Posted on 06/26/2024 9:09:58 AM PDT by Red Badger
Novel drug treatment developed for diabetes shows promising results of enhanced sleep and overall health for patients diagnosed with obesity and living with obstructive sleep apnea
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Researchers at University of California San Diego School of Medicine and international collaborators have led a worldwide, advanced study demonstrating the potential of tirzepatide, known to manage type 2 diabetes, as the first effective drug therapy for obstructive sleep apnea (OSA), a sleep-related disorder characterized by repeated episodes of irregular breathing due to complete or partial blockage of the upper airway.
The results, published in the June 21, 2024 online edition of New England Journal of Medicine, highlight the treatment’s potential to improve the quality of life for millions around the world affected by OSA.
“This study marks a significant milestone in the treatment of OSA, offering a promising new therapeutic option that addresses both respiratory and metabolic complications,” said Atul Malhotra, MD, lead author of the study, professor of medicine at University of California San Diego School of Medicine and director of sleep medicine at UC San Diego Health.
OSA can result in reduced oxygen levels in the blood and can also be associated with an increased risk of cardiovascular complications, such as hypertension and heart disease. Recent studies, also led by Malhotra, suggest that the number of OSA patients worldwide is close to 936 million.
Conducted in two Phase III, double-blinded, randomized, controlled trials, the new study cohort involved 469 participants diagnosed with clinical obesity and living with moderate-to-severe OSA. They were recruited from sites in nine different countries, including the U.S., Australia and Germany. Participants either used or did not use continuous positive airway pressure (CPAP) therapy, the most common sleep apnea treatment which uses a machine to maintain an open airway during sleep, preventing interruptions in breathing. Patients were administered either 10 or 15 mg of the drug by injection or a placebo. The impact of tirzepatide was evaluated over 52 weeks.
Researchers found that tirzepatide led to a significant decrease in the number of breathing interruptions during sleep, a key indicator used to measure the severity of OSA. This improvement was much greater than what was seen in participants that were given a placebo. Importantly, some participants that took the drug reached a point where CPAP therapy might not be necessary. Considerable data suggest that a drug therapy that targets both sleep apnea and obesity is beneficial rather than treating either condition alone.
Additionally, the drug therapy improved other aspects related to OSA, such as reducing the risk factors of cardiovascular diseases and improved body weight. The most common side effect reported was mild stomach issues.
“Historically, treating OSA meant using devices during sleep, like a CPAP machine, to alleviate breathing difficulties and symptoms,” Malhotra said. “However, its effectiveness relies on consistent use. This new drug treatment offers a more accessible alternative for individuals who cannot tolerate or adhere to existing therapies. We believe that the combination of CPAP therapy with weight loss will be optimal for improving cardiometabolic risk and symptoms. Tirzepatide can also target specific underlying mechanisms of sleep apnea, potentially leading to more personalized and effective treatment.”
Malhotra adds that having a drug therapy for OSA represents a significant advancement in the field.
“It means we can offer an innovative solution, signifying hope and a new standard of care to provide relief to countless individuals and their families who have struggled with the limitations of existing treatments,” said Malhotra. “This breakthrough opens the door to a new era of OSA management for people diagnosed with obesity, potentially transforming how we approach and treat this pervasive condition on a global scale.”
Next steps include conducting clinical trials to examine longer term effects of tirzepatide.
Co-authors of the study include: Ronald Grunstein, University of Sydney; Ingo Fietze, University Hospital Berlin; Terri Weaver, University of Illinois Chicago; Susan Redline, Ali Azarbarzin, and Scott Sands, Harvard Medical School; Richard Schwab, University of Pennsylvania; and Julia Dunn, Sujatro Chakladar, Mathijs Bunck, and Josef Bednarik, Eli Lilly and Company.
Funding support for the study came, in part, from Eli Lilly and Company.
Disclosure: Atul Malhotra serves as a consultant to Eli Lilly and Company.
https://www.nejm.org/doi/10.1056/NEJMoa2404881
https://newatlas.com/medical/sleep-apnea-drug-obesity/
Interesting.
There is also a smaller, less intrusive device that can be used at home. It still has lots of wires, though.
I did a sleep study at home over Memorial Day weekend.
I wore a monitor on my left wrist with cap that fit over my little finger and a wire leading to my . It kept track of vitals.
It also had a monitor that I applied to the skin/bone at the base of my neck. It picked up the vibrations when I was snoring.
My question to ALL of you is have any of you tried the mouth guards either advertised on the internet/Facebook OR had one made by your dentist?
FYI, my dentist was the person who diagnosed me based on grinding my teeth and me telling him I snore like a freight train. According to my wife/son.
There’s a little ring out there now that can measure all sorts of information when it’s worn. Called an Oura ring. On the pricy side but maybe can use an HSA
/FSA to pay for it.
Hubby uses a mouth guard at night for grinding his teeth. He’s gotten a thinner one more recently that he likes much better. He rarely snores, and doesn’t have sleep apnea, nor is he overweight. He does wear an Oura ring to measure how good his sleep is.
I don’t need a ring to tell me that info. I know when I wake up each morning if I got into a good REM cycle during the night.
I use a mouthguard, but I don’t know if it stops me from snoring. I use it due to my bruxism (tooth grinding), especially with the molars, my most valuable teeth, helping to crush and pulverize foods before I swallow.
I have health ins. but it does not cover a physician level mouthguard. So, I will shop at Sporting stores, such as Big 5, and buy a few of the mouth guards they sell to boxers or other athletes. Physician Level Mouthguard = $450 of more!
Big 5 retail mouthguard = $8 to $10.
I have a mouth guard for my top teeth. It was made by my previous dentist to keep me from grinding my bottom front teeth into my top front teeth.
The I switched dentists. Brought in the mouth guard. The new dentist asks me IF I have ever been tested for sleep apnea?
I asked why. He asks me IF I snore. Yes, why? he responds that people who grind their teeth and snore typically(75% of the time) also have sleep apnea. He then advised I get tested.
There are mouth guards that go on your top AND bottom teeth. They are connected so it pushes your bottom teeth out so that your airway remains open.
The grinding of your teeth in my case is a symptom of my body/mouth trying to keep my airway open when I am sleeping.
I use CPAP and am on Mounjaro 10mg now (just upped from 7.5). Lost about 35 pounds or so in a year. Had CPAP since 2008. Would love to go off it, but I feel kind of dependent on it. Very difficult to fall asleep without it.
tirzepatide is a WEIGH LOSS drug and has zero direct affect on apnea or sleep ... ANY medication, medical procedure or lifestyle improvement that assisted weight loss would have exactly the same result as tirzepatide: reduced need for CPAP and improved sleep ...
somehow big pharma managed to get both the medical media and the consumer media to go along with their ridiculous and grossly misleading nonsense about this WEIGHT LOSS drug ...
I have a ResMed Airiset 10 “Autoset” cpap machine. It seems to be a CPAP with some of the functionality of a BIPAP. My breathing doc said it is the gold standard or CPAP machines.
At first my machine used constant pressure. When I returned for a follow-up visit with the doc, I complained that my lungs (diaphragm, I suppose) felt tired all the time, making it uncomfortable and more difficult to use the machine.
He changed the settings to that the machine could sense when I was exhaling, and reduce the pressure until I stopped breathing out. I felt the difference that night.
Now, I do not want to sleep without CPAP. I have clogged sinuses frequently, and the machine helps me to breath through the stoppage.
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