The Food and Drug Administration (FDA) on Dec. 20 approved the obesity medicationZepbound(tirzepatide) as the first pharmaceutical treatment for moderate-to-severeobstructive sleep apnea (OSA)in adults withobesity.

About 17% of people in the United States have moderate or severe OSA, and the condition is more common in older adults and people with obesity.

The approval marks a second indication for Zepbound, which was approved to treat overweight and obesity and uses the same active ingredient as the type 2 diabetes medicationMounjaro.

“Too often, OSA is brushed off as ‘just snoring’—but it’s far more than that,” Julie Flygare, JD, president and CEO of Project Sleep, said in apress release from the drugmaker Eli Lilly. “It’s important to understand OSA symptoms and know that treatments are available, including new options like Zepbound. We hope this will spark more meaningful conversations between patients and health care providers and ultimately lead to better health outcomes.”

Why GLP-1 Drugs May Improve Sleep Apnea

The First Medication for Obstructive Sleep Apnea

Zepbound is the first medication approved for OSA. The current gold standard for OSA treatment is positive airway pressure (PAP). Continuous PAP, orCPAP, machines help open airways and significantly reduce the number of sleep disruptions the average patient experiences in a night.

In a Lilly study, participants who used PAP therapy had about 25 fewer sleep disruptions in an hour when they took Zepbound, compared to five fewer sleep disruptions in the placebo group.

In another study, people who used Zepbound without PAP therapy had around 28 fewer sleep disruptions per hour, compared to about five fewer events in the placebo group.

After one year, up to half of the adults taking Zepbound no longer had symptoms associated with OSA.

“That’s pretty good and robust data,”Jorge Moreno, MD, an internal medicine physician at Yale Medicine who is board-certified in obesity medicine and was not affiliated with the Lilly trial, told Verywell.

Many people may not be able to use a CPAP machine due to discomfort, irritation, and concerns about how it will affect their appearance or interactions with bed partners.Moreno said he expects that Zepbound could be used in addition to PAP or as an alternate for people who are uncomfortable using a sleep machine.

“I have patients that completely cannot tolerate the CPAP machine. They fight it all night, they take it off, and they don’t use it as often as they should,” Moreno said. “Those patients may try Zepbound and see if that helps with treatment adherence.”

Zepbound Helps People Lose More Weight Than Wegovy, According to Eli Lilly Trial

Access and Affordability of Zepbound

Moreno said a patient’s ability to take Zepbound continuously will depend on how reliable their access to the drug is. The FDA removed Zepbound from its drug shortage list this week for the first time since its approval last year. However, some worry that the move could affect people who rely on cheaper generic versions of the drug. When a drug is removed from the shortage list, compounding pharmacies may no longer mix off-brand versions for people who can’t access the name-brand drug.

It’s not yet clear if health insurance companies will cover the cost of Zepbound for people with OSA. Many health insurers plan to increase co-pays or suspend coverage forGLP-1 medicationsin 2025.Insurers may also require patients to try other treatments before covering Zepbound for OSA.The OSA indication is the latest in a slate of approvals for using blockbuster obesity medications to treat comorbid health conditions. This year, the FDA granted an indication to Wegovy, Novo Nordisk’s obesity medication, to treat heart failure. Lilly is also seeking an FDA indication for Zepbound to treat heart failure, and the company is testing its use in treatingliver diseaseandsubstance use disorder.

GLP-1 Drug Shortage Is Over. Why Might These Drugs Soon Be Costlier and Harder to Access?

How Zepbound May Fit Into OSA Treatment

In the Lilly trials, participants took the highest dose of Zepbound they could tolerate—10 milligrams or 15 milligrams. They also received dietary and lifestyle guidance.

Moreno said the minority of his patients who take a GLP-1 drug are on the maximum dose of the medication. Most patients are taking a moderate dose of the medication so they can balance their weight loss with side effects.

“The people that are the most successful long term with their weight loss are the individuals that are incorporating all parts of the puzzle: They’re taking medications, they’re changing dietary habits, and they’re active,” Moreno said.

If pharmacologic treatment is right for you, there are other options. In addition to the CPAP, there are a variety of PAP machines that can help regulate your breathing at night. Dental devices, such as mandibular advancement devices and tongue retainers, can also provide some relief.

More intensive treatments include surgery to remove excess tissue from the upper airway and bariatric surgery for long-term weight management.

What This Means For YouIf you consistently wake up feeling unrested or are sleepy during the day, talk to your healthcare provider about getting asleep testfor OSA. Getting a diagnosis can improve your ability to treat OSA and prevent associated long-term health issues, like heart disease, diabetes, and mental health issues.

What This Means For You

If you consistently wake up feeling unrested or are sleepy during the day, talk to your healthcare provider about getting asleep testfor OSA. Getting a diagnosis can improve your ability to treat OSA and prevent associated long-term health issues, like heart disease, diabetes, and mental health issues.

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Veasey SC, Rosen IM.Obstructive sleep apnea in adults.N Engl J Med. 2019;380(15):1442-1449. doi:10.1056/NEJMcp1816152Senaratna CV, Perret JL, Lodge CJ, et al.Prevalence of obstructive sleep apnea in the general population: a systematic review.Sleep Med Rev. 2017;34:70-81. doi:10.1016/j.smrv.2016.07.002Malhotra 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/NEJMoa2404881Pavwoski P, Shelgikar AV.Treatment options for obstructive sleep apnea.Neurol Clin Pract. 2017;7(1):77-85. doi:10.1212/CPJ.0000000000000320Klein HE.Rising costs lead insurers to drop weight loss drug coverage, further increasing patient burden.Am J Manag Care.2024;30(Spec No. 10):SP781-SP782. doi:10.37765/ajmc.2024.89614

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Veasey SC, Rosen IM.Obstructive sleep apnea in adults.N Engl J Med. 2019;380(15):1442-1449. doi:10.1056/NEJMcp1816152Senaratna CV, Perret JL, Lodge CJ, et al.Prevalence of obstructive sleep apnea in the general population: a systematic review.Sleep Med Rev. 2017;34:70-81. doi:10.1016/j.smrv.2016.07.002Malhotra 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/NEJMoa2404881Pavwoski P, Shelgikar AV.Treatment options for obstructive sleep apnea.Neurol Clin Pract. 2017;7(1):77-85. doi:10.1212/CPJ.0000000000000320Klein HE.Rising costs lead insurers to drop weight loss drug coverage, further increasing patient burden.Am J Manag Care.2024;30(Spec No. 10):SP781-SP782. doi:10.37765/ajmc.2024.89614

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Veasey SC, Rosen IM.Obstructive sleep apnea in adults.N Engl J Med. 2019;380(15):1442-1449. doi:10.1056/NEJMcp1816152Senaratna CV, Perret JL, Lodge CJ, et al.Prevalence of obstructive sleep apnea in the general population: a systematic review.Sleep Med Rev. 2017;34:70-81. doi:10.1016/j.smrv.2016.07.002Malhotra 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/NEJMoa2404881Pavwoski P, Shelgikar AV.Treatment options for obstructive sleep apnea.Neurol Clin Pract. 2017;7(1):77-85. doi:10.1212/CPJ.0000000000000320Klein HE.Rising costs lead insurers to drop weight loss drug coverage, further increasing patient burden.Am J Manag Care.2024;30(Spec No. 10):SP781-SP782. doi:10.37765/ajmc.2024.89614

Veasey SC, Rosen IM.Obstructive sleep apnea in adults.N Engl J Med. 2019;380(15):1442-1449. doi:10.1056/NEJMcp1816152

Senaratna CV, Perret JL, Lodge CJ, et al.Prevalence of obstructive sleep apnea in the general population: a systematic review.Sleep Med Rev. 2017;34:70-81. doi:10.1016/j.smrv.2016.07.002

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

Pavwoski P, Shelgikar AV.Treatment options for obstructive sleep apnea.Neurol Clin Pract. 2017;7(1):77-85. doi:10.1212/CPJ.0000000000000320

Klein HE.Rising costs lead insurers to drop weight loss drug coverage, further increasing patient burden.Am J Manag Care.2024;30(Spec No. 10):SP781-SP782. doi:10.37765/ajmc.2024.89614

Meet Our Medical Expert Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?OtherHelpfulReport an ErrorSubmit

What is your feedback?