NEJM Publishes the Retatrutide Sleep Apnea Trials (October 21, 2026)

The New England Journal of Medicine published the retatrutide sleep apnea trials on October 21, 2026, and the NEJM paper shows every dose cutting apnea events well beyond placebo. In people without diabetes, events fell by 34.3 an hour on 9 mg and 31.7 on 12 mg, against 9.9 on placebo, after 80 weeks. This retatrutide sleep apnea NEJM paper is by Grunstein and colleagues.

What follows is what the paper's abstract reports and how it changes the earlier numbers. The condition itself, and how retatrutide compares with treatments you can get now, is on the retatrutide for sleep apnea page.

Two trials inside the TRIUMPH program

The paper covers two double-blind Phase 3 trials nested in larger basket trials. TRIUMPH-1-OSA enrolled 243 people with moderate-to-severe obstructive sleep apnea and no diabetes, inside TRIUMPH-1. TRIUMPH-2-OSA enrolled 448 people with sleep apnea and type 2 diabetes, inside TRIUMPH-2. Everyone had a BMI of 27 or more.

On average they started at 58.6 and 55.9 events per hour on the apnea-hypopnea index (AHI), the count of breathing pauses and shallow breaths per hour of sleep. Average weight was 119.6 kg and 115.9 kg.

The retatrutide sleep apnea NEJM results by dose

The main analysis uses a hybrid-treatment estimand. Change in AHI at 80 weeks, in events per hour:

Against placebo, the differences were -13.0, -24.4 and -21.9 in TRIUMPH-1-OSA and -8.9, -14.4 and -15.1 in TRIUMPH-2-OSA. The confidence interval that comes closest to zero, -15.9 to -2.0 for 4 mg in the diabetes trial, still stays below it. The everyone-randomized (ITT) differences are close: -13.2, -24.7 and -22.5, then -8.8, -13.9 and -15.0.

Weight was a key secondary endpoint. On the treatment-regimen estimand it fell by 12.5% to 22.2% across doses in TRIUMPH-1-OSA and 12.1% to 18.5% in TRIUMPH-2-OSA, against 4.8% and 5.6% on placebo.

How this changes the June numbers

In June, Lilly's ADA release said AHI fell by "up to" 36.1 events per hour (60.6%) in the TRIUMPH-1 sleep apnea group. That figure used the efficacy estimand and picked the best arm, with no placebo value beside it. The NEJM paper gives every arm, the placebo result and a different estimand, so the 34.3 and 36.1 figures aren't two versions of one number. Quote them with their labels, or quote the paper.

Our read: on the 9 mg figure, someone starting at about 58 events an hour would end near 24 on average (our arithmetic), which is a lot fewer pauses a night. In people with type 2 diabetes, the drop beyond placebo on 9 mg and 12 mg was about 60% to 70% as large (our arithmetic).

What isn't known yet

We read the abstract. The side effect tables, how many people stopped treatment and any results by sex are in the full text, which we haven't checked. Nobody has compared retatrutide with tirzepatide for sleep apnea, although Zepbound's label already lists 10 mg and 15 mg maintenance doses for it. That's tirzepatide, an approved option, not retatrutide data.

What happens next for sleep apnea

In its August 5, 2026 earnings filing with the SEC, Lilly said its clinical data package was complete to support registrations for obesity, obstructive sleep apnea and knee osteoarthritis pain. Lilly last said, on September 29, 2026, that it plans to submit retatrutide to the FDA in the first quarter of 2027 as a Biologics License Application (BLA). On October 2, 2026, the FDA decided that retatrutide is a drug, not a biological product, so an application would need to be filed under section 505 of the Federal Food, Drug, and Cosmetic Act. Lilly's appeal on that question is pending in the Seventh Circuit, and we found no ruling as of October 31, 2026.

No approved version exists yet, so nothing listed as retatrutide for sale is the drug these trials tested. If you snore heavily or stop breathing in your sleep, a sleep study and the treatments available now are the place to start. The ADA 2026 news page has the first look at these trials.