Health Canada has given the green light to Zepbound, a weight-loss medication, for the treatment of obstructive sleep apnea in adults with obesity. This approval, issued on June 11, signifies Zepbound as the sole GLP-1 drug sanctioned in Canada for managing the sleep disorder characterized by temporary breathing cessation due to an obstructed upper airway caused by relaxed throat muscles or excess fatty tissue.
Noted risks of sleep apnea include daytime drowsiness, along with potential complications such as high blood pressure, heart attacks, and strokes, as stated by Dr. Mandeep Singh, a sleep science clinician investigator at University Health Network in Toronto. Sleep apnea is commonly linked with obesity and can be mitigated through weight loss.
Tirzepatide, the active component in Zepbound, targets GLP-1 and GIP hormone receptors to curb appetite, leading to weight reduction. Eli Lilly’s tirzepatide products, including Zepbound and diabetes treatment Mounjaro, compete with Novo Nordisk’s semaglutide medications Ozempic and Wegovy.
Marie-Pier Burelle, a spokesperson for Health Canada, emphasized that tirzepatide should be administered weekly alongside a reduced-calorie diet and increased physical activity for obese adults with a body mass index (BMI) of 30kg/m2 or higher. Burelle cautioned that Zepbound is not a direct replacement for continuous positive airway pressure (CPAP), the primary therapy for moderate to severe sleep apnea, emphasizing that patients should not discontinue CPAP usage without medical guidance.
Health Canada’s approval followed Phase 3 trials involving obese individuals with sleep apnea. Results revealed a significant reduction in breathing interruptions among patients on tirzepatide compared to those on a placebo. Singh, not involved in the trials, highlighted that the severity of sleep apnea is determined by the frequency of breathing interruptions per hour of sleep.
Singh expressed optimism regarding tirzepatide offering an additional option for obstructive sleep apnea patients and underscored the need for further research on the medication’s impact on non-obese individuals with sleep apnea. Potential benefits of weight loss with GLP-1 drugs for sleep apnea patients are yet to be substantiated by research.
Common side effects of GLP-1 drugs like tirzepatide include nausea, vomiting, diarrhea, and constipation, with rare but severe complications such as pancreatitis, bowel obstruction, and gallstones. Singh emphasized the importance of discussing treatment options’ risks and benefits with patients diagnosed with obstructive sleep apnea, with Zepbound now among the considerations.
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