Tirzepatide and Semaglutide for the Treatment of Obstructive Sleep Apnea and Obesity: A Retrospective Analysis
Main Article Content
Abstract
Background: Obesity is the leading risk factor for obstructive sleep apnea. Weight loss can improve both sleep quality and overall health. New anti-obesity medications (AOMs), including semaglutide and tirzepatide, offer promising options for managing obesity and may be potential treatment options for obstructive sleep apnea.
Methods: We conducted a retrospective claims analysis using Kythera Labs data from November 2022 to June 2024. Patients with obesity and evidence of AOM utilization were identified based on diagnosis and prescription claim(s) for Zepbound or Wegovy (identification period, 1 Nov. 2023–31 Dec. 2023) and had at least 6 months to measure incidence of obstructive sleep apnea. Patients with obesity were classified into two cohorts: an AOM cohort that received tirzepatide (Zepbound) or semaglutide (Wegovy) during the identification period (index date = first AOM claim) and a non-AOM cohort with no evidence of AOM use during the study period. Random index dates were selected within the AOM cohort’s range and included a 1% random sample of eligible patients. OSA risk was assessed during the follow-up period using Cox regression.
Results: We identified 20,384 patients with obesity and AOM use (semaglutide, 17,859; tirzepatide, 2,525) and 85,018 patients with obesity in the non-AOM cohort. Compared with the non-AOM cohort, the AOM cohort had a higher percentage with a Chronic Disease Score ≥2 (52.25% vs 8.44%; p<.001). However, the incidence of obstructive sleep apnea was lower in the AOM cohort (3.12%) than the non-AOM cohort (12.56%; p<.001). Subgroup analysis of the AOM cohort showed that tirzepatide users had a slightly lower incidence of obstructive sleep apnea than semaglutide users (2.65% vs 3.18%) (p=.0303). After adjusting for sociodemographic and clinical characteristics, the AOM cohort showed a 40% lower likelihood of obstructive sleep apnea than the non-AOM cohort (hazard ratio=0.60, p<.0001). However, there was no statistically significant difference in the risk of obstructive sleep apnea between tirzepatide and semaglutide users (p=.1664).
Conclusions: This study reveals a significant association between AOM use and a lowered risk of obstructive sleep apnea after adjustment for demographic and clinical variables.
Article Details
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