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ForumsTirzepatide (Mounjaro / Zepbound)Tirzepatide body composition: SURMOUNT-1 DEXA substudy data — what worked for you?

Tirzepatide body composition: SURMOUNT-1 DEXA substudy data — what worked for you?

JessicaM_2024 Sun, Nov 2, 2025 at 8:30 AM 10 replies 956 viewsPage 1 of 2
JessicaM_2024
Member
823
3,456
Mar 2024
Portland, OR
Nov 2, 2025 at 9:55 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 ≥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?

44 8james_edin, FranDenver, Dr.BariatricHTX and 41 others
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Dr.PathRoch
Member
456
2,123
Jun 2024
Rochester, MN
Nov 2, 2025 at 10:12 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 — 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 — 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.

— Board-certified in sleep medicine and pulmonology

5 8InsuranceTom, WendyG_ATL, SaraMom3 and 2 others
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SarahChen_PharmD
VIP Member
4,567
22,341
Dec 2023
San Diego, CA
Nov 2, 2025 at 10:29 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 — 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.

13 4paul_denver, TinaHashiRN, robert_kc and 10 others
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labquiet_amy
Senior Member
1,234
6,789
Mar 2024
Cambridge, MA
Nov 2, 2025 at 10:46 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?

14 15bri_stats, pete_manc_UK, anna.melb_AU and 11 others
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DebRD_ATL
Senior Member
1,678
7,890
Feb 2024
Atlanta, GA
Nov 2, 2025 at 11:03 AM#5

I'm at 12.5mg. The sleep improvements were noticeable pretty early — 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 — no desaturations below 90%.

Last edited: Nov 2, 2025 at 3:03 PM
26 14HealthEcon_DC, PedsEndoPhilly, SleepDoc_PDX and 23 others
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