Tirzepatide for Obstructive Sleep Apnea: A Novel Therapeutic Promise and the Perioperative Considerations

Indian J Otolaryngol Head Neck Surg. 2025 Jun;77(6):2430-2432. doi: 10.1007/s12070-025-05485-6. Epub 2025 Apr 28.

Abstract

Obstructive sleep apnea (OSA) is a prevalent global health issue, with recent advances in pharmacotherapy expanding treatment options. Tirzepatide, a dual GLP-1 and GIP receptor agonist, has been newly approved by the FDA for managing moderate to severe OSA, following promising results from major randomized trials. Initially indicated for type 2 diabetes mellitus, Tirzepatide promotes glycemic control and weight loss through incretin-mediated insulin secretion and appetite suppression. As its use becomes more widespread, perioperative physicians and head-neck surgeons must be familiar with its pharmacokinetics and associated risks. Notably, delayed gastric emptying, a dose-dependent side effect, raises concerns of pulmonary aspiration during general anesthesia. Preoperative gastric ultrasound, diet modification, and individualized glycemic management are recommended strategies. Given the limited high-quality data, a multidisciplinary, institution-specific approach remains essential in managing patients on Tirzepatide in the perioperative setting.

Keywords: Gastroparesis; Glucagon-like peptide 1; Sleep apnea, obstructive; Tirzepatide.