Once-Nightly Oxybate Reduces Sleep-Related Eating, Samelisant Improves Excessive Daytime Sleepiness, Tirzepatide's Impact on OSA and Obesity

Welcome to this special edition of Neurology News Network. I'm Marco Meglio. This week’s episode is centered around the 2025 SLEEP Annual Meeting, held June 8-11 in Seattle, Washington.

Using retrospective chart reviews, findings from a small-scale, single-site analysis revealed that switching treatment to once-nightly sodium oxybate (Lumryz; Avadel Pharmaceuticals) was associated with improvements in sleep-related eating disorder (SRED) among patients with narcolepsy. SRED is a type of parasomnia characterized by episodes of involuntary eating and drinking that occur during partial arousals from sleep, often without full awareness or memory of the event. In the context of narcolepsy, SRED is more common and may be part of the broader disruption of sleep-wake regulation seen in the disorder. All told, treatment with ON-SXB resulted in resolution of SRED among all individuals within 6 months of the switch. More notably, 5 (63%) individuals experienced a reduction in body mass index (BMI) after switching to ON-SXB.

Findings from a phase 2 study (NCT04072380) testing investigational samelisant (Suven Life Sciences) as a monotherapy for patients with narcolepsy revealed that treatment with the agent led to a significant effect on excessive daytime sleepiness (EDS) in these patients. Overall, the data further support its development in a phase 3 study, expected to be initiated this quarter. In this randomized, proof-of-concept study of 190 patients with narcolepsy and EDS, treatment with samelisant led to a statistically significant decrease in the primary end point of Epworth Sleepiness Scale (ESS) scores over a 14-day period (P <.024). Relative to placebo, those on the agent had a clinically meaningful reduction of –2.1 points in total score.

A new post-hoc analysis of phase 3 trial data presented at the 2025 SLEEP Annual Meeting, held June 8 to 11, in Seattle, Washington, revealed that patients with moderate-to-severe obstructive sleep apnea (OSA) and obesity who were “moderately/very sleepy” and treated with tirzepatide (Zepbound; Eli Lilly and Company) generally showed greater improvements in sleep-related outcomes, particularly among those who did not use positive airway pressure (PAP) therapy. Presented by lead author Terri E. Weaver, PhD, RN, FAAN, ATSF, FAASM, Emerita Professor of Biobehavioral Nursing Science at University of Illinois Chicago College of Nursing, the analysis included 2 phase 3 studies (SURMOUNT-1, NCT04184622; SURMOUNT-2, NCT04657003) that assessed tirzepatide compared with placebo in patients with moderate-to-severe OSA and obesity. Study 1 included participants not using PAP therapy at baseline (N = 194), whereas Study 2 included participants who were on PAP therapy (N = 193).

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