Why GLP-1 Drugs May Improve Sleep Apnea

Obesity medications such as Wegovy (semaglutide) and Zepbound (tirzepatide) have been shown to help with conditions beyond weight loss, including heart disease and fatty liver disease. Now, we can add sleep apnea to the myriad of ailments that these drugs seem to continue to have an impact on. 

Eli Lilly, the maker of Zepbound, said its phase 3 clinical trials found that participants taking tirzepatide saw a significant drop in their symptoms of obstructive sleep apnea, a condition that affects approximately 26% of Americans between the ages of 30 and 70.

In the clinical trials, scores measured by the apnea-hypopnea index (AHI), which measures the number of breathing interruptions or reductions per hour—decreased by 55% to 62.8% on average for those using the medication.

The improvement in sleep apnea symptoms is linked to weight loss, according to Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center.

“Excess weight can deposit in the airways around the throat and things and make it somewhat sloppy. So the tissues kind of fall back and obstruct the airway,” Ali told Verywell. “When a patient loses weight, they lose that extra fat and tissue in their airways, so the obstructive sleep apnea goes away.”

Ali said many of his patients have sleep apnea, but the condition often remains undiagnosed until confirmed through a sleep study.

Although Continuous Positive Airway Pressure (CPAP) machines are considered the “gold standard” for managing sleep apnea, they can be expensive, bulky, and challenging for patients to use in the long run.

The link between GLP-1 medications and sleep apnea is not new. A 2016 clinical trial found that weight loss resulting from liraglutide—a GLP-1 drug approved to treat obesity in 2022—could improve sleep apnea symptoms in patients.

“Weight loss can help, but some people will continue to have sleep apnea due to other causes, such as oral and airway anatomy,” said Alex Dimitriu, MD, founder of Menlo Park Psychiatry & Sleep Medicine.

If GLP-1 drugs prove to be helpful in improving sleep apnea, it might open up more avenues for insurance coverage. Patients who are on these medications often have to pay out-of-pocket because insurance doesn’t cover them.

“Sleep apnea is one of these medical conditions that the insurance companies deem as significant enough that they would approve surgery if they fall under a certain BMI range,” Ali said.

Dimitriu said he would like to see more research on how dental morphology—the unique features of each person’s dental anatomy—is affected by weight loss, and how sleep health intersects with weight fluctuation and the study of things like cravings.

Still, he said people need to keep in mind the limits of GLP-1 drugs when it comes to sleep apnea.

“Not all sleep apnea is from obesity, and thus, losing weight may not be an effective treatment for everyone,” Dimitriu said. “Nasal congestion, palatal, dental, and jaw structure can all play a role, and some of these may not be improved as much as obesity when someone starts losing weight.”

According to Lilly, the company will present its clinical trial results on sleep apnea later this year with the hope of applying for FDA approval shortly after.