Tirzepatide cut the number of breathing pauses during sleep roughly in half. In the two SURMOUNT-OSA trials it fell by 50.7 and 58.7 percent after a year, against 3.0 and 2.5 percent on placebo. In 42 to 50 percent of people on tirzepatide, sleep apnoea fell back to a mild form without daytime sleepiness or disappeared. Body weight fell by 17.7 and 19.6 percent at the same time. If you snore, wake up tired and struggle with excess weight, below are all the numbers from this trial.
What is sleep apnoea and what does it have to do with weight?
Obstructive sleep apnoea is a breathing disorder during sleep in which the airway collapses and interrupts breathing. The pauses lower oxygen in the blood and disturb sleep, although we usually do not remember them. Sleep apnoea is also linked with serious complications of the heart and blood vessels.
The severity of apnoea is measured with the AHI, the number of pauses and shallow breaths per hour of sleep. The American Academy of Sleep Medicine regards a score of 15 or more as clinically significant. Excess body fat is one of the causes of the disease, which is why tirzepatide was tested in people with obesity.
How was the SURMOUNT-OSA trial run?
SURMOUNT-OSA consists of two phase 3 trials in 469 adults with obesity and moderate or severe sleep apnoea. They ran from June 2022 to March 2024, and the results were published in the New England Journal of Medicine. None of the participants had diabetes.
- Trial 1: 234 people who did not use a CPAP machine, a mask that delivers air under pressure.
- Trial 2: 235 people who used CPAP throughout the trial.
- Dose: the highest dose tolerated by the participant, 10 mg or 15 mg of tirzepatide once a week, for 52 weeks.
- Measurement: a sleep study in a laboratory, polysomnography, at the start, at week 20 and at week 52.
At the start the mean AHI was 51.5 and 49.5 per hour, more than three times the entry threshold. Mean body mass index was over 38, and participants weighed about 115 kg on average.
How much did the number of breathing pauses fall?
After a year the number of pauses fell by 25.3 per hour in trial 1 and by 29.3 in trial 2. On placebo the fall was 5.3 and 5.5 per hour. The table collects the main results of both trials.
| Result after 52 weeks | Trial 1, tirzepatide | Trial 1, placebo | Trial 2, tirzepatide | Trial 2, placebo |
|---|---|---|---|---|
| Change in AHI per hour | minus 25.3 | minus 5.3 | minus 29.3 | minus 5.5 |
| Change in AHI in percent | minus 50.7 | minus 3.0 | minus 58.7 | minus 2.5 |
| AHI down by at least half | 61.2 percent of people | 19.0 percent of people | 72.4 percent of people | 23.3 percent of people |
| Mild apnoea without sleepiness or resolution | 42.2 percent of people | 15.9 percent of people | 50.2 percent of people | 14.3 percent of people |
| Change in body weight | minus 17.7 percent | minus 1.6 percent | minus 19.6 percent | minus 2.3 percent |
The authors judged this fall clinically meaningful, because halving the AHI is regarded as such. The last row of the table shows that tirzepatide brought a weight loss in the high teens of percent, while placebo brought almost none.
In how many people did sleep apnoea almost disappear?
Sleep apnoea fell back to a mild form or disappeared in 42.2 percent of people in trial 1 and 50.2 percent in trial 2. The researchers counted people with an AHI below 5 per hour here. They also counted people with an AHI of 5 to 14 who no longer had excessive daytime sleepiness.
Sleepiness was rated on the Epworth scale, on which a score of 10 points or less is normal. On placebo only 15.9 and 14.3 percent of people reached such a result. The chance of a clear improvement was therefore about three times higher on tirzepatide.
What else improved besides breathing?
Blood oxygen during sleep, blood pressure and inflammation improved. The researchers measured the hypoxic burden, that is how long and how deeply blood oxygen falls in each hour of sleep. At the start it was 153.6 and 132.2 percent-minutes per hour in the tirzepatide groups. After a year it fell by 95.2 and 103.0.
- Systolic blood pressure after 48 weeks: minus 9.5 mm Hg on tirzepatide against minus 1.8 on placebo in trial 1, and minus 7.6 against minus 3.9 in trial 2.
- CRP protein, a marker of inflammation: a fall of 1.4 mg/l in both trials against 0.7 and 0.3 mg/l on placebo.
- Completion of the trial: 91.5 percent of people on tirzepatide and 74.4 percent on placebo stayed to the end.
The fall in blood pressure on tirzepatide is broken down in a separate guide on semaglutide and tirzepatide and blood pressure. The most common adverse effects concerned the stomach and gut and were usually mild or moderate.
Is it only about weight loss?
Not only, because better breathing itself also added to the benefit. This was shown by an analysis of SURMOUNT-OSA data published in January 2026 in Nature Medicine. The researchers checked what part of the improvement came from weight loss and what part from better breathing at night.
Improvement in apnoea and oxygen levels lowered CRP, insulin resistance and triglycerides independently of weight. Systolic blood pressure fell thanks to both factors together. The authors conclude that the best effect for the heart and metabolism comes from treating sleep apnoea and obesity at the same time.
Guidelines advise people with sleep apnoea to lose 7 to 11 percent of their weight. The authors of the main paper note that this is hard to achieve with lifestyle change alone. In SURMOUNT-OSA tirzepatide gave a weight loss of 17.7 and 19.6 percent, clearly more than this threshold.
Do people sleep better on tirzepatide?
Yes, participants themselves rated their sleep clearly better than people on placebo. They were asked with PROMIS questionnaires about sleep disturbance and how lack of sleep gets in the way during the day. The results of both trials were pooled for 234 people on tirzepatide and 233 on placebo.
| PROMIS questionnaire after 52 weeks | Tirzepatide | Placebo |
|---|---|---|
| Daytime impairment from lack of sleep | minus 7.5 points | minus 3.6 points |
| Sleep disturbance | minus 5.7 points | minus 2.7 points |
A separate 2025 analysis in Sleep Medicine added further scales. On tirzepatide, functioning in daily activities, overall quality of life and most areas of the SF-36 questionnaire improved. In trial 1 daytime sleepiness measured on the Epworth scale also fell.
What did data from everyday practice show?
Data from practice point to fewer deaths and complications in people with sleep apnoea treated with tirzepatide. A study published in 2025 in the journal Chest covered 42,300 people with sleep apnoea and obesity from the TriNetX database. Half received tirzepatide and the other half lifestyle change only. The groups were statistically matched to be similar to each other.
- Death from any cause: risk about 56 percent lower.
- Major cardiovascular events: risk about 27 percent lower.
- Major kidney events: risk about 57 percent lower.
This is an observational study, not a randomised one, so it shows an association, not proof of cause. The results were nevertheless consistent across groups of age, sex, weight and in people using CPAP. The only exception was the group aged 18 to 39.
What dose of tirzepatide was used?
SURMOUNT-OSA aimed at 10 mg or 15 mg of tirzepatide once a week, depending on tolerance. The starting dose was 2.5 mg a week, raised by 2.5 mg every 4 weeks over at most 20 weeks. Stomach complaints appeared mainly during this period of dose increases.
The results of each dose from other trials are collected in the guide on tirzepatide doses in trials. How weight changes month by month is shown in the guide on tirzepatide results after a month, 3 months and a year.
Where to buy tirzepatide?
The shop has tirzepatide in three versions. Tirzepatide 20 mg Bio-Peptide costs 200 EUR and is in stock. Tirzepatide 20 mg Genheal costs 200 EUR and is available to order. Tirzepatide 40 mg Nouveaux in a pen costs 350 EUR and is in stock.
All brands and versions are collected on the tirzepatide page. The products in the shop are material for laboratory research, not the medicine Zepbound. Other benefits of tirzepatide and semaglutide beyond weight are described in the guide semaglutide and tirzepatide beyond weight loss.
Frequently asked questions
Does tirzepatide treat sleep apnoea?
In the SURMOUNT-OSA trials tirzepatide cut the number of breathing pauses by 50.7 and 58.7 percent after a year. In 42 to 50 percent of people, sleep apnoea fell back to a mild form without sleepiness or disappeared.
Does tirzepatide work for sleep apnoea in people using CPAP?
Yes. In trial 2 participants used CPAP, and their number of breathing pauses fell by 29.3 per hour against 5.5 on placebo.
How much weight did SURMOUNT-OSA participants lose?
After 52 weeks body weight fell by 17.7 percent in trial 1 and by 19.6 percent in trial 2. On placebo the fall was 1.6 and 2.3 percent.
Does the improvement in sleep apnoea come only from weight loss?
Not only. A 2026 analysis showed that better breathing at night lowered CRP, insulin resistance and triglycerides independently of weight.
What dose of tirzepatide was used for sleep apnoea?
SURMOUNT-OSA used 10 mg or 15 mg once a week, the highest dose tolerated by the participant, for 52 weeks.
Sources
- Malhotra A, Grunstein RR, Fietze I et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. New England Journal of Medicine, 2024, 391(13): 1193-1205. https://doi.org/10.1056/NEJMoa2404881
- Malhotra A, Grunstein R, Azarbarzin A et al. Tirzepatide on obstructive sleep apnea-related cardiometabolic risk: secondary outcomes of the SURMOUNT-OSA randomized trial. Nature Medicine, 2026, 32(2): 653-659. https://doi.org/10.1038/s41591-025-04071-1
- Kanu C, Shinde S, Chakladar S et al. Effect of tirzepatide treatment on patient-reported outcomes among SURMOUNT-OSA participants with obstructive sleep apnea and obesity. Sleep Medicine, 2025, 134: 106719. https://doi.org/10.1016/j.sleep.2025.106719
- Wu JY, Chen CC, Ling Tu W et al. Clinical Impact of Tirzepatide on Patients With OSA and Obesity. Chest, 2025, 168(3): 785-796. https://doi.org/10.1016/j.chest.2025.03.030