Brian Weeks, MD, is an ENT-Otolaryngologist is at Senta Clinic.

Brian Weeks, MD

affects an estimated 30 million adults in the US, yet up to 80% of cases remain undiagnosed.

 To better understand how GLP-1 agonists are shaping OSA care, 

spoke with Brian Weeks, MD, an ENT-otolaryngologist at Senta Clinic

. In this Q&A, Dr. Weeks discussed the impact of pharmacologic options like tirzepatide on patient care and how they may fit alongside traditional OSA treatments.

The phase 3 SURMOUNT-OSA trial showed that tirzepatide reduced the apnea-hypopnea index (AHI) by up to 63%, highlighting its potential to meaningfully improve OSA severity in patients with obesity.

 Unlike CPAP therapy or surgery, tirzepatide addresses underlying metabolic drivers, offering a new pathway for patients who have struggled with conventional options. These findings signal a shift in how clinicians think about individualized care in OSA.

Weeks explored the promise and limitations of tirzepatide, the importance of patient selection, and the growing need for collaboration among sleep specialists, pulmonologists, and surgeons. As pharmacologic therapies gain traction, they may not replace existing interventions but expand the treatment toolkit.

: From a pharmacological standpoint, how do you see individualized treatment strategies evolving for patients with sleep apnea?

 There's been a lot of new changes in the way that [OSA] therapies are advertised and messaged to patients and delivered. One of those is certainly seeing the advent of pharmacological therapies, particularly GLP-1 receptor agonists. Most physicians now consider that as a very good option for some patients in the treatment armamentarium, but I think it's one of many ways that we are approaching the problem now.

: What impact has the growing use of GLP-1 receptor agonists, such as tirzepatide, had on the way clinicians think about managing sleep apnea?

 Tirzepatide was the one that was focused on with a sleep study or sleep trial, but the class of medications in particular has been impactful on obstructive sleep apnea for a variety of reasons. First and foremost, in most medical evidence that's been published, patients with obstructive sleep apnea and elevated BMI have a direct correlation.

The study that you're referring to is called the Surmount trial, and it was a study that looked at tirzepatide and its direct effect on obstructive sleep apnea. I think it's important to think about it in two different ways. Firstly…many people [who] are normal weight have obstructive sleep apnea. And secondly, just because you're overweight and you lose weight doesn't mean your sleep apnea is going to go away.

: What patient profiles or pharmacological considerations help you determine which GLP-1 therapy may be an appropriate path for sleep apnea care?

 When we think about sleep apnea and treatment with these types of medications…the medical evidence is probably the most powerful thing. [Tirzepatide is] probably the first medication that pops to a lot of people's minds because of its correlation with the study.

General considerations when using these types of medications include the following. First and foremost, there are different doses. There are different dosing strategies. Some medications are delivered via an injection once a week… [or] taken orally daily. It's really an individual consideration with the patient and the physician, but probably because of the study, tirzepatide is the most popular one that comes to mind with a lot of the patients that I deal with obstructive sleep apnea.

There are a number of other drugs that are being studied. Some of those medications are long-standing anti-anxiety medications. We have low-dose [depression] medications…There are a couple of other studies being done right now with new medications that have not published clinical data, but there are certainly other directions that are being taken for pharmacological treatment of sleep apnea, and I think there's excitement, but we also are cautiously awaiting the results of many of these studies.

: With tirzepatide showing strong results in OSA, how do you see pharmacologic therapies influencing the role of surgical approaches in sleep apnea management?

 It's another tool in the tool belt of the physician who's treating sleep apnea patients. A lot of the patients that do suffer from obstructive sleep apnea are overweight, and so their body mass index is an important component that's contributing to their disease. But there's a lot of patients that come into our practices that don't have weight issues, or that have weight issues and have additional structural issues, so I think it really just has to be thought of as a tool. Now, obviously, for overweight patients, it's a ray of hope for them.

I always consider non-surgical therapies for my patients [who] have obstructive sleep apnea. Traditional therapies like CPAP therapy and devices that we wear in our mouths are front and center. Those things have always been there. Pharmacological therapy is obviously an additional tool.

We're also seeing a tremendously new kind of avenue of treatment that involves the upper airway muscle, and strengthening the muscle tone in the upper airway is now becoming something that I think a lot of people are excited about. We've also heard about stimulators that move nerves and open up [the] airway. So, there's an array of treatments.

: Do you anticipate that fewer patients will need invasive interventions, or might these medications expand the pool of patients who are candidates for surgery by improving overall cardiometabolic health before procedures?

 It’s likely to be both. I think it will make some people improve their sleep and their sleep apnea so much that they don't need additional therapies. There will be other people [who] reduce the severity of their apnea, maybe from a very severe level to a mild or moderate level. While those people are certainly improved from a health perspective, they're still going to require additional treatment.

: Have you observed an increase in referrals or diagnostic testing for OSA in your practice?

 Most definitely. It's front of mind for most primary physicians. Now, obstructive sleep apnea is a very, very serious health problem. It's not something that can be ignored. And when we look at the cumulative numbers of sleep apnea, there's probably more than 30 million people in the United States alone that suffer from this condition, and probably 80% of those patients, statistically, have not been diagnosed.

What that means is, there's a lot of people walking around in the world [who] really are not getting rest, and they're suffering the health consequences of sleep apnea. I can't tell you how many people come into my office, and the only thing they tell me is, ‘I don't want to wear that mask…I can't imagine my wife wanting to sleep next to me with me wearing a mask on my face.’ And I do understand that. I mean, you have to change your lifestyle. And so again, thinking about progressive treatments and pharmacological treatments fall into that. So the referrals are increasing because people are aware, and I think the treatments will increase as people are more aware of these non-lifestyle, noninvasive treatments.

: Do you think that this increase in referrals is potentially linked to the patient demand for GLP-1 therapies?

 Listen, I think a lot of people in the world would like to lose weight. We know that obesity is a huge problem [in the US]. When a medication can help you [lose weight], a lot of people are excited about that.

: How should a surgeon, sleep specialist, and pulmonologist collaborate in this new era where both structural and metabolic treatments are viable pathways for OSA?

 Collaboration is really important… I work extremely closely with my pulmonary colleagues. As a surgeon, I think there's some thought about the non-surgeons protecting the patients from the surgeons because surgeons like to do surgery. But I will say, with the advent of all these new therapies, the pharmacological side, the surgical side, with the progressive surgical treatments, and also with the non-surgical treatments…I think that there's a lot more opportunity for collaboration when we have a patient who's morbidly obese or very overweight [to] start that patient on a pharmacological therapy, drop their severity level down a significant amount.

: What do we still need to learn about combining surgical and pharmacologic strategies to optimize long-term OSA outcomes?

 My philosophy has always been that…if you can fix a patient with surgery in a way that they're happy with that doesn't affect their lifestyle and that treats their underlying disease condition, by all means you should do so. Many patients can't tolerate a lot of the non-surgical therapies.

Every patient [who] comes into my practice gets a proper airway evaluation. The…upper airway, the tongue, the throat…need to be directly [examined] to determine what type of treatment will be best for the patient. So, whether it's a CPAP device or a mandibular device, whether it's oral muscular stimulation, whether it's an implant or just some small changes in the airway, all of those things need to be considered.

Learn About Obstructive Sleep Apnea (OSA). American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/sleep-apnea/learn-about-sleep-apnea

Faria A, Allen AH, Fox N, Ayas N, Laher I. The public health burden of obstructive sleep apnea. Sleep Sci. 2021 Jul-Sep;14(3):257-265. doi: 10.5935/1984-0063.20200111. PMID: 35186204; PMCID: PMC8848533.

Tirzepatide reduced sleep apnea severity by up to nearly two-thirds in adults with obstructive sleep apnea (OSA) and obesity | Eli Lilly and Company. Eli Lilly and Company. Published 2022. https://investor.lilly.com/news-releases/news-release-details/tirzepatide-reduced-sleep-apnea-severity-nearly-two-thirds

Articles

Obstructive sleep apnea (OSA) affects millions, with many cases undiagnosed. GLP-1 agonists, particularly tirzepatide, show promise in OSA management by reducing apnea severity, especially in obese patients. Unlike traditional treatments like CPAP or surgery, tirzepatide targets metabolic factors, offering a novel approach. The SURMOUNT-OSA trial demonstrated significant efficacy, prompting a reevaluation of individualized care strategies. Collaboration among specialists is crucial as pharmacologic options expand the treatment landscape. While these therapies may not replace existing interventions, they enhance the toolkit, potentially reducing the need for invasive procedures.

Weeks discusses how tirzepatide is impacting treatment strategies for obstructive sleep apnea and driving collaboration across specialties.

Tirzepatide’s Role in Obstructive Sleep Apnea Care: Q&A With Brian Weeks, MD

Tirzepatide Is A ‘Ray of Hope’ for Patients with OSA: Referral Uptick, Who Benefits 

Ever since the US Food & Drug Administration (FDA) approved tirzepatide (Zepbound) for 

 last December, there has been an increase in OSA referrals.

Tripeptide’s FDA approval, announced by Eli Lilly and Company on December 20, 2024, was based on positive findings from the Phase 3 SURMOUNT-OSA clinical trial.

 The pivotal trial assessed tirzepatide (10 mg or 15 mg), a dual-activating glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 agonist, in 469 adults with OSA and obesity over 52 weeks. Among this patient population, tirzepatide provided significant improvements in the apnea-hypopnea index, oxygenation, patient-reported outcomes, blood pressure, and C-reactive protein levels.

Participants on tirzepatide achieved an average of up to 20% weight loss and experienced ≥ 25 fewer breathing interruptions for each hour slept (

Among patients not on PAP therapy, tirzepatide was approximately 5 times more effective than placebo in reducing breathing disruptions. Tirzepatide led to 25 fewer hourly breathing disruptions, compared with 5 in patients on placebo. For those on PAP therapy, tirzepatide brought 29 fewer hourly breathing disruptions, compared with 6 for placebo.

Tirzepatide continued to demonstrate improvements at 1 year, with approximately 42% of adults treated with tirzepatide and 50% of adults on tirzepatide and PAP therapy experiencing remission or mild, non-symptomatic OSA. Whereas in the placebo arm, 16% and 14% experienced remission or non-symptomatic OSA, respectively.

Tirzepatide is the first and only prescription medicine available for adults with moderate-to-severe OSA and obesity, and since its approval, OSA awareness has risen among patients and healthcare providers. GLP-1s have driven attention to this previously underrecognized and undertreated sleep disorder.

“We're seeing lot of lots and lots of patients who are inquiring about GLP-1s as one of the potential treatment options for obstructive sleep apnea, and we also seeing that it has raised the awareness of sleep disorders, particularly obstructive sleep apnea,” Atul Malhotra, MD, lead investigator of the SURMOUNT-OSA trial and sleep medicine specialist at UC San Diego Health, told 

 spoke with 4 experts regarding GLP-1’s impact on sleep apnea, receiving insight from specialists in sleep medicine, pulmonology, and otolaryngology.

“A lot of the patients that do suffer from obstructive sleep apnea are overweight, and so their body mass index is an important component that's contributing to their disease, but there's a lot of patients that come into our practices that don't have weight issues, or that have weight issues and have additional structural issues, so I think it really just has to be thought of as a tool,” said Brian Weeks, MD, an ENT-Otolaryngologist is at Senta Clinic, during an interview with 

 “Now, obviously, for overweight patients, it's a ray of light, it's a ray of hope for them, but it's one tool in the armamentarium that we have.”

(sleep medicine and pulmonary medicine specialist)

Relevant disclosures: Malhotra (Eli Lilly and Company, LivaNova USA, ZOLL Respicardia, Itamar Medical, Avadel CNS Pharmaceuticals, Axsome Therapeutics, JAZZ Pharmaceuticals), Weeks (Stryker Corporation), Walia (Eli Lilly and Company, Resmed Corp, JAZZ Pharmaceuticals, Boston Scientific Corporation, Itamar Medical, Harmony Biosciences, Lilly USA, Fisher & Paykel Healthcare, Novo Nordisk, Merck Sharp & Dohme), and Kundel (ZOLL Respicardia, Eli Lilly and Company).

Iapoce, C. FDA Approves Tirzepatide for Obstructive Sleep Apnea in Obesity. Hcplive.com. Published December 20, 2024. Accessed September 25, 2025. 

https://www.hcplive.com/view/fda-approves-tirzepatide-for-obstructive-sleep-apnea-in-obesity

Malhotra A, Grunstein RR, Fietze I, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. 

. 2024;391(13):1193-1205. doi:10.1056/NEJMoa2404881

Videos

FDA approval of tirzepatide for OSA sparks a surge in referrals as experts highlight weight loss benefits, symptom relief, and patient selection.

Tirzepatide Is A ‘Ray of Hope’ for Patients with OSA: Referral Uptick, Who Benefits

Real-world evidence shows that GLP-1 therapies impact far more than weight loss alone. For example, patients taking GLP-1s have experienced significant reductions in major adverse cardiovascular events along with improved metabolic outcomes.

While these medications can play a critical role in helping patients live healthier and happier lives, they should not be viewed as a standalone solution for 

The Hidden Risks of Undiagnosed & Untreated Sleep Apnea

I often remind my patients that snoring isn’t just a nuisance—it’s frequently a sign of OSA, which affects > 30 million Americans, though 80% remain undiagnosed. Many GLP-1 patients may still struggle with snoring, fatigue, and morning headaches caused by nighttime airway collapse once they’ve achieved their weight loss goals. Lingering OSA symptoms may also silently undermine the progress these patients have made when it comes to reducing other health concerns and risks.

Even in mild to moderate cases, if left untreated, OSA increases the risk of hypertension, cognitive decline, and type 2 diabetes. Because the condition stems from unique physiologic causes, it requires its own targeted treatment approach—one that addresses airway function directly.

Beyond CPAP: Introducing Neuromuscular Electrical Stimulation (NMES)

Traditional OSA treatments, such as CPAP and oral appliances, are often met with adherence challenges. On the other hand, daytime neuromuscular electrical stimulation (NMES) offers a physiologic solution with improved adherence.

By retraining the tongue and airway muscles to maintain tone during sleep, NMES reduces both snoring and apnea episodes. Outside of treating OSA, NMES has been particularly successful in treating swallowing, voice, and laryngeal disorders. Additionally, NMES has been successfully leveraged in orthopedic and neurologic rehabilitation, as well as pain management.

Unlike pharmacologic treatment or CPAP, neuromuscular stimulation addresses the underlying dysfunction of airway collapse, providing lasting improvements without masks or machines.

As a practicing physician, I always consider my patients’ lifestyles in any prescription and clinical recommendation. Historically, CPAP has been the go-to solution for more severe cases of sleep apnea, and there has been a severe unmet need when it comes to non-invasive sleep therapies for mild to moderate OSA. Various in-market solutions can offer patients clinically tested, FDA-cleared relief while offering convenience and ease of use.

Takeaways for Multispecialty Doctors in the Era of GLP-1s

OSA is a cross-specialty condition, demanding vigilance beyond the ENT office.

 Patients achieving significant weight loss on GLP-1s should be screened for residual snoring, fatigue, or poor sleep quality.

OSA is a contributor to hypertension, arrhythmia, heart-failure risk, as well as a driver of cognitive decline and dementia if left untreated.

CPAP adherence rates hover between 30-60%, especially among patients with milder symptoms, leaving millions without sustainable therapy. With physiologic therapies, physicians can expand their toolkit to improve treatment adherence and their patients’ quality of life.

GLP-1 therapies are transforming weight loss treatment and chronic disease management as we know it, but they cannot replace dedicated treatment for OSA. Snoring and sleep apnea deserve recognition as independent conditions with serious long-term consequences. For multispecialty clinicians, the takeaway is clear: weight loss and OSA therapy can be complementary but are not interchangeable. By screening, referring, and treating OSA directly, clinicians can help patients breathe, sleep, and live better.

Bonavitacola, J. GLP-1 Receptor Agonists Reduce Adverse Cardiovascular Outcomes, Improve Survival. AJMC. August 2, 2025. 

https://www.ajmc.com/view/glp-1-receptor-agonists-reduce-adverse-cardiovascular-outcomes-improve-survival?utm_

Snoring and apnea treatment you can live with — and sleep without. Spring Sleep. 

GLP-1 therapies offer significant benefits beyond weight loss, including reductions in major adverse cardiovascular events and improved metabolic outcomes. However, they should not be seen as a standalone solution for obstructive sleep apnea (OSA), which affects millions and often remains undiagnosed. Traditional OSA treatments like CPAP face adherence challenges, while neuromuscular electrical stimulation (NMES) offers a promising alternative by addressing airway dysfunction. Multispecialty clinicians should recognize OSA as a serious condition with long-term consequences, ensuring comprehensive screening and treatment to complement weight loss therapies.

GLP-1 therapies support weight loss, but OSA requires dedicated airway treatment options such as CPAP or neuromuscular stimulation.