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Forumsβ€ΊTirzepatide (Mounjaro / Zepbound)β€ΊSURMOUNT-OSA: tirzepatide and sleep apnea AHI reduction

SURMOUNT-OSA: tirzepatide and sleep apnea AHI reduction

SleepDoc_PDX Tue, Mar 10, 2026 at 7:06 AM 12 replies 308 viewsPage 1 of 3
SleepDoc_PDX
Member
289
1,234
Sep 2024
Portland, OR
Mar 10, 2026 at 8:31 AM#1

Can we talk about the SURMOUNT-OSA results? Because they are genuinely life-changing for those of us with obstructive sleep apnea.

For those who haven't seen it:

SURMOUNT-OSA Trial Summary:

  • Population: Adults with moderate-to-severe OSA and obesity (BMI β‰₯30)
  • Two sub-studies: those not using CPAP/PAP at baseline (Study 1) and those using CPAP/PAP (Study 2)
  • Primary endpoint: Change in AHI (apnea-hypopnea index) from baseline

Key results (52 weeks):

EndpointTirz (max 15mg)Placebo
AHI reduction (Study 1)-25.3 events/hr-5.3 events/hr
AHI reduction (Study 2)-29.3 events/hr-5.5 events/hr
Patients achieving AHI <5 (mild/resolved)~42%~6%
Patients achieving AHI <15 (no longer moderate/severe)~62%~14%
Body weight reduction~18-20%~2%

42% of patients achieved AHI <5, which is essentially RESOLUTION of sleep apnea. I'm 54 years old and I've been on CPAP for 12 years. The idea that a weekly injection might let me ditch this machine is incredibly exciting.

Anyone else here with OSA on tirz? What's been your experience?

9 4pete_nash, hank_denver, carlos_SATX and 6 others
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sean_dublin
Member
212
890
Nov 2024
Dublin, IE
Mar 10, 2026 at 8:48 AM#2

Sleep medicine physician here. SURMOUNT-OSA is one of the most impactful obesity-related trials published in recent years, and I say that as someone who prescribes CPAP for a living.

Important clinical nuances:

  1. The AHI reductions are massive. A 25-point AHI reduction is the difference between severe OSA and normal. For context, CPAP typically reduces AHI to <5 when used properly, but adherence is terrible (~50% stop using it within a year). A medication-based approach that achieves this for 42% of patients is clinically transformative.
  2. This isn't just about the weight loss. The AHI improvements exceeded what would be predicted from weight loss alone, suggesting tirzepatide may have direct effects on upper airway physiology β€” possibly through reduction of pharyngeal fat deposition and/or anti-inflammatory effects on upper airway tissues.
  3. Quality of life metrics were also significantly improved β€” Epworth Sleepiness Scale, FOSQ (Functional Outcomes of Sleep Questionnaire), and patient-reported snoring all improved dramatically.
  4. Caveat: If you're on CPAP, do NOT stop it without a repeat sleep study and discussion with your sleep doc. Even if you feel better, untreated residual OSA can still increase cardiovascular risk.

I'm now having conversations with patients about tirzepatide as a potential CPAP exit strategy, which is something I never thought I'd say.

β€” Board-certified in sleep medicine and pulmonology

2 11sean_dublin, hannah_MT
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Dr.SleepRoch
Senior Member
1,123
5,678
Apr 2024
Rochester, MN
Mar 10, 2026 at 9:05 AM#3

I am one of those success stories. Started tirz 8 months ago at BMI 38 with moderate OSA (AHI 22). Lost 52 lbs, did a repeat home sleep test last month β€” AHI is now 3.8. THREE POINT EIGHT. My sleep doctor said I can stop CPAP.

I cried in his office. I literally cried. I've hated that machine for 6 years. The mask marks, the dry mouth, the hose getting tangled, the noise, traveling with it... all gone.

I sleep better now without CPAP than I ever did with it. My husband says I don't snore anymore. I wake up feeling actually rested instead of just "less terrible."

This drug changed my life. I know that sounds dramatic but it's the truth.

46 4Dr.NephBHM_UK, kim_atl_prep, sarah_TO and 43 others
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rick_sfbay
Member
289
1,234
Jan 2025
San Francisco, CA
Mar 10, 2026 at 9:22 AM#4

Michelle that's incredible and exactly what I'm hoping for. Can I ask what dose you're on and how quickly the sleep improvements started?

Last edited: Mar 10, 2026 at 3:22 PM
2 2FranDenver, Dr.BariatricHTX
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adam_van
Member
212
890
Nov 2024
Vancouver, CA
Mar 10, 2026 at 9:39 AM#5

I'm at 12.5mg. The sleep improvements were noticeable pretty early β€” probably by month 2-3, even before major weight loss. My husband noticed the snoring reduced first, then I started waking up feeling more refreshed. By month 4 I was "forgetting" to put on my CPAP because I was sleeping so well without it (I know, bad, don't do this before getting tested).

The home sleep test at month 7 confirmed what I was feeling. Went from AHI 22 to 3.8. Repeat oximetry was normal too β€” no desaturations below 90%.

49 6hyun_seoul, jim_asheville, matt_MKE and 46 others
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