Popular Weight Loss and Diabetes Drugs May Also Help Alleviate Sleep Apnea Symptoms
Fact checked by Nick Blackmer
GLP-1 drugs, including Ozempic, Wegovy, and Zepbound, may help people sleep better.
This is because losing weight can ease symptoms of sleep apnea, which can then result in a more restful night.
Experts recommend people speak to a trusted healthcare provider if they have questions or concerns regarding their sleep health.
In addition to helping manage diabetes and obesity, certain popular GLP-1 medications could be also help people improve their sleep.
Tirzepatide, better known as Zepbound or Mounjaro, may be able to alleviate some sleep apnea symptoms in people with obesity, according to drug maker Eli Lilly.
On Wednesday, the company released results from two clinical trials, both of which compared tirzepatide use to a placebo over the course of a year.
The first found that, for people not using positive airway pressure (PAP) therapy, tirzepatide led to about 27 fewer sleep apnea events per hour. The second—which included people using PAP therapy—found tirzepatide users had about 30 fewer sleep apnea events per hour. For comparison, participants taking the placebo in both trials saw five and six fewer sleep apnea events per hour, respectively.
Obstructive sleep apnea (OSA) is a serious condition in which breathing stops and starts over repeatedly while a person sleeps, keeping the body from getting enough oxygen. Obesity is a common risk factor for OSA.
The results of these clinical trials haven't yet been submitted to a peer-reviewed journal, but Eli Lilly said it plans to do so in late June.
Though these results were only for tirzepatide, it's likely that other GLP-1 medications—including semaglutide, or Ozempic and Wegovy—could cause similar effects on sleep.
Anecdotally, this was true for Jeannine Manning. She started taking Ozempic in March 2023, and was prescribed the drug to help control her type 2 diabetes and manage her weight.
By October, she had lost 50 pounds, and was seeing other unexpected health benefits.
“I’ve ditched my apnea machine,” she told Health. “I fall asleep faster and sleep much better.”
Manning has lived with OSA for decades. For about 15 years, she used a continuous positive airway pressure (CPAP) machine, which provides constant air pressure to the upper airways so they remain open and enable breathing during sleep.
No longer needing a CPAP machine due to improved sleep was an added benefit of taking Ozempic that Manning didn’t plan on.
“I knew when my weight went up, so did my snoring, but I didn’t anticipate that my sleep apnea [and] snoring would almost disappear with weight loss,” she said. “I was more concerned with other health issues to even think about it.”
Here’s how drugs such as Zepbound, Wegovy, and Ozempic, can impact someone’s sleep health.
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Interrupted Breathing Is the Main Indicator of Sleep Apnea
There are a few different kinds of sleep apnea that someone might experience.
OSA is the most common type of sleep apnea.
Anything that can obstruct the airway can cause OSA. The most common causes include:
Obesity
Large tonsils
Changes in hormone levels
Other risk factors include age, being male, family history and genetics, heart or kidney failure, and drinking alcohol or smoking.
Central sleep apnea is another form that occurs when the brain doesn’t send the necessary signals to the body to breathe.
Symptoms of sleep apnea during sleep include:
Starting and stopping breathing
Gasping for air
Continuous and loud snoring
Waking up a lot to pee
Symptoms of sleep apnea that are noticed during wake times include:
Feeling tired or sleepy due to an inability to focus
Dry mouth
Headaches
Decreased interest in sex
To diagnose sleep apnea, a doctor may suggest a sleep study, which involves monitoring brain waves, heart rate, breathing, and oxygen levels while they sleep.
Once diagnosed, treatment options often include lifestyle changes like limiting alcohol, exercising, and weight management.
The most common sleep apnea treatment is the CPAP machine. Additional treatment options include oral devices, implants, exercises for the mouth and face, as well as the following surgeries:
Adenotonsillectomy, which removes the tonsils and adenoids
Removal of mouth and throat tissue to open the upper airway
Upper or lower jaw advancement to make the upper airway bigger
Related: Sleep Awards 2022: 30 Products to Help You Sleep Better
Anti-Obesity Medications May Ease Sleep Apnea Symptoms
While GLP-1 medications like Ozempic are not officially recommended for OSA, Sethu Reddy, MD, president of the American Association of Clinical Endocrinology, said reports like Manning’s are not surprising.
“[It] is well known that obesity is associated with many adverse effects on health, and weight loss by any means is associated with improvement in many health benefits,” he told Health.
He explained that GLP-1 medications may improve symptoms of OSA for people with diabetes, as well as people with obesity.
The most likely explanation for this improvement is weight loss.
“Reduced fat tissue in the neck may directly reduce obstruction in the neck. Reduced abdominal obesity could also result in improvements in breathing mechanics as well,” Reddy said “Weight loss has been found to be the most significant intervention for improvement in sleep apnea.”
Biochemically, obesity can intensify OSA, Karl Nadolsky, DO, endocrinologist and diplomate at the American Board of Obesity Medicine, told Health.
So focusing on weight management can, in turn, decrease OSA severity.
“OSA is a common obesity-related complication but remains underdiagnosed and untreated,” he said. “Achieving over 10%, preferably [over] 15%, weight reduction can dramatically improve sleep apnea and with greater weight reduction, induce remission."
The relationship between OSA and obesity is intricate, involving multidirectional aspects, Nadolsky added.
“Obesity causes, and is itself exacerbated by, OSA, and [is associated] with insulin resistance and increased cardiovascular risks,” he said. “Unfortunately, treating the OSA with CPAP only does not seem to improve weight reduction.”
Continuing Research to Connect GLP-1 Drugs and Sleep Apnea
Because of the known effects GLP-1 drugs have on the brain, Reddy said more research could explain a connection to sleep that is not directly linked to weight.
“It may be possible that GLP-1 analogs may improve sleep apnea through central mechanisms as well,” he said. “Their effects on sleep and wakefulness through direct effects on the hypothalamus in the brain are being investigated.”
To prescribe GLP-1 medications specifically for OSA, Reddy said more clinical trials studying the effects of GLP-1 analogs on OSA are needed.
“These trials would be essential to seek a specific FDA-approved recommendation for these drugs in obstructive sleep apnea,” he said.
This is the next step for Zepbound, and its potential to treat OSA—Eli Lilly said it plans to submit its clinical trial data to the FDA this summer.
However, Nadolsky explained that current research does point to the impact GLP-1 drugs have on obesity, so some conclusions regarding the connection between GLP-1 drugs, obesity, and bettered sleep are implied.
Related: New Research Shows How Sleep Apnea Might Affect Heart Health
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