Sleep apnea is a common sleep-related breathing problem that affects millions of Americans and frequently goes undiagnosed.
The American Diabetes Association reports that 60–90% of people with obstructive sleep apnea, a common type of sleep apnea, have obesity or are overweight. The most recent data from the World Health Organization (WHO) reports that around 800 million people worldwide have obesity.
On April 17, 2024, drugmaker Eli Lilly announced that people with obesity who were taking the anti-obesity medication Zepbound (tirzepatide) or those with type 2 diabetes who were taking Mounjaro (tirzepatide) were relieved from obstructive sleep apnea or from periods of stopped breathing during sleep.
This article explains the connection between obesity and sleep apnea and how medications like Zepbound can affect your sleep health.
What Is Sleep Apnea?
Sleep apnea is a common sleep condition that causes repeated pauses in breathing while you’re asleep. People with sleep apnea frequently stop breathing for seconds or minutes when they sleep. While these lapses may cause you to wake up sometimes and lower the quality of your sleep, you may not completely awaken, and you may be unaware of your irregular breathing during the night.
Most people with sleep apnea experience symptoms like:
- Too much sleep during the day
- Loud snoring accompanied by gasping or choking sounds
- Shortness of breath after waking
- Morning headaches lasting several hours after waking up
- Restless sleep and nighttime awakenings
- Dry mouth or sore throat upon waking up
- Increased urge to urinate during the night
- Reduced libido
- Nighttime sweating
- Irritability, moodiness, or frustration
- Reduced concentration
The two major types of sleep apnea include central sleep apnea (CSA) and obstructive sleep apnea (OSA).
Breathing problems in OSA are caused by an airway constriction that occurs during sleep, while breathing issues in CSA are caused by a breakdown in communication between the brain and the muscles involved in breathing.
In addition to lowering sleep quality, these breathing disruptions may have serious health effects if left untreated.
How Is Obesity Linked to Obstructive Sleep Apnea?
Several factors can increase the risk of developing obstructive sleep apnea (OSA), but the condition is more common in people who are overweight or obese. Excess weight leads to the accumulation of fat deposits around your neck, known as pharyngeal fat, which can obstruct the upper airway during sleep when the airway muscles are naturally relaxed. This obstruction often causes snoring, as air is forced through a restricted passage, producing a loud noise.
Excess abdominal fat can also compress the chest wall, reducing lung volume and further limiting airflow. This decreased lung capacity makes the upper airway more prone to collapse during sleep.
Research shows that the risk of obstructive sleep apnea (OSA) increases significantly as body mass index (BMI) increases. For example, a 10% weight gain is associated with a six-fold increase in the likelihood of developing OSA.
While obesity is a leading cause, other factors can also contribute to OSA, including enlarged tonsils, anatomical characteristics such as a large neck or narrow throat, and certain medical conditions like endocrine disorders (diabetes, thyroid disease), acid reflux, lung diseases, and heart problems.
Weight Loss Medications Like Zepbound may Help Treat Sleep Apnea
Research suggests that weight loss is one of the most effective ways to reduce the severity of OSA.
Tirzepatide, marketed under Zepbound for weight loss and Mounjaro for diabetes management, works by targeting glucagon-like peptide-1 (GLP-1) and Gastric inhibitory polypeptide (GIP) receptor agonists. These hormones are naturally produced in the intestines after meals, which decreases appetite. Zepbound also slows the passage of food through the digestive system, helping you to feel fuller faster. The result is weight loss, which can, in turn, alleviate the physical factors contributing to sleep apnea.
On December 20, 2024, Zepbound (tirzepatide), an obesity drug, was approved by the Food and Drug Administration (FDA) as the first pharmaceutical treatment for moderate-to-severe obstructive sleep apnea (OSA) in people.
Zepbound, which was first approved to treat obesity and overweight, now has a second indication.
Data from two phase 3 clinical trials conducted in 2024 supported Lilly’s application to the FDA. The clinical trials explored tirzepatide’s use in treating moderate-to-severe obstructive sleep apnea in people with obesity.
The first study involved people who were unable or unwilling to wear a continuous positive airway pressure (CPAP) machine—a frequently prescribed device for treating sleep apnea. Participants were given weekly injections of tirzepatide or a non-acting placebo.
After 52 weeks, tirzepatide users experienced an average of 27.4 fewer apnea episodes per hour, while the placebo group experienced an average decrease of 4.8 occurrences per hour.
People who were already using a CPAP machine and intended to keep using it during the trial were included in another study. Tirzepatide was given to half of the subjects, while a placebo was given to the other half.
People in the tirzepatide group experienced an average reduction of 30.4 apnea occurrences per hour, while those in the placebo group experienced an average reduction of six events per hour.
Participants in both studies saw a weight loss of about 20%.
The approval of Zepbound for OSA is part of a growing trend of using obesity medications to treat related health conditions. Earlier in 2024, the FDA approved Wegovy, Novo Nordisk’s obesity medication, for the treatment of heart failure. Lilly is also pursuing FDA approval for Zepbound to treat heart failure and is investigating its potential for managing liver disease and substance use disorders.
Does Insurance Cover Zepbound for Sleep Apnea?
While some insurance companies like Tricare and Blue Cross Blue Shield may cover Zepbound for weight loss, it’s currently unclear whether insurers will cover Zepbound for people with obstructive sleep apnea (OSA). Even if they cover, they may require patients to try other treatments, like CPAP machines, before approving coverage for Zepbound as part of OSA management. Contact your insurance provider directly to determine your coverage.
Zepbound costs approximately $1,000 per month. However, people with insurance coverage for the medication may pay a lower amount. Eli Lilly may also provide a savings card for those without insurance.
Manage Your Weight Loss Online
Have you tried countless methods to lose weight, only to see it come creeping back? Obesity is a complex, chronic medical condition that affects people throughout their lives, often resisting simple solutions. Besides causing sleep apnea, obesity can also lead to other serious health issues like heart disease, type 2 diabetes, joint problems, and even certain cancers.
At NP2GO, we take the time and care to determine the complex biological factors (medical problems, hormones/medications, environment, and lifestyle) influencing your weight and create a personalized treatment plan to help you lose weight and keep it off permanently.
Our board-certified healthcare providers are qualified to prescribe the best prescription medications for weight loss. After consultation, our online doctors will order any required exams and lab tests to identify the best course of treatment for your needs.
While we don’t accept insurance, we can help you with prior authorizations if needed. Some of the medications we prescribe for weight loss online include Zepbound, Wegovy, Ozempic, Mounjaro, and Phentermine.
We have immediate openings. Book an online consultation today to start your weight loss journey. We look forward to speaking with you!