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 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 favourable shifts in airway physiology and ventilatory control. Glucagon-like peptide-1–based therapy may represent a promising treatment for obesity-related OSA, warranting further mechanistic studies.