The headline trial: SURMOUNT-OSA
SURMOUNT-OSA (Tirzepatide for the Treatment of Obstructive Sleep Apnea in People with Obesity)
Malhotra et al., New England Journal of Medicine, June 2024
Tirzepatide 10 or 15 mg weekly reduced the apnea-hypopnea index (AHI) by 27 events per hour versus 5 events per hour for placebo, at 52 weeks. Approximately 43 to 52 percent of treated patients achieved disease resolution (AHI less than 5, or AHI 5 to 14 with no excessive daytime sleepiness). FDA approval for moderate-to-severe OSA with obesity granted December 2024.
Trial enrollment criteria
- AHI of 15 or greater (moderate to severe OSA) confirmed by polysomnography or home sleep apnea test
- BMI greater than or equal to 30
- Either on CPAP/PAP therapy or not (the trial enrolled both)
Does this trial apply to you?
Documented OSA with AHI of 15 or greater on a sleep study, combined with BMI 30 or higher, meets the SURMOUNT-OSA criteria. This is a Medicare-eligible indication (unlike pure obesity, which is excluded under the 2003 MMA statute), and it is increasingly being approved by commercial plans under the FDA label expansion.
What to ask your prescriber
- Most recent sleep study results with AHI value and date
- CPAP usage, intolerance or non-adherence history
- Whether sleep medicine consultation is needed (some plans require it)
- Whether the OSA indication or obesity-with-comorbidity indication is the cleaner PA path
Editorial notes
- GLP-1 treatment for OSA does not replace CPAP for patients with severe disease. Continue your PAP therapy until sleep medicine confirms remission.
- Sleep studies older than three years are often rejected by PA reviewers; ask for a repeat if needed.
- The OSA indication is a Medicare-eligible pathway for Wegovy/Zepbound, important for the senior cluster.
Clinical trials for Moderate-to-severe obstructive sleep apnea (OSA) with obesity
Or browse the full GLP-1 clinical trials directory, filterable by condition, state and phase.
Take it to your prescriber: PA letter templates
Editable prior-authorization letter templates that cite the registration trial above. Pick the plan your prescriber will submit to, copy the template, fill in the patient-specific findings and have your clinician sign and submit.
Not seeing your plan? The full PA letter librarycovers 20 plans × 10 indications = 200 templates. The appeal letter library handles denials.
Drug profiles
Other GLP-1 conditions
Editorial provenance
Editorial review by John, Editor on 2026-05-23, against SURMOUNT-OSA (Malhotra et al., New England Journal of Medicine, June 2024). We do not yet have a credentialed medical reviewer on staff (actively recruiting). This page summarises public registration-trial data and FDA labeling. It is not clinician-authored medical advice.
Disclaimer
Educational summary of published registration trial data. Not medical advice. Not a substitute for evaluation by a treating clinician. Trial-level results do not guarantee individual outcomes. Discuss eligibility, contraindications, dose adjustments and drug interactions with your prescriber. We do not have a credentialed medical reviewer on staff yet (actively recruiting); the content below is editor-written from public registration-trial publications and FDA labeling, not clinician-authored medical advice.