement devices (MAD) are the recommended type of oral appliances, which are efficacious in reducing the severity of OSA, although to a lesser extent than standard CPAP therapy 2.
- Oral appliance therapy can be considered as a viable treatment alternative to CPAP in patients with mild to moderate OSA 3.
CPAP Therapy
- CPAP is considered the gold standard therapy for OSA, delivering pressurized air into the upper airway to relieve obstruction during sleep 4.
- However, adherence to CPAP therapy can be highly variable, and alternative treatment options are available for those who are unable to adhere to CPAP or choose an alternative treatment modality 4.
Combination Therapy
- Combination therapy with CPAP and oral appliance (CPAP + OA) can reduce therapeutic CPAP requirements and minimize epiglottic pressure swings in patients with incomplete responses to OA therapy alone 5.
- This combination may be a beneficial alternative for patients with incomplete responses to oral appliance therapy and those who cannot tolerate high CPAP levels 5.