A First and a Burst of Evidence for Sleep Apnea and Obesity

Bursting ShellWe like to celebrate firsts. And yesterday, we got one to celebrate in the first ever drug treatment shown to be effective for sleep apnea – the obesity medicine called tirzepatide.

In presenting this new research at the American Diabetes Association Scientific Sessions yesterday, Atul Malhotra reminded us, “sleep is an important part of cardiometabolic health.” When sleep is poor, health suffers. Malhotra was also lead author on the simultaneous publication of this study in the New England Journal of Medicine. In fact, his publication and presentation detail the findings of two distinct, well-controlled clinical trials. He and his co-authors concluded:

“In two trials, the participants who received tirzepatide had a clinically meaningful change in sleep-disordered breathing and alleviation of perceived sleep disturbance and sleep-related impairment, as well as reductions in common obstructive sleep apnea-related cardiovascular risk factors.”

Pick your metaphor – home run, slam dunk, or stunning masterpiece – this work marks an important step toward fully describing how treating obesity effectively can deliver astonishing improvements in cardiometabolic health.

An Added Burst of Evidence

On top of the news about Tirzepatide came an impressive study in the Journal of the American College of Cardiology. Ali Aminian and colleagues published observational data from a large cohort of metabolic surgery patients with moderate to severe sleep apnea. Over a ten-year period, they found a 42% reduction in major events like heart attacks and strokes. They found a 37% reduction in deaths.

So yes, the medical importance of relieving sleep apnea is great.

Potentially Life-Changing

But medical jargon does not move everyone. More meaningful to many people is the impact this medicine can have on a person’s life. With the story of Sue Clasen, Dani Blum does a fine job of bringing this to life in the New York Times. Clasen suffered with sleep apnea for years. She found relief after taking a GLP-1 to lose weight. Blum wrote of Clasen’s difficulty with CPAP therapy:

“Her father-in-law had a heart attack that his doctors attributed to untreated sleep apnea. She kept thinking about him as she tried to find a CPAP mask that fit better. ‘I knew how serious it was – I was just like, OK, I have to keep at it, keep trying, I’ll get it right,’ she said. ‘And I just never did.’

“Ms. Clasen’s CPAP machine now sits on a shelf in her closet, collecting dust. On a recent flight to Las Vegas, she slept so soundly the man sitting next to her joked that she looked dead. ‘All I keep thinking about it is, if that was a year ago, I would have been snoring so loud,’ she said.”

Sleep is an important dimension of cardiometabolic health that too many people neglect. So the first ever drug treatment to help with this is indeed a big deal.

Click here for the study and here for an editorial to go with it. For access to Blum’s reporting on it, click here. For the study by Aminian et al, click here and here for further perspective.

Bursting Shell, painting by C. R. W. Nevinson / WikiArt

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June 22, 2024

4 Responses to “A First and a Burst of Evidence for Sleep Apnea and Obesity”

  1. June 22, 2024 at 10:00 am, Allen Browne said:

    The disease of obesity has over 200 complications. Safe, effective treatment of this chronic disease just makes sense. The evidence is mounting, undeniable, and inescapable.


  2. June 22, 2024 at 11:44 am, Angela Golden said:

    I am happy for the headline, but how is this any different than just treating obesity for the improvement in sleep apnea. All of the patients in the study last 14-16% of their weight so isn’t that the message? Lose this amount of weight (AND SUSTAIN it) and you treat not only sleep apnea but the other 200 complications as mention by Dr. Browne.

    • June 22, 2024 at 4:05 pm, Ted said:

      For the first time ever, we have proof that treating obesity improves outcomes for sleep apnea. Belief is good, evidence is even better.

  3. June 23, 2024 at 8:48 pm, John Dixon said:

    This may be the first treatment for sleep apnea that saves lives!