Endotypic trait responses to 12-month tirzepatide treatment for an obese patient with obstructive sleep apnea: a case report.

INTRODUCTION: 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). CASE PRESENTATION: 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. CONCLUSION: 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.