Endotypic Trait Responses to 12-Month Tirzepatide Treatment for an Obese Patient with Obstructive Sleep Apnea: A Case...

Obesity is a major risk factor for obstructive sleep apnea (OSA), and weight loss induced by glucagon-like peptide-1 (GLP-1) receptor agonists has been associated with reductions in the apnea-hypopnea index (AHI).

We report a 35-year-old obese man with severe OSA who received tirzepatide for 12 months during the SURMOUNT-OSA trial. His body mass index decreased from 31.0 to 24.9 kg/m2, and AHI decreased from 54.8 to 4.4 events/h. Endotypic traits demonstrated improved upper airway patency, increased compensatory pharyngeal muscle responsiveness, reduced loop gain, and a lower arousal threshold, accompanied by paradoxically longer event duration.

This case suggests that tirzepatide improves OSA through weight loss as well as favorable shifts in airway physiology and ventilatory control. GLP-1-based therapy may represent a promising treatment for obesity-related OSA, warranting further mechanistic studies.