Tirzepatide reduced apnea-hypopnea index (AHI) by approximately 30 events per hour at 52 weeks in adults with moderate-to-severe OSA + obesity — the SURMOUNT-OSA trial. Approximately 50% of patients achieved disease remission. Basis for the December 2024 FDA approval of Zepbound for OSA — the first drug ever FDA-approved for OSA.
The evidence
SURMOUNT-OSA (NEJM 2024): AHI reduction −25.3 events/hr (tirzepatide) vs −5.3 (placebo) in PAP-naive cohort at 52 weeks. ~50% achieved OSA disease remission. ESS sleepiness scores substantially reduced. Two parallel cohorts: on PAP, and not on PAP.
FDA-approved labeling status
Zepbound FDA-approved for moderate-to-severe OSA in adults with BMI ≥30 (December 2024). First drug ever FDA-approved for OSA. Coverage varies by plan. On Medicare, people with moderate-to-severe sleep apnea are not eligible for the GLP-1 Bridge; Medicare.gov says their Part D plan might cover a GLP-1.
Practical considerations
Eligibility: moderate-to-severe OSA (AHI ≥15) AND BMI ≥30. PAP therapy can continue concurrently. Compounded tirzepatide is not interchangeable for the FDA-approved OSA indication — branded Zepbound is required for label-specific use.