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Study · Case report or series · n = 1 · 2026

4 results

Unexplained hypercapnia with normal pulmonary evaluation in a patient receiving semaglutide: a diagnostic challenge.

Prasad S, Ahuja A, Katwa LC, Sharma S, Parmar V, Agrawal S

JCEM case reports22 Apr 2026

PMID42027588 (opens in a new tab)PMCIDPMC13100657 (opens in a new tab)DOI10.1210/jcemcr/luag121 (opens in a new tab)PepBankPUB-42027588
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Summary

Glucagon-like peptide-1 (GLP-1) receptor agonists are widely used for the management of obesity; however, respiratory complications are rarely documented. A 40-year-old person without diabetes with obesity (body mass index [BMI] 36 kg/m2) developed excessive daytime sleepiness and morning headaches four weeks after semaglutide dose escalation to 1 mg per week. Arterial blood gas analysis revealed respiratory acidosis (pH 7.33 [reference range (RR): 7.35-7.45], partial pressure of arterial carbon dioxide [PaCO2] 56 mmHg [RR: 35-45 mmHg]) with a normal alveolar-arterial (A-a) gradient. A comprehensive evaluation excluded conventional causes of hypercapnia. Overnight capnographic monitoring using transcutaneous carbon dioxide (CO2) demonstrated sustained nocturnal hypercapnia without apneic events (Apnea-Hypopnea Index [AHI] < 5 events/hour), suggesting impaired central ventilatory drive rather than sleep-disordered breathing. Following semaglutide discontinuation and temporary noninvasive ventilation (NIV), symptoms resolved within 10 days. Arterial blood gas levels normalized at 3 weeks (pH 7.38, PaCO2 44 mmHg). The patient remained asymptomatic at the 3-month follow-up. This case demonstrates a previously uncharacterized association between semaglutide and reversible central respiratory depression. Clinicians should remain vigilant for unexplained hypercapnia in individuals receiving GLP-1 receptor agonists, particularly following dose escalation.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study4

4 results from studies that gave the peptide. 4 results from people.

  1. 01HumanCase report or seriesSafety outcome

    In a person with obesity without diabetes, excessive daytime sleepiness and morning headaches developed four weeks after semaglutide dose escalation to 1 mg per week.

    In plain wordsOne person with obesity developed daytime sleepiness and morning headaches four weeks after the semaglutide dose was raised.

    Peptide
    Semaglutide
    Outcome
    IncreaseExcessive daytime sleepiness and morning headaches
    Study

    n = 1

    Outcome group
    Adverse events · Respiratory
    Studied dose
    1 mg per weekAs given in this study (human).

    Source sentences

    Summary
    A 40-year-old person without diabetes with obesity (body mass index [BMI] 36 kg/m2) developed excessive daytime sleepiness and morning headaches four weeks after semaglutide dose escalation to 1 mg per week.
  2. 02HumanCase report or seriesSafety outcome

    In a person receiving semaglutide, arterial blood gas analysis showed respiratory acidosis with a PaCO2 of 56 mmHg and a normal alveolar-arterial gradient.

    In plain wordsIn one person taking semaglutide, blood tests showed too much carbon dioxide and acidic blood, with normal lung gas exchange.

    Peptide
    Semaglutide
    Outcome
    IncreaseRespiratory acidosis with raised PaCO2
    Study

    n = 1

    Outcome group
    Adverse events · Respiratory
    Studied dose
    1 mg per weekAs given in this study (human).

    Measurements

    PaCO2
    56 mmHg
    arterial blood gas
    pH
    7.33
    arterial blood gas

    Source sentences

    Summary
    Arterial blood gas analysis revealed respiratory acidosis (pH 7.33 [reference range (RR): 7.35-7.45], partial pressure of arterial carbon dioxide [PaCO2] 56 mmHg [RR: 35-45 mmHg]) with a normal alveolar-arterial (A-a) gradient.
    1 context sentence
    Summary · context
    A 40-year-old person without diabetes with obesity (body mass index [BMI] 36 kg/m2) developed excessive daytime sleepiness and morning headaches four weeks after semaglutide dose escalation to 1 mg per week.
  3. 03HumanCase report or seriesSafety outcome

    In a person receiving semaglutide, overnight monitoring showed sustained nocturnal hypercapnia without apneic events, suggesting impaired central ventilatory drive.

    In plain wordsIn one person taking semaglutide, overnight monitoring showed high carbon dioxide levels without breathing pauses.

    Peptide
    Semaglutide
    Outcome
    IncreaseNocturnal hypercapnia
    Study

    n = 1

    Outcome group
    Adverse events · Respiratory
    Studied dose
    1 mg per weekAs given in this study (human).

    Measurements

    Apnea-Hypopnea Index
    < 5 events/hour
    overnight monitoring

    Source sentences

    Summary
    Overnight capnographic monitoring using transcutaneous carbon dioxide (CO2) demonstrated sustained nocturnal hypercapnia without apneic events (Apnea-Hypopnea Index [AHI] < 5 events/hour), suggesting impaired central ventilatory drive rather than sleep-disordered breathing.
    1 context sentence
    Summary · context
    A 40-year-old person without diabetes with obesity (body mass index [BMI] 36 kg/m2) developed excessive daytime sleepiness and morning headaches four weeks after semaglutide dose escalation to 1 mg per week.
  4. 04HumanCase report or seriesSafety outcome

    In a person with hypercapnia, symptoms resolved within 10 days and arterial blood gas levels normalised at 3 weeks after semaglutide discontinuation and temporary noninvasive ventilation.

    In plain wordsIn one person, symptoms went away within 10 days and blood gases returned to normal after semaglutide was stopped and temporary breathing support was used.

    Peptide
    Semaglutide
    Outcome
    DecreaseResolution of hypercapnia after semaglutide discontinuation
    Study

    n = 1

    Outcome group
    Adverse events · Respiratory
    Studied dose
    1 mg per week · 3 weeks to 3 months follow-upAs given in this study (human).

    Measurements

    PaCO2
    44 mmHg
    3 weeks
    pH
    7.38
    3 weeks

    Source sentences

    Summary
    Following semaglutide discontinuation and temporary noninvasive ventilation (NIV), symptoms resolved within 10 days.
    2 context sentences
    Summary · context
    Arterial blood gas levels normalized at 3 weeks (pH 7.38, PaCO2 44 mmHg).
    Summary · context
    A 40-year-old person without diabetes with obesity (body mass index [BMI] 36 kg/m2) developed excessive daytime sleepiness and morning headaches four weeks after semaglutide dose escalation to 1 mg per week.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 2Current

    11 Oct 2026, 00:04 UTC

    Study results updated

  2. Version 1

    9 Oct 2026, 03:06 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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