TIRZEPATIDE IN THE MANAGEMENT OF OBSTRUCTIVE SLEEP APNEA ASSOCIATED WITH OBESITY: CURRENT EVIDENCE

Resumo

Introduction: Tirzepatide is an innovative drug approved by the U.S. Food and Drug Administration (FDA) for the treatment of type 2 diabetes mellitus (T2DM). This drug also demonstrates efficacy in weight loss, justifying its off -label use for the treatment of obesity. Obstructive sleep apnea (OSA) is characterized by respiratory disturbances during sleep, is associated with significant cardiovascular complications, and excess adiposity is a major risk factor for OSA. The benefit of substantial weight reduction in the treatment of patients with OSA is well recognized; therefore, tirzepatide, a dual agonist of GIP/GLP -1 receptors, offers a novel cardiometabolic strategy that goes beyond glycemic control, also promoting significant weight reduction. Objectives: To analyze recent scientific evidence on the use of tirzepatide as adjunctive therapy in obstructive sleep apn ea. Materials and Methods: A narrative literature review was conducted based on studies published in the PubMed database over the last 5 years. The search was performed using the descriptors "tirzepatide" and "obstructive sleep apnea". Original articles, clinical trials, systematic reviews, meta -analyses, and randomized controlled trials with a direct approach to the topic were included. Results: Current guidelines recommend a weight reduction of approximately 7% to 11% in patients with obstructive sleep ap nea (OSA), although this goal is often difficult to achieve with lifestyle interventions alone. Bariatric surgery has demonstrated significant benefits in reducing the severity of OSA in adults; however, due to its invasive nature and eligibility criteria, it is not a viable option for many obese patients. In this context, pharmacological therapies have gained prominence. Clinical studies have shown that tirzepatide promotes substantial reductions in body weight, in addition to improving relevant cardiometabolic factors such as blood pressure and inflammatory markers. More recently, clinical trials have shown that, in individuals with moderate to severe OSA associated with obesity, tirzepatide significantly reduces the apnea-hypopnea index (AHI), body weight, hypoxic load, and systolic blood pressure, as well as improving patient -reported outcomes related to sleep and quality of life. Although the observed benefits are substantial, it is not yet fully established to what extent the improvement in OSA is mediated directly by the pharmacological action of tirzepatide or secondary to significant weight loss. Conclusion: Tirzepatide, a new drug for metabolic intervention, has demonstrated promising clinical value in the management of OSA, expanding the therapeutic landscape for individualized treatment. However, further studies are needed to define the full role of tirzepatide in the adjunctive treatment of obstructive sleep apnea.