From the Guidelines
No, Zepbound and Mounjaro (tirzepatide) are not currently FDA-approved for the treatment of sleep apnea. These medications are approved for different indications: Mounjaro is approved for type 2 diabetes management, while Zepbound is approved for chronic weight management in adults with obesity or overweight with at least one weight-related condition. Although recent research suggests tirzepatide may improve obstructive sleep apnea symptoms in some patients with obesity, this is considered an off-label use. The improvement in sleep apnea symptoms is likely related to the significant weight loss these medications can produce, as excess weight is a major risk factor for sleep apnea, as noted in the American College of Physicians guideline 1. The standard treatments for sleep apnea remain CPAP (continuous positive airway pressure) therapy, oral appliances, positional therapy, and in some cases, surgical interventions. Patients with sleep apnea should work with their healthcare providers to determine the most appropriate treatment approach based on the severity of their condition and individual health factors. Key considerations include the patient's preferences, potential for adherence to therapy, and specific reasons for nonadherence, as well as costs, as highlighted in the guideline recommendations 1. However, the most recent and highest quality study should be prioritized, but in this case, all studies are from the same year and journal, so the first study is chosen 1. Some key points to consider in the treatment of sleep apnea include:
- The importance of weight loss in obese patients, as recommended by the American College of Physicians guideline 1
- The use of CPAP therapy as the standard first-line treatment for sleep apnea, as noted in the guideline 1
- The potential for alternative therapies, such as mandibular advancement devices, in patients who do not tolerate or adhere to CPAP, as suggested in the guideline 1
From the Research
Zepbound and Mounjaro Approval for Sleep Apnea
- Zepbound and Mounjaro (tirzepatide) are being studied for their potential in treating sleep apnea, particularly in patients with obesity.
- According to the SURMOUNT-OSA study 2, tirzepatide has been shown to reduce the frequency and severity of sleep apnea episodes, improve sleep quality, and lower arterial blood pressure in patients with obesity and obstructive sleep apnea (OSA).
- The study found that tirzepatide is indicated in the management of people with obesity or overweight who present at least one weight-related comorbidity factor, including OSA 2.
- Another study 3 is currently evaluating the efficacy and safety of tirzepatide for the treatment of moderate to severe OSA in people with obesity, with results expected to provide further insight into its potential as a treatment option.
Current Treatment Options for Sleep Apnea
- Currently, there are no widely effective pharmacotherapies for individuals with sleep apnea, except for those with underlying medical conditions such as hypothyroidism or acromegaly 4.
- Weight loss is a standard recommendation for OSA treatment in people with obesity or overweight, but it can be challenging to achieve and maintain without bariatric surgery 4, 3.
- Other treatment options, such as continuous positive airway pressure (CPAP) therapy, oral appliances, and surgical modifications of the airway, are considered part of the routine management of patients with OSA 4, 5.
Ongoing Research and Future Directions
- The SURMOUNT-OSA phase 3 trial 3 is investigating the efficacy and safety of tirzepatide for the treatment of moderate to severe OSA in people with obesity, with results expected to provide further insight into its potential as a treatment option.
- Further research is needed to explore new therapeutic treatment options for OSA, including the development of universally effective pharmacotherapies 4, 5.