Does Zepbound replace CPAP?

No. CPAP remains the gold standard treatment for OSA. Zepbound addresses a root cause—obesity—but CPAP should not be discontinued without medical supervision and repeat sleep studies.

Is Zepbound safe for patients with sleep apnea?

Yes. Safety was consistent with previous tirzepatide studies. The most common side effects were gastrointestinal. Warnings include thyroid C-cell tumors, pancreatitis, gallbladder disease, and aspiration risk with anesthesia. Supervised use is essential.

Tirzepatide & Sleep Apnea

Name: Zepbound (tirzepatide) for Obstructive Sleep Apnea
Creator: Dr. Joshua Silva, MD

Joshua Silva, MD
Oct 10
3 min read

On December 20, 2024, the FDA approved Zepbound (tirzepatide) as the first medication indicated to treat moderate-to-severe obstructive sleep apnea in adults with obesity. The approval was based on the SURMOUNT-OSA trials, which showed significant reductions in apnea–hypopnea index (AHI), body weight, hypoxic burden, and systolic blood pressure. For patients in Utah, this represents a major breakthrough—a therapy that can address both weight and sleep apnea in one treatment plan.

Zepbound tirzepatide FDA-approved treatment for obstructive sleep apnea in adults with obesity — SURMOUNT-OSA trial results. — Zepbound approved for Obstructive Sleep Apnea

How does Zepbound (tirzepatide) help sleep apnea?

Zepbound (tirzepatide) works by targeting GLP-1 and GIP receptors, which suppress appetite, improve insulin sensitivity, and lead to substantial weight loss. Since obesity is the strongest risk factor for obstructive sleep apnea (OSA), weight reduction improves airway stability and reduces the number of apnea and hypopnea events during sleep. In the SURMOUNT-OSA trials, tirzepatide not only reduced body weight but also lowered apnea–hypopnea index (AHI), hypoxic burden, and systolic blood pressure — all of which contribute to better sleep quality and heart health.

Who qualifies for Zepbound’s (tirzepatide) sleep apnea indication?

The FDA approved Zepbound (tirzepatide) on December 20, 2024 for adults with obesity (BMI ≥30) and moderate-to-severe obstructive sleep apnea.

“Moderate-to-severe OSA” is generally defined as an AHI ≥15 events/hour.
Candidates do not need to have diabetes to qualify.
Zepbound is prescribed as part of a supervised weight management program.

Does Zepbound (tirzepatide) replace CPAP?

No. CPAP (continuous positive airway pressure) remains the gold standard therapy for moderate-to-severe OSA because it mechanically keeps the airway open during sleep. However, many patients struggle with CPAP adherence. Zepbound offers a new option that addresses a root cause of OSA: excess weight.

Some patients may be able to reduce or discontinue CPAP after weight loss on tirzepatide, but this should only be done under medical supervision and after repeat sleep studies confirm improvement.

What were the SURMOUNT-OSA trial results?

The SURMOUNT-OSA Phase 3 program included two randomized controlled trials published in the New England Journal of Medicine (2024):

AHI reduction: Tirzepatide lowered apnea–hypopnea index (AHI) by 20–25 events/hour more than placebo at 52 weeks.
Weight loss: Participants lost ~18–20% of body weight on tirzepatide vs ~2% on placebo.
Hypoxic burden: Time spent with low oxygen saturation was cut nearly in half.
Blood pressure: Systolic BP decreased by 7–10 mmHg.

These results led directly to FDA approval as the first drug specifically indicated for OSA with obesity.

Is Zepbound (tirzepatide) safe for patients with sleep apnea?

Yes — safety was consistent with prior tirzepatide studies. The most common side effects were gastrointestinal (nausea, diarrhea, constipation, vomiting, GERD). Warnings include:

Thyroid C-cell tumors (do not use if personal/family history of medullary thyroid carcinoma or MEN2).
Pancreatitis and gallbladder disease (seek care if severe abdominal pain develops).
Anesthesia risks: As with other GLP-1s, slowed gastric emptying may increase aspiration risk.

Patients with OSA often have cardiovascular risks, so Zepbound’s improvements in blood pressure, weight, and oxygenation are considered clinically meaningful.

Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice.

Ready to explore Zepbound for weight loss and sleep apnea? Book a consultation at Potere Health MD in St. George or Cedar City, Utah today.

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About the Author

Dr. Joshua Silva, MD, is a licensed physician and Medical Director of Potere Health MD. He completed residency training in Occupational and Environmental Medicine from the University of Utah and now specializes in evidence-based weight management, including GLP-1/GIP therapies (semaglutide, tirzepatide). Dr. Silva provides in-person and virtual care for patients throughout Utah.