Zepbound vs. CPAP: Why Medication Alone Isn’t the Full Solution for Sleep Apnea

The recent FDA approval of Zepbound (tirzepatide) for the treatment of moderate to severe obstructive sleep apnea (OSA) in adults with obesity is generating well-deserved attention. As a once-weekly injectable medication that promotes significant weight loss, Zepbound is offering hope for patients who have long struggled with CPAP machines or who are newly diagnosed and hesitant to begin device-based therapy.

But while Zepbound has exciting potential, it’s important to set realistic expectations. At The Respire Institute, we believe Zepbound may enhance sleep apnea care, but it is not a one-size-fits-all replacement for CPAP. Instead, it’s a new tool that fits into a broader, patient-specific strategy. Here’s why CPAP still matters, and how Zepbound fits into the long game.

How CPAP Works—and Why It’s Still the Gold Standard

CPAP (Continuous Positive Airway Pressure) therapy works by delivering a steady stream of air through a mask to keep your upper airway open during sleep. It’s the most effective, immediate solution for preventing the apneas and hypopneas that define OSA.

When used consistently, CPAP can:

• Eliminate breathing interruptions
• Normalize oxygen levels
• Improve sleep quality and energy
• Reduce the risk of high blood pressure, stroke, and cardiovascular issues

CPAP works overnight—and from day one. For patients who adhere to therapy, symptom relief can be noticeable almost immediately.

How Zepbound Works and What it Doesn’t Do

Zepbound promotes weight loss by mimicking hormones that regulate appetite and digestion. Over time, this leads to significant weight reduction, which in turn can reduce the severity of sleep apnea in individuals with obesity.

However, Zepbound does not directly address the structural cause of sleep apnea: the collapsing of the upper airway. It can take months to see sleep-related improvements, and for many patients, weight loss may not fully resolve the condition.

Zepbound may help lower your apnea-hypopnea index (AHI). Still, it likely won’t normalize oxygen levels on its own, especially in those with anatomical issues or other contributing factors like alcohol use, allergies, or genetics.

The Misconception: Medication Instead of CPAP

With all the excitement surrounding Zepbound’s approval, it’s easy to assume this medication can replace CPAP therapy. In reality, the FDA has approved it only for use in adults with obesity who are unable or unwilling to use CPAP.

That distinction is key. Zepbound is not a front-line therapy—it’s an alternative option for a specific subset of patients. Even in those cases, sleep specialists may still recommend:

• Baseline and follow-up sleep studies to track progress
• Lifestyle interventions
• Monitoring for persistent oxygen desaturation

Zepbound may reduce the number of apneas per hour, but CPAP is still the most reliable option for fully treating the condition, especially for those at high cardiovascular risk.

How to Know What’s Right for You

Every patient is different. The right treatment depends on several factors:

• Your apnea severity (mild, moderate, or severe)
• Your body mass index (BMI) and weight history
• Your experience with CPAP or Inspire therapy
• Other health concerns like diabetes, hypertension, or pulmonary issues

At The Respire Institute, we begin with a comprehensive sleep evaluation and diagnostic testing to gain a complete understanding of the situation. From there, we create a personalized plan that may include:

• Starting with CPAP for immediate relief
• Integrating Zepbound into a broader weight and respiratory care strategy
• Periodically reassessing your condition as you lose weight
• Exploring non-device options like Inspire therapy if needed

A Combined Approach May Offer the Best Results

For many patients, the most successful outcomes come from combining therapies. Starting with CPAP ensures your symptoms are controlled right away, while Zepbound works in the background to support long-term improvement.

This dual approach can:

• Shorten the time it takes to reduce dependence on CPAP
• Improve energy and motivation for lifestyle changes
• Lead to better heart and metabolic health overall

And if weight loss results in a significant reduction in your AHI, our team will help you re-evaluate your diagnosis and explore the possibility of stepping down or discontinuing CPAP, safely and with expert guidance.

Let’s Talk About What Works for You

At The Respire Institute, we’re committed to delivering care that’s both evidence-based and personalized. Zepbound brings a new option to the table, but the best outcomes still come from a team that understands your full picture and supports you every step of the way.

Schedule your consultation today to learn whether Zepbound, CPAP, or a combined plan is right for you.