How does Zepbound help treat sleep apnea?

Zepbound (tirzepatide) can treat obstructive sleep apnea (OSA) in patients with obesity by lowering the number of times during sleep that breathing stops (apnea) or becomes significantly reduced (hypopnea). This may help improve symptoms like reduced sleep quality and daytime sleepiness. Patients with OSA also lost an average 45 to 50 pounds during treatment.

In studies, Zepbound was also shown to be effective with or without the use of positive airway pressure (PAP) therapy, compared to placebo, and roughly one-half of study participants no longer had symptoms associated with OSA after one year.

Zepbound, manufactured by Eli Lilly, is a dual glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist. It works by activating hormone receptors to reduce appetite and food intake, leading to weight loss that may improve OSA symptoms.

• Zepbound was approved for OSA in December 2024 and is the first U.S. prescription medicine for adults with moderate-to-severe obstructive sleep apnea (OSA) and obesity.
• It was also previously approved in November 2023 to help reduce excess body weight and maintain long-term weight reduction in adults with obesity, or adults with overweight who also have weight-related medical problems.
• It is not known if Zepbound is safe and effective for use in children.

Tirzepatide, the active ingredient in Zepbound, was first approved under the brand name Mounjaro (also from Eli Lilly) in May 2022 to improve glycemic (blood sugar) control in adults with type 2 diabetes.

Studies of Zepbound for Sleep Apnea

Approval for Zepbound use in obstructive sleep apnea (OSA) was based on the SURMOUNT-OSA Phase 3 global studies with 469 participants with OSA unable or unwilling to use positive airway pressure (PAP). In two studies, Zepbound was evaluated for the treatment of OSA in adults with obesity, with and without the use of PAP therapy over one year. Patients did not have type 2 diabetes.

The primary objective of this study was to show that Zepbound was superior to a placebo treatment (an injection with no medicine) in the change in apnea-hypopnea index (AHI) over one year.

The apnea-hypopnea index (AHI) measures the severity of OSA and looks at the number of times per hour during sleep that breathing stops (apnea) or becomes significantly reduced (hypopnea).

Results

Zepbound was found to be about 5 times more effective than placebo, and results were statistically and clinically significant.

• Studies in adults with moderate-to-severe obstructive sleep apnea (OSA) who were not using positive airway pressure (PAP) therapy showed that Zepbound led to 25 fewer breathing disruptions per hour compared to 5 disruptions with placebo, as measured by AHI.
• In patients who were using PAP, Zepbound led to 29 fewer breathing disruptions per hour compared to 6 disruptions with placebo, as measured by AHI.

The improvement in AHI in participants with OSA is likely related to body weight reduction with Zepbound.

• In addition to improved OSA symptoms, adults on Zepbound lost an average of 18% of their body weight (45 lbs / 20.5 kg), while adults using Zepbound and PAP therapy lost an average of 20% of their body weight (50 lbs or 22.7 kg).
• This was compared to the placebo group which lost 4 lbs (1.8 kg) and 6 lbs (2.7 kg) (about 2% of body weight, on average), respectively.

After one year in two different studies, 42% or 50% of adults on Zepbound had no sleep apnea (remission) or mild, non-symptomatic OSA, compared to 16% or 14% using a placebo.

Also, patients treated with Zepbound achieved a greater reduction in systolic blood pressure and high-sensitivity C-reactive protein levels compared to placebo. Patients also reported improved sleep.

Related questions

• Ozempic Side Effects to Watch For
• Zepbound Vs Mounjaro: Complete Comparison Guide for Weight Loss and Diabetes Treatment
• Why am I not losing weight on Mounjaro?

Side effects with Zepbound

In the obstructive sleep apnea studies, the most frequently reported adverse events were related to the stomach, and found to be primarily mild to moderate in severity.

The most common adverse reactions with Zepbound include:

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Stomach area pain
• Indigestion
• Injection site reactions
• Fatigue
• Allergic reactions (typically fever and rash)
• Belching
• Hair loss
• Heartburn

Zepbound contains tirzepatide and should not be used with other tirzepatide-containing products (like Mounjaro) or any GLP-1 receptor agonist medicines.

Zepbound causes thyroid C-cell tumors in rats. It is unknown whether Zepbound causes such tumors, including medullary thyroid cancer, in humans. Zepbound should not be used in patients with a personal or family history of medullary thyroid cancer or in patients with Multiple Endocrine Neoplasia syndrome type 2.

These are not all the possible side effects of Zepbound. If you are concerned about any side effects with use of this medicine, speak to your healthcare provider.

What is obstructive sleep apnea?

Obstructive sleep apnea (OSA) is a serious breathing disorder that is characterized by complete or partial collapses of the upper airway during sleep. This may lead to pauses in breathing, shallow breathing, waking up from sleep and a potential decrease in blood oxygen. Snoring, fatigue and excessive daytime sleepiness are key symptoms of OSA.

While OSA can affect anyone, it is more common in people who have obesity or overweight.

Positive airway pressure (PAP) is the standard of care for moderate to severe OSA. PAP is a general term for the machines used during sleep that push air under pressure into the lungs to help prevent apnea. There are several different types of PAP machines, including continuous PAP (CPAP).

How is Zepbound given for sleep apnea?

Zepbound is given as a subcutaneous (under the skin) injection in your stomach area, thigh or upper arm. It is used once per week, at any time of the day. It is used in addition to a reduced-calorie diet and increased physical activity. Your healthcare provider will teach you how to inject the medicine, so it can be used at home.

You will start with lower doses to help with stomach side effects like nausea, diarrhea, vomiting or constipation, or diarrhea. Your doctor will slowly increase your dose to the best maintenance dose to help you tolerate side effects. Doses can be given with or without food.

• The recommended starting dosage is 2.5 mg injected subcutaneously (under the skin) once weekly for 4 weeks
• The recommended maintenance dose for obstructive sleep apnea (OSA) is 10 mg or 15 mg injected subcutaneously once weekly.

Your doctor will prescribe your dose and schedule for injections. Follow their dosing instructions exactly.

This is not all the information you need to know about Zepbound (tirzepatide) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.