Weight loss drug trial claiming to reduce Sleep Apnea. Hmmm?

I am a faithful cpaper so it doesn't affect me. Even if this drug works I won't be taking it, but it does offer hope for those who might feel otherwise.

This Eli Lilly study *sounds* impressive if true.

"The researchers found that after 52 weeks, Zepbound had led to an average reduction of 27.4 events per hour in people who were not on PAP machines, compared to a reduction of 4.8 events per hour for people on the placebo. In people who did use PAP machines, Zepbound led to an average reduction of 30.4 events per hour, compared to an average reduction of 6 events per hour for the placebo group."

https://www.msn.com/en-us/health/other/ ... r-BB1lLIT2

Arlene1963 wrote: ↑

Wed Apr 17, 2024 8:26 am

. . .
In people who did use PAP machines, Zepbound led to an average reduction of 30.4 events per hour, compared to an average reduction of 6 events per hour for the placebo group."
. . .

This statement better serves as evidence that cpap settings are customarily WRONG.
Many of us have no need for smoke and mirrors; having set our machines thoughtfully.

I don’t see this as an alternative to CPAP anyway - reducing events by 60% is great, but that leaves the other 40% that need to be treated. Also, the testing was only on people that qualified as obese, so is not applicable to the rest of the sleep apnea population. Add in the side effects of the medication, and I doubt this will turn out to be much of a real solution.

It’s a shame there can be such a stigma attached to using the machine.

From the subject article:

In both trials, people on Zepbound lost, on average, around 20% of their body weight, which Lilly suspects contributed to the reduction in sleep apnea events.

Most likely, the immediate cause was the weight loss.

In people who did use PAP machines, Zepbound led to an average reduction of 30.4 events per hour, compared to an average reduction of 6 events per hour for the placebo group.

That makes no sense.

In participants with obesity or overweight, withdrawing tirzepatide (Zepbound) led to substantial regain of lost weight, whereas continued treatment maintained and augmented initial weight reduction. https://pubmed.ncbi.nlm.nih.gov/38078870/

In other words, you have to take this drug the rest of your life to maintain the weight loss.

NoOnesPerfect wrote: ↑

Wed Apr 17, 2024 11:00 am

It’s a shame there can be such a stigma attached to using the machine.

No stigma for me. I just tell them, "You look like you could benefit from using CPAP."

ChicagoGranny wrote: ↑

Wed Apr 17, 2024 11:24 am

From the subject article:

In both trials, people on Zepbound lost, on average, around 20% of their body weight, which Lilly suspects contributed to the reduction in sleep apnea events.

Most likely, the immediate cause was the weight loss.

Of course. Results were taken at 52 weeks... see below.

In people who did use PAP machines, Zepbound led to an average reduction of 30.4 events per hour, compared to an average reduction of 6 events per hour for the placebo group.

That makes no sense.

They were tested bare-knuckle, no PAP. Placebo has a strong effect, eh? That's why we control for it.

Here's the Lilly release, much better info than MSM's take, dated today:

https://investor.lilly.com/news-release ... two-thirds

This is preliminary... peer review coming. Same drug as Mounjaro in USA... I'm on it... lost 10lbs so far... very hard to get the higher doses above 10mg. Yes, it will be a much more significant lifetime maintenance expense than CPAP. Here in USA they should just add it to the water.

If the placebo resulted in a "5.0% [reduction in AHI] from baseline," shouldn't they first try giving patients twenty times more placebo?

Mounjaro IS saving lives.

But all that may end soon if we can't find a way to make enough of the stuff to sell at a high enough price to bankrupt the entire health system.

Oh, wait. Never mind.

lazarus wrote: ↑

Wed Apr 17, 2024 7:54 pm

If the placebo resulted in a "5.0% [reduction in AHI] from baseline," shouldn't they first try giving patients twenty times more placebo?

Homeopathy teaches us that *dilution* increases strength... until, of course, there are no molecules left, at which time the concoction becomes dangerous! I believe there's a horse saddle involved in there somewhere... and how to dilute a placebo?

Mounjaro IS saving lives.

But all that may end soon if we can't find a way to make enough of the stuff to sell at a high enough price to bankrupt the entire health system.

Oh, wait. Never mind.

The folks getting the big doses are paying top dollar. It's the schmucks like me that can't get the 12.5's and 15's.

Weight loss definitely works for some people in reducing or eliminating OSA. If it does, the trick is to maintain the weight loss long term. And those drugs have some nasty side effects, not sure how much has been studied truly long-term (20 - 30 years???). We are learning a lot of drugs we THOUGHT were benign as far as adverse effects are turning out to not be so benign after all.

For some people though, weight loss is not enough. If I could reduce my untreated AHI by even 30 events per hour, I'd STILL have very severe OSA.

Kind of reminds me of the hype for some OSA surgeries being "successful" where "successful" is defined by reducing your AHI by 50%. Still not enough for most people to get off CPAP.

I can't explain everything those drugs do. (Can anyone?) But I can describe what Ozempic and Mounjaro feel like, for me.

They give me the sensation of clarifying the discussion between my so-called gut-brain and my motivation center.

Before, when my body craved a particular food, the message I would get from my belly after I ate it was "hmm, not sure I got what I wanted/needed from that, so have some more."

Now if, for example, I crave an orange and eat an orange, the message I get is "thanks, we got just what we needed down here; so you can stop."

For me, I perceive the benefit in slowing the entire digestion process down as being that of giving my body the time it needs to extract the nutrients it wants beyond just calories.

Is that really what happens or how it all actually works? I don't know. No one does. Yet. I certainly don't think that was the original thought process or intent of those who discovered the effects. I am only describing what it feels like to me--a communication clarifier and digestion modifier that allows me some ease and relief in making healthier food and portion choices without having to deal with the noise of a confused and needy digestion system.

I feel similar sensations both from Ozempic and from Mounjaro. I have only taken them for Type 2 diabetes but have lost about 50 pounds from my nearly six-foot-three-inch frame as a welcome side-effect.

It took a while before my gut adapted to each drug, but it was worth it to me to allow that adaptation to happen.

And every drug can have unwanted effects over time, just as a knowledgeable poster stated above, so I hope a better approach comes along soon so I won't have to poke holes in my skin every week.

Mileages vary according to drive habits, weather, and terrain.

Both drugs increase insulin production and in the process slow down digestion. They do it in somewhat different ways.

"In people who did use PAP machines, Zepbound led to an average reduction of 30.4 events per hour, compared to an average reduction of 6 events per hour for the placebo group."

Since the reduction of AHI was ~60% in the Zepbound pappers, this equates to AHI of 75 prior to treatment. So these patients had pretty severe OSA while on CPAP before taking the drug? Does not make a lot of sense.

Will need to see the raw numbers in a scientific article before making any kind of conclusions.

Apnea vs weight loss--isn't this a chicken vs egg debate?
It disturbs me that so many "cpap alternatives" are nothing more than the product of
99% greed vs 1% science.

Will be interesting to follow all this. While testing after losing weight showed my OSA just marginally improved, the benefits of losing weight have gone far beyond sleep apnea. Enjoying reading the experiences with the meds. Got a family member on one of them. Back in the mid 2000s when one of the earlier diabetes drugs reported to cause weight loss, Byetta, came out, my doc put me on it. Being on steroids for months had blown my weight up. I did lose weight with it in combo with going off the steroids, but every time I ate I was sitting on the toilet with my head hanging in the waste can. Everything came out both ends as soon as I ate it. When my doc last year offered to prescribe one of the newer meds for me I was afraid to take a chance. Besides, I had already lost over 60 lbs and my A1C was 5.4 and I was afraid it would make my sugar too low. I wonder about non-diabetics who take it for weight loss - isn't that a possibility for them? Knowing the difference in how I feel without so much excess weight, if I were to ever find myself getting out of hand again and unable to stop it with other efforts, I think I'd risk trying the meds if my sugar qualified me for insurance coverage. One of my greatest regrets is not doing something about my weight before it broke my body down. Seeing so many TV personalities losing weight and guessing this is the route they are going. I'm just glad they have found something to help them. Losing weight can feel so overwhelming.