Sleep apnea treatment
Zepbound (Tirzepatide) for Sleep Apnea in Canada
Quick answer
In June 2026, Health Canada approved Zepbound (tirzepatide) to treat moderate to severe obstructive sleep apnea in adults with obesity (a body mass index of 30 or more), together with a reduced-calorie diet and more physical activity. It is the first medication approved for sleep apnea in Canada. In clinical trials, it lowered the number of breathing events by about 25 to 29 per hour on average, compared with about 5 per hour on placebo, and 42% to 50% of people reached remission or mild sleep apnea. It is a prescription weekly injection, and many people will still need CPAP.
At a glance
Key takeaways
Zepbound is approved in Canada for moderate to severe obstructive sleep apnea in adults with a BMI of 30 or more.
It works mainly through weight loss, so it is not for people with sleep apnea who do not have obesity.
You need a sleep study showing moderate to severe sleep apnea and a prescription from a physician or nurse practitioner.
Do not stop CPAP on your own; your care team should retest your sleep apnea after significant weight loss.
What is Zepbound?
Zepbound is the brand name for tirzepatide, a once-weekly injection that acts on two gut hormone receptors (GIP and GLP-1) to reduce appetite and support weight loss. It was approved in Canada for chronic weight management in 2025 and for obstructive sleep apnea on June 16, 2026 (Eli Lilly Canada). The same medicine is sold as Mounjaro for type 2 diabetes, but Mounjaro is not approved for sleep apnea.
Who it is approved for
Health Canada’s approved use is: “the treatment of moderate to severe obstructive sleep apnea (OSA) in adults with obesity (BMI 30 kg/m² or greater), to be used in combination with a reduced-calorie diet and increased physical activity” (Eli Lilly Canada). That means you need:
- a diagnosis of obstructive sleep apnea that is moderate or severe (an AHI of 15 or more) from a sleep study;
- a body mass index of 30 or more;
- a prescription from a physician or nurse practitioner who has reviewed your health history.
It is not approved for people under 18, for central sleep apnea, or for people with sleep apnea who do not have obesity.
How well does it work?
Two 52-week SURMOUNT-OSA trials compared tirzepatide with placebo in adults with moderate to severe sleep apnea and obesity (Zepbound product monograph):
| People not using CPAP | People using CPAP | |
|---|---|---|
| Average AHI at the start | 50.1 events per hour | 46.1 events per hour |
| Change in AHI with tirzepatide | 25.3 fewer events per hour | 29.3 fewer events per hour |
| Change in AHI with placebo | 5.3 fewer events per hour | 5.5 fewer events per hour |
| Reached remission or mild sleep apnea with tirzepatide | 42.2% | 50.2% |
| Reached remission or mild sleep apnea with placebo | 15.9% | 14.3% |
In the trials, remission or mild sleep apnea meant an AHI under 5, or an AHI of 5 to 14 with little daytime sleepiness. Results in the CPAP group were measured after people stopped CPAP for a week.
Does Zepbound replace CPAP?
Not automatically. In the trials, roughly half of people taking tirzepatide still had more than mild sleep apnea after a year, while CPAP works from the first night. Keep using CPAP as prescribed unless your care team tells you otherwise. After significant weight loss, a repeat sleep study can show whether your sleep apnea has improved enough to change your treatment. Our home sleep test and CPAP support team can help with that follow-up.
How it is taken
Zepbound is injected under the skin once a week. Treatment starts at a low dose and is increased gradually, usually every four weeks, to help limit stomach side effects (product monograph). Your prescriber decides your dose.
Side effects and who should not use it
The most common side effects are nausea, diarrhea, constipation and vomiting, especially when the dose is increased. Other warnings in the product monograph include pancreatitis, gallbladder problems, low blood sugar when used with insulin or some diabetes pills, and mood changes (product monograph).
- Do not use it if you or a family member have had medullary thyroid cancer or multiple endocrine neoplasia type 2 (MEN 2).
- Do not use it if you are pregnant or planning a pregnancy.
- If you take birth control pills, ask about adding a barrier method, because tirzepatide can make oral contraceptives less effective for a while after starting or increasing the dose.
- Tell your anesthetist before any surgery or procedure.
Cost and coverage in Canada
Approval by Health Canada does not automatically mean it is covered. Private and workplace plans each decide whether to cover Zepbound for sleep apnea, and a documented sleep apnea diagnosis may support a prior-authorization request (Benefits and Pensions Monitor). Provincial drug plans do not generally cover it. Ask your insurer and pharmacist about the cost before you start.
Other treatment options
CPAP remains the most common and most effective first treatment for moderate to severe sleep apnea. Other options include oral appliances, positional therapy and, for some people, surgery. See sleep apnea treatment and our CPAP therapy guide.
Other sleep apnea medicines being studied
Zepbound is the first medicine approved in Canada to treat obstructive sleep apnea itself. Two others are in development:
- AD109. An investigational pill that acts on the airway muscles. It is under review by the US FDA (decision expected February 2027).
- Sultiame. Studied in a 2025 phase 2 trial.
Neither is approved in Canada. They work differently from Zepbound, which improves sleep apnea mainly by helping with weight loss. Neither should be expected to replace CPAP for most people. See medicines for sleep apnea.
Sources
- Eli Lilly Canada. Health Canada approves Zepbound as the first obstructive sleep apnea medication in Canada (June 16, 2026). https://www.lilly.com/en-ca/news/press-releases/zepbound-osa-noc
- Eli Lilly Canada. Zepbound product monograph (June 2026). https://pi.lilly.com/ca/zepbound-ca-pm.pdf
- Benefits and Pensions Monitor. Sleep apnea drug approved by Health Canada. https://www.benefitsandpensionsmonitor.com/news/industry-news/sleep-apnea-drug-approved-health-canada/393746
- Eli Lilly Canada. Mounjaro product monograph. https://pi.lilly.com/ca/mounjaro-ca-pm.pdf
- Apnimed. Apnimed announces FDA acceptance of new drug application for AD109. July 2026. https://ir.apnimed.com/news-releases/news-release-details/apnimed-announces-fda-acceptance-new-drug-application-ad109
- Randerath W, et al. Sultiame once per day in obstructive sleep apnoea (FLOW): a multicentre, randomised, double-blind, placebo-controlled, dose-finding, phase 2 trial. Lancet. 2025;406(10514):1983-1992. https://doi.org/10.1016/S0140-6736(25)01196-1
Disclaimer
This page is general health information, not medical advice, and it does not replace an assessment by a qualified health professional. Virtual Sleep Care does not currently serve Quebec, Yukon, the Northwest Territories or Nunavut. Virtual Sleep Care does not prescribe Zepbound. Talk to your physician or nurse practitioner about whether it is right for you.