FDA Approves Eli Lilly’s Weight Loss Drug Zepbound To Treat Sleep Apnea
Studies show it could reduce apnea episodes by as much as 70%
GLP-1 receptor agonist drugs like Ozempic, Wegovy and Mounjaro have helped millions of Americans lose weight and better manage their type 2 diabetes. And as of December 20, Eli Lilly’s weight loss drug Zepbound (tirzepetide) has become the first prescription medication FDA-approved to treat obstructive sleep apnea by increasing airflow and improving sleep quality.
Since sleep apnea affects nearly a billion people worldwide, and using a CPAP machine (the standard treatment for sleep apnea) can be cumbersome, the approval by the Food and Drug Administration is making headlines. Not only has the drug been shown to improve quality of life, it also offers a promising alternative to current therapies. We reached out to sleep medicine and obesity medicine physicians to learn more about Zepbound’s benefits for obstructive sleep apnea. Here’s what you need to know.
What is obstructive sleep apnea?
“Obstructive sleep apnea (OSA) is a sleep disorder where a person’s breathing repeatedly stops and starts during sleep because the throat muscles relax too much, blocking the airway,” explains Lizzie Benge, MD, a sleep medicine physician at Brigham and Women’s Hospital and faculty member at Harvard Medical School’s Division of Sleep and Circadian Disorders. “Imagine a garden hose that gets pinched off, stopping the flow of water—that’s similar to what happens in OSA when airflow is blocked.”
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When this happens repeatedly throughout the night, it disrupts your natural sleep cycle, leaving you tired and irritable come morning. The effects of daytime fatigue is something nearly 49 percent of readers could attest to when polled. If that wasn’t bad enough, untreated OSA increases the risk of more severe health problems, too.
“It’s frequently associated with low oxygen levels and elevated stress hormones during sleep, which can lead to high blood pressure, heart problems, strokes and diabetes,” says Raj Dasgupta, MD, a board-certified sleep medicine physician and Chief Medical Advisor for Garage Gym Reviews. “On top of that, it can leave you feeling drained which might make daily life and even driving more dangerous.”
Considering the wide-ranging effects OSA can have on your health, researchers are always looking for better ways to manage the condition. Dr. Benge says current treatments are limited to lifestyle changes, continuous positive airway pressure (CPAP) therapy (more on that below) and surgery.
FDA approves Eli Lilly’s weight loss drug to treat sleep apnea
Zepbound was approved to treat adults with moderate to severe obstructive sleep apnea. The FDA advised that the medication be used in conjunction with a reduced-calorie diet and increased physical activity, both of which aid weight loss and, in turn, improve sleep apnea symptoms. “This is a major step forward for patients with obstructive sleep apnea,” said Sally Seymour, MD, director of the Division of Pulmonology, Allergy and Critical Care at the FDA’s Center for Drug Evaluation and Research, in a statement.
How Zepbound helps manage sleep apnea
Eli Lilly conducted two separate studies on their popular weight loss over the course of a year. The first enrolled patients with moderate to severe OSA and obesity. After taking tirzepatide (Zepbound) for a year, these participants experienced a 55 percent reduction in apneic events (involuntary pauses in breathing) per hour compared to the start of the trial.
The second study involved adults with moderate to severe sleep apnea and obesity who used a CPAP machine in addition to Zepbound during the entire trial. A CPAP “relies on a mask that a patient wears over their nose and/or mouth during sleep to keep [the] airway open,” explains Dr. Dasgupta. After a year, these participants experienced a 63 percent decrease in apneic events per hour compared to the start of the trial.
While the study results are impressive, about 70 percent of the trial participants were men. Further research on women needs to be done to determine if these findings extend to the population as a whole. Regardless, Dr. Dasgupta says Zepbound could be a good treatment option for people whose OSA “is predominantly caused by excess weight.”
How weight loss impacts sleep apnea
“Excess fat around the neck and throat can put additional pressure on the airway,” explains Michael L. Glickman, MD, a triple board-certified obesity medicine physician and the founder and CEO of Revolution Medicine. “This pressure makes it harder for the muscles in the throat to stay open during sleep, leading to airway collapse.”
However, losing weight can ease the airway pressure, reducing apnea episodes. So it makes sense that weight loss drugs like Eli LIlly’s Zepbound are being explored as alternatives to traditional obstructive sleep apnea therapies.
What the experts say about Zepbound for sleep apnea
“These studies are exciting because they show tirzepatide (Zepbound) can help with obstructive sleep apnea in certain people by predominantly helping them lose weight,” Dr. Dasgupta says. “It’s encouraging to see this kind of progress, though more research will help us understand how it fits into current treatment algorithms and long-term effects.”
Dr. Glickman echoes this insight, adding that the results are “intriguing and promising, especially considering the growing burden of OSA and obesity. While it’s not entirely surprising that tirzepatide had this effect, the results reinforce the strong link between weight and OSA severity.”
So it makes sense the the FDA has now approved Eli Lilly’s weight loss drug as one tool to help manage obstructive sleep apnea.
How to talk to your doctor about Zepbound for sleep apnea
If you’re one of the millions of Americans struggling with excess weight and obstructive sleep apnea, these findings and the new drug approval offer hope for potential relief beyond CPAP and surgery.
Before Eli Lilly’s weight loss drug was approved by the Food and Drug Administration for sleep apnea, getting it off-label was challenging. “Off-label prescribing carries complexities,” Dr. Benge says. “It requires strong evidence and careful consideration of risks versus benefits.” Now, getting Zepbound for OSA should be an easier process since it’s been approved to treat this condition.
Previously, Dr. Glickman said he didn’t prescribe Zepbound specifically for OSA without a patient being overweight or obesity. “We [did] prescribe it for weight management in patients with overweight or obesity who are also affected by OSA,” he added. “Addressing obesity through effective weight loss strategies, like those supported by tirzepatide (Zepbound), can significantly improve OSA symptoms for many individuals.”
Dr. Dasgupta said he understands why Eli Lilly’s weight loss drug is becoming a more common treatment option for sleep apnea. “I can see why some physicians would offer Zepbound for patients who have OSA along with type 2 diabetes and/or obesity. Particularly if they haven’t had luck with other traditional options, such as continuous positive airway pressure (CPAP).”
Is using Zepbound for sleep apnea expensive?
If you and your doctor decide Zepbound is a good option, you’re likely wondering about the potential cost. Many insurance plans, including Medicare, don’t cover anti-obesity medication unless it’s prescribed for an FDA-approved treatment. Since Zepbound has been approved to treat sleep apnea, it could open the door to Medicare and insurance coverage for the weight loss drug.
Without insurance covearge, most people pay $1,000 or more per month for Zepbound, according to Dr. Glickman. But savings are possible, even if your insurance company is not yet covering Zepbound for sleep apnea. For example, Eli Lilly, Zepbound’s manufacturer, offers savings cards for eligible patients. If that’s not an option, Dr. Benge suggests exploring patient assistance programs or participating in a clinical trial, both of which can help reduce expenses.
The bottom line on using weight loss drugs for sleep apnea
The idea that a medication could provide lasting sleep apnea relief is groundbreaking. But since current data suggests Zepbound’s ability to tame OSA symptoms is directly tied to weight loss, Dr. Dasgupta notes it is likely to benefit a subset of patients who have sleep apnea due to excess weight. Further, these potential benefits will take time. Weight loss occurs slowly and requires a commitment to lifestyle changes, whereas current sleep apnea treatments, like CPAP, provide immediate relief.
The potential is exciting nonetheless and the benefits could very well ripple outward. “One thing I’ve heard from patients who successfully manage their weight and OSA is how much their efforts help their partners, too,” Dr. Glickman says. “I can’t count how many times a patient has joked, ‘My spouse says thank you for finally letting them sleep!’ It’s a great reminder of how improving our health can positively impact everyone around us.”
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