CPAP or Zepbound? Patients, doctors debate sleep apnea treatment
June 9 (UPI) A clash is brewing between doctors and patients when it comes to treatment for sleep apnea in those with obesity, a new study reports.
Doctors favor treatment with continuous positive airway pressure, or CPAP, machines, researchers are slated to report this week at a meeting of the American Academy of Sleep Medicine. The machines keep airways open using mild air pressure provided through a mask patients wear while sleeping.
But patients would rather treat their sleep apnea with tirzepatide (Zepbound), a GLP-1 weight-loss drug, researchers found.
"The results highlight a need for real-world comparative effectiveness data of CPAP versus tirzepatide, and a potential mismatch between patient and provider preferences when managing comorbid obesity and obstructive sleep apnea," lead researcher Ahmed Khalaf said in a news release.
He's a sleep technician in the pulmonary, critical care and sleep medicine division at University of California-San Diego.
Nearly 30 million adults in the United States have sleep apnea, a disease in which the upper airway collapses during sleep, causing people to wake repeatedly.
CPAP has been considered the gold standard for treating sleep apnea, but some patients find the machines too bulky and noisy.
About 50% of people prescribed CPAP either can't use it often enough to matter or find it too bothersome, according to Harvard Medical School. Common problems include mask discomfort, dry mouth, breathing that feels out of sync and noise from the machine.
Late last year, the U.S. Food and Drug Administration approved Zepbound as the first drug to treat people with obesity and sleep apnea.
At the time, the sleep medicine society hailed the approval as "a positive development for patients and clinicians, who now have another treatment option for this sleep disorder," according to a statement from the academy.
But Zepbound is only for people with obesity and sleep apnea, the society noted. Also, Zepbound can reduce the severity of sleep apnea through weight loss, but might not cure the problem.
For the new study, researchers analyzed nationwide online survey data from 365 patients, and also spoke to 17 sleep medicine professionals at UCSD.
Doctors favored CPAP over Zepbound 53% to 26%, while patients favored Zepbound over CPAP 48% to 35%.
Both doctors and patients supported treatment that combined CPAP and Zepbound, but doctors were more enthusiastic about combination therapy, 88% versus 61%.
The patients' preferences are likely driven by their own experiences -- 78% said they were either current or former users of CPAP, results show.
By comparison, only 23% of patients said they'd ever used Zepbound or Ozempic (semaglutide), the other prominent GLP-1 drug.
Principal investigator Dr. Chris Schmickl, an assistant professor of medicine at University of California-San Diego, expressed surprise at the level of disagreement between patients and providers.
"Recognizing differing attitudes toward treatment is crucial for developing a realistic and achievable action plan," he said in a news release. "Additional research to understand the underlying reasons behind these preferences will offer valuable insights for providers to guide treatment decisions."
Researchers are scheduled to present these findings Wednesday at the society meeting in Seattle.
Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
More information
Harvard Medical School has more on managing CPAP problems.
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