From the Guidelines
Mounjaro (tirzepatide) is not a primary treatment for Obstructive Sleep Apnea (OSA), and CPAP therapy remains the first-line treatment for OSA, as recommended by the American College of Physicians 1. For patients with OSA who also have type 2 diabetes or obesity, Mounjaro can be prescribed at an initial dose of 2.5mg weekly by subcutaneous injection, gradually increasing to a maintenance dose of 5-15mg weekly as tolerated. Weight loss of 15-20% of body weight, which many patients achieve on Mounjaro, can significantly improve OSA severity by reducing fat deposits around the upper airway that contribute to obstruction during sleep. This improvement occurs because excess tissue in the neck and throat area can collapse during sleep, blocking airflow; weight loss reduces this tissue and improves airway patency. However, Mounjaro should not replace standard OSA treatments like CPAP therapy, and patients should continue using their prescribed OSA treatments while taking Mounjaro and have their OSA reassessed after significant weight loss to determine if treatment adjustments are needed, as suggested by studies on non-CPAP therapies in obstructive sleep apnea 1. Key points to consider when treating OSA include:
- CPAP therapy as the first-line treatment
- Mandibular advancement devices as an alternative therapy for patients who prefer them or have adverse effects from CPAP
- Weight loss as a beneficial factor in improving OSA severity
- The importance of continuing standard OSA treatments while using Mounjaro and reassessing OSA after significant weight loss. It is essential to prioritize CPAP therapy and other established treatments for OSA, while considering the potential benefits of weight loss with Mounjaro for patients with comorbidities like type 2 diabetes or obesity, as supported by the clinical practice guidelines from the American College of Physicians 1.
From the Research
Efficacy of Mounjaro (Tirzepatide) for Obstructive Sleep Apnea (OSA)
- There is evidence to suggest that Mounjaro (tirzepatide) may be effective in treating Obstructive Sleep Apnea (OSA) 2.
- A meta-analysis found that glucagon-like peptide 1 receptor agonists (GLP-1RA), including tirzepatide, significantly decreased the apnea-hypopnea index (AHI) in OSA individuals 2.
- Tirzepatide was found to reduce AHI more than liraglutide, another GLP-1RA, with an estimated treatment difference of -21.86 events per hour 2.
- The use of GLP-1RA, including tirzepatide, was also associated with weight loss and lower blood pressure 2.
Mechanism of Action
- Tirzepatide is a dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors 3.
- The native GIP and GLP-1 hormones stimulate insulin secretion and decrease glucagon secretion, and GLP-1 also delays gastric emptying, suppresses appetite, and improves satiety 3.
Studies on OSA and Related Conditions
- While there are studies on the treatment of OSA with continuous positive airway pressure (CPAP) 4, 5, 6, there is limited direct evidence on the use of Mounjaro (tirzepatide) for OSA.
- However, the available evidence suggests that GLP-1RA, including tirzepatide, may have a therapeutic effect on OSA 2.