Earlier this year, Long Islanders dealing with sleep apnea overwhelmed the sleep center at St. Charles Hospital in Port Jefferson. The surge in inquiries followed the FDA’s approval of Zepbound, marking it as the first weight loss medication aimed at treating this condition.
“Patients were really curious about this,” mentioned David Warkentin, the system director for Catholic Health Sleep Service.
Fast forward six months, and while sleep experts believe Zepbound offers an encouraging treatment option, they caution it isn’t a magic solution for a disorder affecting around 30 million adults in the U.S., with about 80% of those undiagnosed.
“It really opens up a lot of new avenues for personalized sleep medicine,” he added.
WHAT TO KNOW
- Since its approval, Zepbound has spurred significant interest from Long Islanders regarding its potential to treat obstructive sleep apnea in certain patients with obesity.
- Experts assert that the drug can assist with weight loss, which might alleviate some symptoms of obstructive sleep apnea, but it isn’t a universal remedy.
- Consulting with sleep medicine specialists for evaluation before starting any new treatment is highly recommended for obstructive sleep apnea patients.
This development also highlights the increasing utilization of GLP-1 medications to manage chronic health issues like diabetes, weight control, and cardiovascular diseases. Experts indicate that weight loss can relieve some of the symptoms associated with obstructive sleep apnea—a condition where individuals cease breathing multiple times per night due to a blocked or narrowed airway caused by relaxed throat muscles.
The brain reacts to these interruptions by waking the individual to resume breathing, leading to a cycle that disrupts sleep and ultimately leaves them feeling fatigued through the day.
Dr. Gary Wohlberg, director of the South Shore University Hospital Sleep Center, noted that weight loss can ease fatty deposits in the airway, which may help prevent blockages during sleep. For patients who struggle with dieting and exercise, the medication might provide a much-needed boost. “But, you really need to change your behavior. It should go hand in hand with better nutrition and activity,” he emphasized.
On the other hand, Dr. Avram Gold, medical director of Stony Brook University’s Sleep Disorders Center, expressed skepticism about whether weight loss alone leads to sustainable improvements for those with obstructive sleep apnea.
“It can make a difference in how they feel,” he explained. “But it won’t bring them back to normal.”
Beyond just helping with weight loss, there might be other mechanisms at play with these drugs that could combat sleep apnea.
“There’s a theory that certain medications, especially Zepbound, might help reduce inflammation and enhance airflow,” added Wohlberg. Warkentin mentioned that researchers are also investigating whether the drug could have protective benefits for brain cells, possibly enhancing the brain’s ability to manage breathing while asleep.
However, accessing this medication can be tricky for patients. Many health insurance plans don’t cover weight-loss drugs, and those that do may require individuals to meet specific criteria regarding body mass index and chronic illnesses. For those paying out of pocket, the monthly cost is approximately $1,000, and just because Zepbound is authorized for treating sleep apnea doesn’t assure insurance coverage.
A patient’s experience
Diana Bonilla, 34, from Patchogue, was diagnosed with mild sleep apnea late last year. This condition, she noted, emerged as she gained weight with age.
Seeking alternatives to traditional treatments like CPAP machines—which require users to wear a mask that connects to a device delivering pressurized air—she decided to try weight loss. “I was at 203 pounds, and I’m only 4-foot-11, so that was quite a lot for me,” she shared.
After starting Zepbound in May 2024, she has shed weight down to 134 pounds. Bonilla, who works as an administrative assistant at Northwell Health, reported feeling more energetic, her husband noted her snoring has ceased, and follow-up tests showed no indications of sleep apnea.
“I think it’s the best thing that’s ever been invented,” she remarked about the medication. “But you also have to change your eating habits and aim for a healthier lifestyle.”
Warkentin and other experts in sleep medicine reiterated that Zepbound isn’t a “magic bullet” and emphasized the need to consider multiple health factors when determining treatment.
Not all individuals with obstructive sleep apnea are overweight; others may have physical characteristics like enlarged tonsils or tongue size that complicate breathing while sleeping. While shedding pounds can alleviate symptoms, thorough assessments and collaboration with specialists are crucial for formulating the right treatment plan. “People hope for a quick fix, but it’s actually a journey,” Warkentin observed. “It’s important to educate patients and manage expectations.”
Sleep apnea warning signs
Many individuals may overlook or fail to recognize the warning signs of sleep apnea, according to experts.
“Often, people attribute their tiredness and fatigue to various other factors,” remarked Dr. Andrew Namen, a pulmonologist and sleep apnea expert at Wake Forest University School of Medicine, citing that symptoms such as snoring, gasping, and choking during sleep should prompt a conversation with healthcare providers. “People often don’t realize it’s a serious condition, but it’s been linked to significant heart and stroke events.”
Gold believes there’s a connection between sleep apnea and chronic stress, noting associations with chronic fatigue, irritable bowel syndrome, and potentially long COVID. Some patients struggling with obesity have even pursued weight loss surgery to alleviate the pressure on their bodies that can hinder effective breathing during sleep.
For Eric Spronz, dealing with sleep apnea has been a persistent challenge in his life. Diagnosed with “REM behavior disorder” at age 14, he later faced weight issues, reaching 247 pounds. After a serious incident where he nodded off while waiting at a traffic light, he sought further help. Subsequent studies led him to use a CPAP machine and pursue bariatric surgery, along with a weight-loss drug that helped him lose 100 pounds.
Still in treatment due to the complex nature of his sleep disorders, doctors have indicated that he no longer requires the CPAP machine. However, he maintains that weight loss was just “one piece of the puzzle.” “It certainly isn’t a cure for sleep apnea,” he said.
