Alternatives to CPAP
Weight Loss, GLP-1 Drugs and Zepbound for Sleep Apnea
On December 20, 2024 the FDA approved Zepbound (tirzepatide) as the first drug for moderate to severe obstructive sleep apnea in adults with obesity, used with a reduced calorie diet and more physical activity. Weight loss can lower sleep apnea severity, but do not stop CPAP on your own; your clinician should confirm improvement with testing.
What the FDA approved
The FDA's December 20, 2024 announcement says Zepbound (tirzepatide injection) was approved for moderate to severe obstructive sleep apnea in adults with obesity, to be used with a reduced calorie diet and increased physical activity. The FDA described it as the first drug treatment for this condition.
Zepbound is a prescription medicine given by injection. Whether it suits you depends on your weight, health history and other medicines, so it is a decision for you and your prescriber.
Safety warnings
The FDA lists warnings including thyroid C-cell tumors seen in rats (unknown in humans), with use not recommended for people with a personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2. Other risks include pancreatitis, gallbladder problems, low blood sugar especially with insulin or insulin stimulating drugs, acute kidney injury, diabetic retinopathy in people with type 2 diabetes, and suicidal thoughts or behavior.
It also warns about pulmonary aspiration during general anesthesia or deep sedation; tell your providers about planned procedures.
What it means if you use CPAP
Losing weight can reduce the pressure you need and your AHI, and for some people it can bring sleep apnea into the mild or resolved range. That does not happen for everyone.
Keep using CPAP while you lose weight. If you feel the pressure is too high or the mask is suddenly leaking because your face shape changed, tell your clinician and supplier. Only your clinician should change pressure or decide you can stop therapy, ideally after a repeat sleep test.
Other weight loss approaches
Diet, exercise and bariatric surgery are other routes. The AASM's 2021 surgical referral guideline recommends that clinicians discuss referral to a bariatric surgeon with adults with obstructive sleep apnea and obesity (BMI 35 or more) who are intolerant of or unwilling to use PAP.
Insurance coverage for weight loss drugs varies widely, including whether a plan covers them for sleep apnea. Ask your plan.
Frequently asked questions
Is Zepbound FDA approved for sleep apnea?
Yes. On December 20, 2024 the FDA approved Zepbound (tirzepatide) for moderate to severe obstructive sleep apnea in adults with obesity, alongside diet and physical activity.
Can I stop CPAP if I take Zepbound?
Not on your own. Your clinician should reassess you, usually with a sleep test, before you stop or change CPAP.
Does losing weight cure sleep apnea?
It can greatly improve it for some people, but not everyone. Airway anatomy and other factors also matter.
Will my CPAP pressure change if I lose weight?
Your needs may drop. Auto CPAP may adjust within its range, but changes to the prescribed range should come from your clinician.
Sources
Last reviewed October 11, 2026. How we research · Report an error