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Weight related medicines. Because excess weight narrows the airway, the medicines that produce large weight loss also reduce apnea. Tirzepatide is approved; Lilly's eloralintide and Amgen's maridebart cafraglutide are in Phase 3 trials for sleep apnea, at dozens of sites in the US and Canada.
Pills that act on the airway. AD109, a combination that keeps throat muscles active during sleep, is under FDA review after two Phase 3 trials. Other studies test acetazolamide, a decades old medicine, alone or combined with dronabinol, for people whose apnea is not driven by weight.
Nerve stimulation implants. Hypoglossal nerve stimulation, an implant that moves the tongue forward with each breath, has been approved since 2014 for people who cannot use CPAP. Trials now test newer devices that stimulate more than one nerve, combinations with surgery, and pairing stimulation with medicine.
Making CPAP work better. Apps and coaching programs that help people keep using CPAP, which remains the most effective treatment when it is actually worn.
Low tech and positional approaches. Breathing and swallowing exercises, oral appliances, and devices that keep people off their back, tested for mild to moderate apnea.
Children. Studies of airway devices and of surgery combinations for children whose apnea persists after tonsil removal.
CPAP works, but many people stop using it. The approved alternatives are oral appliances fitted by a dentist for mild to moderate apnea, hypoglossal nerve stimulation for people with moderate to severe apnea who cannot tolerate CPAP, surgery in selected cases, and, since December 2024, tirzepatide for people with obesity. In its two trials of 469 adults, tirzepatide cut the number of breathing interruptions per hour substantially compared with placebo. Medicare Part D plans may cover it when it is prescribed for sleep apnea rather than for weight alone. The pipeline is where the change is: if AD109 is approved, it would be the first pill for sleep apnea that does not depend on weight loss, and it is being studied in people with and without obesity.
Almost every treatment trial requires a diagnosis of obstructive sleep apnea confirmed by a sleep study, usually moderate to severe, measured as 15 or more breathing interruptions per hour. Medicine trials for weight related drugs require a BMI in a set range and exclude some medical conditions; trials of airway pills often want people who are not using CPAP or are willing to pause it, and some exclude people with obesity because they target a different cause. Implant trials require that CPAP has failed and that the anatomy of the airway is suitable, checked with a scope. CPAP adherence studies enroll people already prescribed CPAP. Most drug trials are placebo controlled, so no one is promised the study medicine. Eligibility always varies by study.
Not yet diagnosed? Our guide explains how sleep studies work.
Not yet an approved one that works directly on the airway. AD109, taken once at bedtime, is under FDA review. Tirzepatide is an approved injection that treats sleep apnea by reducing weight. Trials of other pills, including acetazolamide combinations, are recruiting.
Some studies offer compensation for time and travel, and study medicines, devices, sleep studies, and visits are typically provided at no cost to participants. Compensation varies by trial and is always described during the informed consent process before you agree to anything.
Curious whether clinical trials pay participants? Here's how compensation actually works.
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