The First Medication for Obstructive Sleep Apnea:

The FDA recently approved tirzepatide (brand name Zepbound) as the first-ever medication to treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity. This marks a big milestone in sleep medicine—but it also has important connections to dentistry.

Let’s break it down.

Why Dentists Should Care About OSA

Obstructive sleep apnea affects nearly 30 million Americans and is strongly tied to obesity. Beyond poor sleep, untreated OSA has ripple effects across the entire body—including the mouth.

• Periodontal Disease: OSA fuels inflammation, which doesn’t just affect the airway—it impacts gum health too. Since periodontal disease is also inflammatory, patients with OSA often have a higher risk.

• Xerostomia (Dry Mouth): Waking up with a dry mouth is common in OSA. Mouth breathing during sleep is the likely cause, creating an environment for cavities and gum disease.

• Sleep Bruxism: Studies show a strong link between OSA and teeth grinding. The repeated arousals during apneic events can trigger muscle activity, leading to tooth wear, TMJ issues, and fatigue.

What is Tirzepatide (Zepbound)?

Tirzepatide is a once-weekly injection originally developed for weight loss. It works by reducing appetite and slowing stomach emptying, helping patients feel full longer and eat less.

Now, Zepbound is also approved to treat OSA in adults with obesity. By helping patients lose weight, it reduces the severity of sleep apnea.

Side Effects of OSA (Beyond Sleep)

Untreated OSA is more than snoring—it’s a whole-body condition. It can lead to:

• Cardiovascular disease: Hypertension, arrhythmias, stroke, and even heart failure.

• Metabolic issues: Insulin resistance and type 2 diabetes.

• Daytime fatigue: Poor concentration, mood swings, and increased accident risk.

• Weight gain: Hormonal changes (like increased ghrelin) make weight management harder.

• Mental health impacts: Depression, anxiety, and reduced quality of life.

But… What About Tirzepatide’s Side Effects?

While this new option is exciting, it comes with risks. Reported side effects include:

• Nausea, vomiting, diarrhea, constipation, reflux, and abdominal pain.

• Serious warnings for thyroid tumors (in animal studies), pancreatitis, gallbladder disease, kidney injury, hypoglycemia, retinopathy, and even suicidal thoughts.

It’s also important to note: Zepbound is approved only for moderate to severe OSA in obese adults. And while weight loss improves OSA, it raises bigger questions:

👉 Is this a lifelong injection?
👉 Does it address the root causes of obesity, or only manage symptoms?

A Dentist’s Perspective: Looking Beyond Medication

While medications like tirzepatide open new doors, dentistry plays a unique role in addressing root causes of OSA.

• Airway development: A high or vaulted palate can contribute to OSA. Early orthodontic and airway-focused interventions may help.

• Myofunctional therapy: Research shows it can reduce apnea-hypopnea index (AHI) by ~50% in adults and ~62% in children, while also improving oxygen levels and reducing snoring.

• Oral appliances: For certain patients, mandibular advancement devices remain a trusted tool.

Final Thoughts

Tirzepatide represents a groundbreaking step in OSA treatment. But, we must remember that medications don’t replace the importance of addressing airway structure, oral habits, and lifestyle factors.

The future of OSA care will likely be interdisciplinary—where dentists, physicians, and patients work together to manage both the symptoms and root causes of this complex condition.

📚 Resources

• FDA Approval of Tirzepatide for OSA

• Bianchi, E. et al. Relationship between periodontal disease and OSA in adults: A systematic review. Dental Research Journal, 2024.

• Oksenberg, A. et al. Dry mouth upon awakening is a common symptom of OSA. Journal of Sleep Research, 2006.

• Doblado NG. et al. Relationship Between Bruxism and OSA: A Systematic Review. J Clin Med, 2025.

• Camacho M. et al. Myofunctional Therapy to Treat OSA: A Systematic Review and Meta-analysis. Sleep, 2015.

True wellness starts in your mouth.
Dr. Norma Cortez
Your Biological & Airway Dentist