Do you snore, wake up tired and have you been told that you stop breathing at night? Many people living with obesity ask me whether the new weight-loss medicines also help with sleep apnoea. In some cases, the answer is yes.
What is obstructive sleep apnoea?
In obstructive sleep apnoea, the airway repeatedly closes while we sleep. Breathing stops for a few seconds, blood oxygen drops and sleep becomes fragmented. The result is tiredness and sleepiness during the day, and the condition is linked to cardiovascular complications. Excess weight is one of its main causes.
The most common warning signs are loud snoring, pauses in breathing noticed by a bed partner, unrefreshing sleep and daytime sleepiness. The diagnosis is confirmed with a sleep study.
What the research says
The SURMOUNT-OSA trials, published in the New England Journal of Medicine in 2024, included adults with obesity and moderate to severe sleep apnoea. Participants received tirzepatide or placebo as a weekly injection for one year. One trial included people who were not using CPAP and the other people who already were.
With tirzepatide, the number of breathing pauses per hour of sleep fell markedly: on average, about 25 to 29 fewer events per hour, compared with about 5 with placebo. Many participants ended up with mild sleep apnoea or none at all. The most frequent side effects were gastrointestinal, such as nausea, diarrhoea and vomiting, mostly mild to moderate.
Based on these results, the FDA, the US medicines regulator, approved tirzepatide in December 2024 for treating moderate to severe obstructive sleep apnoea in adults with obesity.
Retatrutide, a medicine still under investigation, showed results in the same direction in two phase 3 trials published in October 2026.
What you should know
- So far, this benefit has been shown in dedicated trials with tirzepatide. Specific sleep apnoea studies are still lacking for other obesity medicines.
- The results apply to adults with obesity and moderate to severe sleep apnoea.
- CPAP remains the standard treatment. Do not stop it without your doctor’s advice.
Treating obesity often means treating the conditions that come with it as well. Sleep apnoea is a good example.
Verdict: FACT
In adults with obesity and moderate to severe sleep apnoea, tirzepatide markedly reduced sleep apnoea. Whether to treat, and with which medicine, is a decision to make with your doctor.
This article is for information only and does not replace a medical appointment.
References
- Malhotra A, Grunstein RR, Fietze I, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med. 2024;391(13):1193-1205. doi:10.1056/NEJMoa2404881
- U.S. Food and Drug Administration. FDA Approves First Medication for Obstructive Sleep Apnea [press release]. 20 Dec 2024. fda.gov
- Grunstein RR, Somers VK, Azarbarzin A, et al. Retatrutide Once Weekly for Treatment of Obstructive Sleep Apnea. N Engl J Med. Published online 21 October 2026. doi:10.1056/NEJMoa2611477
- Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2019;15(2):335-343. doi:10.5664/jcsm.7640
