Weight loss pills and injections are often touted as miracle drugs. Research shows that they can help you lose weight, better help you manage type II diabetes, and even reduce your risk of heart disease. But lately, a new buzz phrase has circulated: GLP-1 drugs for sleep apnea.
"Medications like these lead to weight loss, which helps to improve sleep apnea," explains Brian Wojeck, MD, MPH, an endocrinologist at Yale Medicine in New Haven, Connecticut. Tirzepatide, which is sold under the brand names Mounjaro and Zepbound, significantly improves sleep apnea symptoms, according to a 2024 study published in The New England Journal of Medicine.
Here’s a closer look at the four major GLP-1 drugs on the market (Ozempic, Mounjaro, Wegovy, and Zepbound):
Of these medications, only Zepbound and Mounjaro (known generically as tirzepatide) are FDA-approved to treat sleep apnea in those with a body mass index (BMI) of 30 or higher. Alternatively, Ozempic (known generically as semaglutide) was approved in 2017 by the FDA to treat type II diabetes. Semaglutide was then approved in 2021 under the brand name Wegovy for weight loss. While Wegovy and Ozempic aren't FDA-approved treatments for sleep apnea, sometimes doctor prescribe these drugs as "off-label" treatments, since people taking them often see their sleep apnea symptoms improve with weight loss.
Is Obesity Related to Sleep Apnea?
There’s a link between your weight and your risk of sleep apnea. A 10% weight gain raises your chances of getting sleep apnea six-fold, according to a 2024 paper published in Sleep Medicine Reviews.
"A higher body weight causes increased pressure on your upper airways," Wojeck says. "This makes them more likely to collapse and make it harder for you to breathe." People who are overweight are also more likely to hyperventilate, or breathe fast, he adds, which can worsen sleep apnea.
If you're overweight and have sleep apnea, one treatment option your doctor may consider is prescribing you a GLP-1 medication.
How GLP-1 Agonists Might Help With Sleep Apnea
Both semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) are GLP-1 agonists, which are medications that help to lower blood sugar levels and promote weight loss. Zepbound is the only one that's FDA-approved for sleep apnea, specifically among people with obesity (defined as a BMI of over 30). But both semaglutide and tirzepatide may help with sleep apnea with the following benefits:
Weight loss
People who take semaglutide for weight loss on average shed about 15% of their body weight within about 16 months. "We know that weight loss can significantly improve symptoms of sleep apnea," points out Atul Malhotra, MD, a sleep medicine specialist at UC San Diego Health. A 2024 study published by Malhotra in The New England Journal of Medicine found that up to half of people who took Zepbound for a year saw their sleep apnea improve to a point where they might even be able to stop their CPAP therapy.
Better breathing
Since semaglutide reduces the amount of fat tissue in the neck, it can open your airways and make it easier for you to breathe while you sleep, Wojeck says. "Weight loss may also slow down your breathing rate, so that you’re less likely to hyperventilate and cause some of the changes associated with sleep apnea," he adds.
Reduced sleep apnea symptoms
You may find that you feel more rested and sleep more soundly after you use a drug like Ozempic or Zepbound. The NEJM study found that patients reported significant improvements on their sleep scores. That means they fell asleep faster and felt like they got better-quality sleep. "The three pillars of health are diet, exercise, and sleep, and they all feed off each other," says Malhotra. "If you don’t sleep well, then it’s much harder to eat right and stay active. That makes it more difficult to manage your weight long term, which in turn makes it tougher to manage sleep apnea."
Will Insurance Cover Ozempic or Zepbound for Sleep Apnea?
Insurance most likely won’t cover Ozempic for sleep apnea, since that specific drug isn’t FDA-approved for it, Wojeck says. But your insurance may cover Zepbound if your doctor prescribes it for sleep apnea and you also have a BMI of 30 or higher. "Since it’s a relatively new medication, your insurance company may want you to first try another treatment for sleep apnea, like a continuous positive airway pressure (CPAP) machine," Wojeck says. But if that doesn’t help, or you find a CPAP hard to use, your insurance company may approve Zepbound as an alternative.
Your insurance company may still require that you get prior authorization before you can use Zepbound for sleep apnea. This usually means that your doctor has to write a letter that explains why you need it, Wojeck says.
GLP-1 Agonists for Sleep Apnea Considerations
It’s important to remember that Ozempic is not a direct treatment for sleep apnea. The only GLP-1 medication that is FDA-approved to treat sleep apnea is Zepbound; it likely does this by lowering your weight. "If you are not overweight, medications like semaglutide and tirzepatide likely won’t help you," Wojeck says. But it may work for you if you have one of the following conditions:
- A BMI of at least 30
- A BMI of at least 27 with another health-related condition like high blood pressure or diabetes
It’s critical that you talk to your doctor about the pros and cons of addressing sleep apnea with Ozempic or Zepbound. "GLP-1 agonists are not benign medications, and they have side effects,” Wojeck says. The most common ones are related to your gut, such as nausea, vomiting, diarrhea, constipation, and stomach pain. But more rarely, they can cause:
- Pancreatitis
- Diabetic retinopathy
- Kidney damage
- Gallbladder disease
- Very low blood sugar
Takeaways
Ozempic is known as a drug that treats type 2 diabetes and helps with weight loss, but it may also improve symptoms of sleep apnea. A similar drug called tirzepatide (Zepbound) was approved by the FDA in December 2024 to treat sleep apnea in people with a BMI of 30 or higher. It works indirectly to treat sleep apnea, since it helps you lose weight. In order to get it covered by insurance, you’ll need to have a diagnosis of both sleep apnea and obesity. These drugs do have side effects, so talk to your doctor to make sure they're the right option for you.
