Daily weight loss pill could replace bulky CPAP machines for millions of sleep apnoea patients, experts say

Millions of sleep apnoea sufferers could swap bulky breathing machines for a weight loss pill, experts say, after a major trial found it slashed the heart risks linked to the condition. 

Obstructive sleep apnoea (OSA), which affects roughly eight million people in the UK, occurs when breathing repeatedly stops and starts throughout the night.

Patients may struggle with loud snoring, gasping or snorting during sleep, as well as excessive sleepiness or fatigue in the day.

In the long-term, obstructive sleep apnoea (OSA) can also cause severe strain to the body – significantly raising the risk of life-threatening cardiovascular and metabolic diseases.

Treatment for the condition is usually a CPAP machine, which uses mild air pressure through a mask to keep the airway open.

But while the device can reduce symptoms, it’s uncomfortable to wear, so nearly half of all people prescribed it either stop using it or never start.

Now, a new study – presented at the American Heart Association Scientific Sessions in Chicago – has found that overweight adults with moderate-to-severe OSA could instead treat symptoms with a daily weight loss pill. 

Participants who took the GLP-1 medication experienced around 18 fewer breathing interruptions an hour, researchers found. 

After one year, those taking the weight loss pill also saw significant improvements in blood oxygen levels, body weight, blood pressure and markers of inflammation, while reporting better sleep.

Orforglipron, produced by the makers of blockbuster weight loss jab Mounjaro, was given the green light by UK health officials in August, after a trial found that it could help users lose more than 12 per cent of their body weight in just 16 months.

However, the drug is not yet available on the NHS.

‘If approved to treat OSA, orforglipron could be a promising oral treatment option for people with overweight or obesity and this condition,’ said Dr Vaishnavi Kundel, director of the Sleep Fellowship at Ichan School of Medicine, NY, and the study’s lead author.

‘Untreated sleep apnoea frequently goes hand in hand with high blood pressure, which can strain the heart and blood vessels over time, leading to increased risk of heart disease and stroke,’ she added.

‘Even a modest decrease in blood pressure can help protect a patient’s heart and overall health.’

Previous research has shown that using continuous positive airway pressure (CPAP) can help lower blood pressure by up to three points.

In the new study, blood pressure fell by around seven points after a year on the weight loss pill.

Dr Kundel said: ‘That’s a meaningful blood pressure change that would have a positive impact on cardiovascular health for people with sleep apnoea.’

The international study involved two clinical trials of 712 adults with moderate-to-severe OSA and a body mass index of 27 or above – placing them in the overweight or obese category.

The first study looked at people who did not use CPAP therapy.

In the second, 349 current CPAP users stopped treatment for a week before undergoing sleep testing.

Half of the participants in each study were randomly assigned to receive the once-daily pill, while the remainder were given a placebo.

Neither the researchers nor participants knew which group they were assigned to.

Researchers conducted overnight sleep studies at the start of the trial, after 24 weeks and after one year, to measure how often participants’ breathing was interrupted due to either a partial or complete collapse of the airway during sleep.

Body weight, blood pressure and oxygen levels, were also monitored throughout the study.

Those taking orforglipron saw a much greater improvement in their sleep apnoea, with breathing interruptions falling by around 18 episodes an hour, compared with just five among those given a placebo.

The drug also significantly reduced the amount of times patients experienced dangerous drops in blood oxygen levels during sleep by up to 51 per cent.

These blood oxygen dips can trigger inflammation and damage blood vessels, further increasing the risk of high blood pressure, heart attack and stroke.

Participants taking orforglipron also lost around 11 per cent of their body weight over a year, versus just one to two per cent among those taking a placebo.

The most commonly reported side effects were nausea, diarrhoea and constipation, which were generally described as mild to moderate.

Researchers said the smaller improvements seen in the placebo group may have reflected modest weight loss, lifestyle changes and better adherence to existing treatments during the trial.

They stressed that the weight loss poll is not intended to replace CPAP therapy, but could provide another treatment option for patients who struggle to tolerate the device – potentially helping up to half of sleep apnoea sufferers.