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 obstructive sleep apnea (OSA) last December, there has been an increase in OSA referrals.1

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.1 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 (P < .001).2 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 HCPLive.

HCPLive 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 HCPLive. “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.”

Expert perspectives:

Atul Malhotra, MD: University of California, San Diego (sleep medicine specialist)

Brian Weeks, MD: Senta Clinic (ENT-Otolaryngologist)

Harneet Walia, MD: Baptist Health South Florida (sleep medicine specialist)

Vaishnavi Kundel, MD: Mount Sinai (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).

References

1. 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

2. Malhotra A, Grunstein RR, Fietze I, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med. 2024;391(13):1193-1205. doi:10.1056/NEJMoa2404881