Small Italian study links tirzepatide plus CPAP to better apnea control but lower CPAP use
A 20-patient study found tirzepatide plus CPAP improved weight and apnea control, but fewer patients stuck with CPAP — a small, unconfirmed signal patients on both treatments may want to watch.
Adding tirzepatide to continuous positive airway pressure (CPAP) treatment produced far greater weight loss and better sleep apnea control than CPAP alone in a 20-patient study, but CPAP adherence at six months was lower in the combination group — 60 percent versus 90 percent — according to a research letter published February 27, 2026 [1].
The letter appeared online in Diabetes, Obesity and Metabolism and is scheduled for the journal's May 2026 issue, volume 28, issue 5, pages 4391–4394 [1]. The authors are researchers in the Department of Systems Medicine at the University of Rome Tor Vergata; corresponding author Claudio Liguori is also affiliated with the Neurology Unit at the University Hospital of Rome Tor Vergata [1]. The letter was peer reviewed, and the authors declare no conflicts of interest [1]. Data are available from the corresponding author on reasonable request [1].
The patients in the study had obstructive sleep apnea along with obesity [1]. Those who received tirzepatide alongside CPAP lost substantially more weight and showed better control of their apnea than those treated with CPAP alone [1]. Tirzepatide is sold in the United States under the brand names Mounjaro and Zepbound [1].
The adherence result is the one that stands out. At six months, 60 percent of patients in the tirzepatide-plus-CPAP group were still adhering to CPAP, compared with 90 percent in the CPAP-only group [1]. The letter reports that the difference did not reach statistical significance in a sample this small, meaning chance could not be ruled out as the explanation [1].
The letter does not report why adherence differed between the two groups, and the study was not designed to answer that question [1]. Whether the pattern would appear in a larger group, whether it would last beyond six months, and whether it is connected to how much better participants felt on the drug have not been reported [1].
Why it matters for patients
CPAP does its job only while it is being used, and this study does not show tirzepatide replacing the machine. Everyone in the study had CPAP as part of treatment; the comparison was CPAP plus tirzepatide against CPAP alone [1].
For people who use both, the finding raises a practical question without answering it: losing weight and sleeping better might change how consistently someone keeps using CPAP. That possibility is suggested by the numbers, but a 20-patient letter is a signal rather than proof, and the difference was not statistically significant [1].
What happened to apnea control among the participants who used CPAP less is not reported in the letter [1]. So it is not known from this study whether the lower adherence in the combination group came at any cost to their sleep apnea outcomes.
Because the sample is so small, the results cannot predict what will happen for any individual patient, and the study reports no breakdown of who stayed on CPAP and who did not [1].
What happens next
The letter moves from online-first publication on February 27, 2026 into the journal's May 2026 print issue, volume 28, issue 5 [1]. The authors point to a larger randomized trial of tirzepatide for obstructive sleep apnea and obesity published in the New England Journal of Medicine in 2024 as background for their work [1].
The letter does not describe any planned follow-up study aimed specifically at CPAP adherence in patients taking tirzepatide, and no such trial has been disclosed in the letter [1].
Sources
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