What is Zepbound (Zepine, a brand name for the generic medication, likely referring to a medication for Obstructive Sleep Apnea (OSA))?

From the Guidelines

Zepbound (tirzepatide) is not specifically approved for obstructive sleep apnea (OSA), but it may indirectly benefit some patients with OSA who are also overweight or obese. Zepbound is FDA-approved for chronic weight management in adults with obesity or overweight with at least one weight-related condition. Since excess weight is a major risk factor for OSA, the significant weight loss achieved with Zepbound (typically 15-20% of body weight) could potentially improve OSA symptoms in some patients, as supported by the American College of Physicians guideline on management of OSA in adults 1. The medication works by mimicking two hormones (GLP-1 and GIP) that regulate appetite and food intake, leading to reduced calorie consumption and weight loss. However, Zepbound should not replace standard OSA treatments like continuous positive airway pressure (CPAP) therapy, which remains the first-line treatment, as recommended by the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1. Patients with OSA should continue their prescribed OSA treatments while using Zepbound for weight management. Any potential benefits for OSA would be considered an indirect effect rather than a primary indication. Always consult with both a sleep specialist and the prescribing physician to coordinate care if considering Zepbound as part of a comprehensive approach to managing obesity and OSA. Some key considerations for managing OSA include:

• Weight loss for overweight or obese patients, as recommended by the American College of Physicians guideline on management of OSA in adults 1
• CPAP therapy as the first-line treatment for moderate to severe OSA, as recommended by the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1
• Mandibular advancement devices as an alternative therapy for patients who prefer them or have adverse effects associated with CPAP, as recommended by the American College of Physicians guideline on management of OSA in adults 1

From the Research

Definition and Treatment of Obstructive Sleep Apnea (OSA)

• Obstructive Sleep Apnea (OSA) is a sleep disorder characterized by repetitive episodes of partial or complete obstruction of the upper airway during sleep 2.
• The gold standard for the diagnosis of sleep apnea is an overnight polysomnogram, with split-night studies becoming increasingly common for quicker implementation of therapy at a reduced cost 2.

Treatment Options for OSA

• Treatment options for sleep apnea include weight loss, positional therapy, oral devices, continuous positive airway pressure (CPAP), and upper airway surgery 3, 4, 5, 2.
• CPAP is the most efficacious and widely used therapy, but its complications include nasal congestion or dryness, mask discomfort, and claustrophobia 2.
• Oral appliance therapy has emerged as an important alternative to CPAP in treating patients with OSA, with some evidence suggesting that adherence to mandibular advancement devices (MADs) may be superior to that of CPAP 3, 4.
• Upper airway surgical intervention remains a second- or third-line treatment class for moderate to severe OSA, with maxillomandibular advancement (MMA) showing considerable and statistically significant improvements in AHI 3, 5.

Zepbound (Zepine) and OSA

• There is no direct mention of Zepbound (Zepine) in the provided studies, and therefore, there is no research evidence to assist in answering this question regarding Zepbound (Zepine) as a medication for Obstructive Sleep Apnea (OSA).