If you or your partner spends every night strapped to a CPAP mask, you know how taxing that routine can be.
The hiss, the straps, the washing. Many people with obstructive sleep apnea give up and sleep without it.
Now two Phase 3 trials published in The New England Journal of Medicine suggest an experimental weekly injection may cut breathing interruptions sharply. The drug is retatrutide, from Eli Lilly.
In the higher-dose groups, 39 to 52 percent of participants reached normal breathing or only mild sleep apnea after 80 weeks of treatment. On placebo, roughly 12 to 24 percent did.
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What the Phase 3 trials actually tested
The two studies, called TRIUMPH-1-OSA and TRIUMPH-2-OSA, enrolled 691 adults in total.
All had moderate-to-severe sleep apnea and overweight or obesity (a body mass index of at least 27).
TRIUMPH-1-OSA included people without type 2 diabetes. TRIUMPH-2-OSA included people with it. Both were double-blind, randomized and placebo-controlled.
Participants got a weekly injection of retatrutide at 4, 9 or 12 milligrams, or a placebo, for 80 weeks. Researchers then measured the apnea-hypopnea index.
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That is the number of times a person stops breathing or breathes very shallowly each hour of sleep.
In TRIUMPH-1-OSA, the 9-milligram dose brought the index down by about 34 events an hour. The 12-milligram dose cut it by around 32. Placebo dropped it by about 10.
In TRIUMPH-2-OSA, the higher doses reduced the index by roughly 25 events an hour. That was about 15 more than placebo achieved.
Retatrutide also drove substantial weight loss. At the higher doses, mean weight loss reached between about 18 and 22 percent of body weight, compared with around 5 percent on placebo.
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How retatrutide differs from Ozempic and Zepbound
Retatrutide hits three hormone receptors at once, GLP-1, GIP and glucagon. The third target is thought to add extra fat-burning on top of the appetite suppression familiar from older drugs.
For comparison, semaglutide (the active ingredient in Novo Nordisk's Ozempic and Wegovy) targets GLP-1 alone. Tirzepatide, sold by Eli Lilly as Mounjaro and Zepbound, targets two of the three.
Sleep apnea has been a target for this drug class before.
Tirzepatide cut breathing disruptions by around 60 percent in an earlier Phase 3 trial of adults with obesity and obstructive sleep apnea.
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Retatrutide now joins that bench with larger weight loss and comparable gains on the breathing index.
What this may mean for CPAP users
Obstructive sleep apnea is estimated to affect close to a billion people worldwide. Many are prescribed a CPAP machine but struggle to stick with it.
A weekly injection that can shift someone from severe sleep apnea down to mild or none is a treatment worth raising with a doctor, not a self-prescription.
The trial was in adults with overweight or obesity, not the general snoring public.
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Side effects in both trials were mostly gastrointestinal, including nausea, diarrhea, constipation and indigestion. They were generally mild to moderate, in line with other GLP-1 drugs.
Retatrutide is still investigational and is not yet approved for any use.
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.