GLP-1 for sleep apnea: what is actually approved

Approved drug

Tirzepatide (Zepbound) — brand only

Indication

Moderate-to-severe OSA with obesity

Approved

December 2024, FDA

Trial

SURMOUNT-OSA (NEJM, 2024)

What the trial showed

SURMOUNT-OSA tested tirzepatide in adults with obesity and moderate-to-severe obstructive sleep apnea. It substantially reduced the apnea-hypopnea index — the count of breathing interruptions per hour — in both participants using CPAP and those who were not. On the strength of it, the FDA approved Zepbound for moderate-to-severe OSA in adults with obesity in December 2024, the first drug ever approved for the condition.

Two things that result does not mean. It is not a cure, and it is not a replacement for CPAP on anyone's say-so but your clinician's — a large share of trial participants still had residual apnea afterwards. And the effect is tied to weight loss in people with obesity; it is not evidence that a GLP-1 helps sleep apnea in someone without it.

Where tirzepatide is sold

These are affiliate partners of ours, listed because they are the ones we have relationships with — not because they were selected on the evidence above, which none of them are approved under. Prices are company-stated and change often. Our disclosure explains how we are paid.

One of them, Sprout Health, was issued an FDA warning letter in September 2025. We have not removed it, and we have not buried that either — read our Sprout Health review before you click through to it.

A separate caution, about headlines rather than records: some of these companies advertise a per-month price that is really a commitment rate. Our Shed review works one of them through in full — the $239 tirzepatide figure it advertises is what a month costs on a twelve-month plan, and the month-to-month rate is $299.

• SkinnyRx

  Compounded-only GLP-1 telehealth selling both molecules as a once-weekly injection or a once-daily tablet, with a microdose option on the tablets.

  Pricing: Read off its own price data rather than its marketing: injectable semaglutide $349/mo month-to-month, injectable tirzepatide $399/mo, with four-, six- and twelve-month rungs beneath each ($299/$249/$199 and $349/$329/$299). The "From $199/month" it advertises everywhere is the TWELVE-MONTH rung — the rate you can stop after a month is $349.

  Caveats: The FDA issued a warning letter to Lean Rx, Inc. dba SkinnyRx on 20 February 2026. Compounded only, not FDA-approved. Every figure it advertises is the twelve-month commitment rate, and brand names appear in its catalog with no purchasable price behind them.

  Visit SkinnyRx ↗

• HumeCare+

  GLP-1 telehealth from the body-composition scale company, with a weekly at-home scan tracking fat and lean mass rather than scale weight.

  Pricing: Nothing is published. Its marketing site prices neither molecule; the figures are reachable only past the assessment, where semaglutide (injection or oral) is $199/mo month-to-month and tirzepatide with B12 and glycine is $299/mo. A non-refundable fee is charged at enrollment and at every refill, and its amount is not printed.

  Caveats: Publishes no price anywhere on its public site, so nothing can be compared before handing over an assessment. No mg dose is stated anywhere, through to the payment page. Its homepage promises "lose 10% in 6 months or your money back" while the written terms describe a 90-day guarantee that excludes anyone who has used a GLP-1 before.

  Visit HumeCare+ ↗

• Direct Meds

  Compounded-only GLP-1 telehealth (launched 2024) offering both oral/sublingual and injectable options with no separate membership fee.

  Pricing: Read live on the company's own product pages: injectable semaglutide $297/mo, injectable tirzepatide $399/mo, and sublingual semaglutide from $249/mo per its FAQ. All-inclusive, no membership; bulk 6- and 12-month rates are advertised but not published.

  Caveats: The FDA issued a warning letter to directmeds.com, Inc. dba DirectMeds in September 2025. Compounded only (not FDA-approved), and the operator runs under multiple domains. Its tirzepatide page also prints "$9.58 per day" beside a $399 monthly price — that is the semaglutide per-day figure; at $399 the real number is about $13.

  Visit Direct Meds ↗

• Gala Health

  Newer operator covering all 50 states with both a compounded path and a brand-name option, so readers who want brand Ozempic have a route.

  Pricing: Compounded tirzepatide $179/mo on a yearly subscription — no month-to-month price is published; the site's own FAQ quotes $199/mo on a 3-month plan. The $149 tier is a sub-therapeutic microdose, not a cheaper full dose. Brand Ozempic listed at ~$1,299.

  Caveats: The $179 headline requires committing to a year. Compounded GLP-1 is not FDA-approved. No oral/sublingual option yet, and it is a relatively new operator with a shorter track record.

  Visit Gala Health ↗

• Trimi

  Compounded semaglutide and tirzepatide GLP-1 telehealth with low entry pricing, available in all 50 states.

  Pricing: Low entry pricing on compounded semaglutide and tirzepatide.

  Caveats: Compounded only (not FDA-approved) and injectable only. The compounding pharmacy is not publicly named.

  Visit Trimi ↗

• Enhance MD

  Compounded GLP-1 telehealth covering semaglutide and tirzepatide, with an optional NAD+ add-on. Ongoing care includes lab testing every six months.

  Pricing: Company-stated: semaglutide $212/mo (first month $112), tirzepatide $280, microdose $169, combo $322. NAD+ available as an add-on.

  Caveats: Compounded only (not FDA-approved). No brand-name or oral option, a higher entry price than some peers, and the states served are not published.

  Visit Enhance MD ↗

• SnagRx

  Cash-pay compounded semaglutide and tirzepatide from Modern Metabolic Medicine, Inc., shipped in 1-2 days. One price at every dose, and its Terms name all four partner pharmacies with street addresses — RedRock, Health Warehouse, Precision Compounding and Triad Rx.

  Pricing: Read live on snagrx.com/semaglutide 2026-08-11: semaglutide $99/mo month-to-month ($89 on 3 months, $79 on 6, $69 on 12); tirzepatide $149/mo ($139, $129, $119). Telehealth visit and shipping included; no insurance, no membership.

  Caveats: Compounded products are not FDA-approved. The $299/$399 shown struck through on the homepage is a permanent anchor, not a rate anyone pays - it sits beside a countdown reading 00:00:00:00. Budget from $99/$149; the $69/$119 tiers need a full year paid up front.

  Visit SnagRx ↗

• HealthRX

  LegitScript-certified (#50087439), physician-supervised telehealth for medical weight loss, offering compounded semaglutide and tirzepatide plus an oral GLP tablet. Transparent pricing with no insurance required.

  Pricing: Company-stated: ~$189/mo injectable, ~$239/mo oral GLP tablet, ~$349/mo GLP + GIP combination.

  Caveats: Compounded products are not FDA-approved. Some tiers are company-stated and the site is thin in places, and the number of states served is not published.

  Visit HealthRX ↗

• RxSpan MD

  Physician-led telehealth founded by Dr. John Diaz, a board-certified plastic surgeon, and available in all 50 states subject to provider licensure. Broad menu spanning compounded semaglutide and tirzepatide — injectable and oral capsules — an advertised brand-name GLP-1 lane and microdosing, plus a longevity line (sermorelin, NAD+, glutathione) that overlaps this site's peptide focus. Includes 24/7 messaging, coaching and free expedited shipping.

  Pricing: From $194/mo. RxSpan publishes transparent, all-inclusive pricing on its own site: compounded semaglutide is $249/mo, dropping to $194/mo on the 12-month plan; tirzepatide is $329/mo; and semaglutide oral capsules are $249/mo. Each plan includes the consult, medication, supplies, shipping and support, and you can cancel or change plans anytime.

  Caveats: Compounded semaglutide/tirzepatide are not FDA-approved (not the same as Wegovy, Ozempic or Zepbound). Published pricing covers the compounded line, so brand-name pricing isn't itemized. A prescription isn't guaranteed — a provider reviews eligibility after checkout. A correction on 2026-08-08 briefly claimed RxSpan names no pharmacy and publishes no state list; both were wrong and were reversed the same day. Its own FAQ names four dispensing pharmacies with phone numbers, names the prescribing physicians with NPIs, and answers the state question at all 50 states subject to licensure. The real caveat is narrower: that same set of four pharmacies and two physicians is published in near-identical wording by every brand on its shared backend, so it describes the supply chain rather than this brand — and it is never presented as a 503A claim, because RxSpan does not make one.

  Visit RxSpan MD ↗

• yourEra

  Compounded GLP-1 telehealth ("A New Era of Personalized Health") carrying both semaglutide and tirzepatide as weekly injectables, alongside a broader menu of NAD+, microdosing protocols and an optional coaching/nutritionist/at-home-labs membership. Markets a 50-state licensed-clinician network; no insurance required, HSA/FSA accepted.

  Pricing: Publicly listed on the site: compounded semaglutide from $199/mo, tirzepatide from $299/mo (weekly injectable). NAD+ from $249/mo, microdosing from $179/mo, optional yourEra Optimum membership +$149/mo.

  Caveats: Compounded only (not FDA-approved) and injectable only — no brand-name or oral lane. Mid-market pricing sits above the cheapest compounders, and the 50-state and efficacy claims are self-reported with a thin independent-review footprint.

  Visit yourEra ↗

• Sprout Health

  LegitScript-certified GLP-1 telehealth offering compounded semaglutide and tirzepatide alongside a real brand-name Wegovy and Zepbound path, with a low-friction start that often skips labs and the video visit.

  Pricing: Company-stated: compounded semaglutide from $149/mo, tirzepatide from $199/mo; brand-name Wegovy/Zepbound available at brand pricing.

  Caveats: The FDA issued a warning letter to Sprout Health Partners LLC dba Sprout Health in September 2025. Compounded products are not FDA-approved and injectable-only (no oral). No named medical director, and state availability is quiz-gated. "No labs, no visit" convenience also means lighter clinical oversight.

  Visit Sprout Health ↗

• Shed

  Formerly ShedRx. A care-team GLP-1 program (physician, nurse, dietitian, coach) with one of the widest format menus — compounded semaglutide/tirzepatide injections plus GLP-1 drops, lozenges and a microdose tier — alongside a brand-name Wegovy, Zepbound and Foundayo route, and a longevity line (sermorelin, NAD+ in three routes, glutathione, methylene blue, LDN) that also earns it a row in our sermorelin ranking.

  Pricing: Read live on the company's own product pages: compounded semaglutide $199/mo month-to-month ($179 on six months, $159 on twelve) and compounded tirzepatide $299/mo ($269 on six, $239 on twelve). The advertised "as low as $159/$239" figures are the twelve-month rungs — Shed's own terms name $199 and $299 as the standard monthly rates. Drops $229/mo, lozenges $199/mo, microdose from $149. Brand Wegovy, Zepbound and Foundayo are $149/mo plus a separate $125/mo Shed membership, with the medication bought through LillyDirect or NovoCare. On the longevity side, sermorelin is $199/mo and NAD+ is $144/mo as a nasal spray or $169/mo as an injection or oral tablet — no term ladder on either.

  Caveats: Compounded drops, lozenges and the microdose tier are not FDA-evaluated in those delivery forms, and the $149 microdose is a sub-therapeutic dose rather than a cheaper full one. Every plan carries a non-refundable two-month minimum commitment — so the smallest purchase is twice the monthly price — and billing may run on 28-day cycles; a twelve-month plan buys 48 weeks of medication, not 52. The 120-day money-back guarantee requires four member commitments including 60 daily app check-ins, and covers weight loss only. The product pages advertise U.S.-based compounding while the terms reserve the right to ship "from sources other than within the United States". The compounding pharmacy and the prescribing clinicians are unnamed, and no state list is published.

  Visit Shed ↗

• Willow

  A women-focused compounded GLP-1 service whose catalog is exactly five products: semaglutide and tirzepatide (injection or sublingual tablet) and an NAD+ injection. Unusually strong on people — 25-plus individually named physicians with their own bio pages, a named CMO, and three dispensing pharmacies named in its terms — Red Rock Home Pharmacy, Epiq Pharmacy and The Pharmacy Hub — which only Breeze Meds matches in this module, and which no other operator here does at all.

  Pricing: Read live from the company's own onboarding API: compounded semaglutide $299/mo and tirzepatide $399/mo, the same price whether you take the injection or the sublingual tablet, with ondansetron $30 as an add-on. Its NAD+ injection (50 mg, subcutaneous) is $199 — and that is the standing month-to-month rate, not an intro or a prepay rung. There is one price object and no three-, six- or twelve-month ladder anywhere in the funnel, which is genuinely rare here. Two qualifiers travel with it: billing is against a 28-day supply, so a year is thirteen fills at about $2,587 rather than twelve at $2,388, and $199 is the price at 50 mg — the company's own FAQ says costs vary by dosage.

  Caveats: It sells no sermorelin, CJC-1295, ipamorelin, tesamorelin or MK-677 — every one of those product slugs 404s — so for a reader on this site it is an adjacent NAD+/GLP-1 option and nothing more. Billing on a 28-day cycle means thirteen charges a year, not twelve. Its public NAD+ page sells the product standalone for cognition and brain fog while its own internal product copy calls it "an NAD+ additive… during your GLP-1 treatment", and the NAD+ intake is a weight-loss questionnaire asking BMI and diabetes history (a normal-BMI profile does reach the same checkout). After month one the injection frequency drops from three times a week to once and the monthly price does not change, so you pay the same for a third of the doses. Compounded and not FDA-approved, in the site's own words. It is explicitly a women's brand and its terms frame the whole service around women's health services. Thirty-six states are enabled and fourteen disabled, while the sign-up dropdown still renders all fifty as selectable. The "4.9/5 from 2,200+ reviews" and "100,000+ patients" claims sit on no third-party platform. And one of the three pharmacies it names, The Pharmacy Hub, is the same dispensary at the same Miami address that Try Ageless and System Labs name in our sermorelin ranking — so naming a pharmacy is not by itself evidence of an independent supply chain.

  Visit Willow ↗

• Sesame Care

  Not a clinic and not a compounder — a two-sided marketplace where independent clinicians list their own cash prices, and you buy the appointment rather than the medication. That makes it the one entry in this module that is a route to a prescriber for a brand-name drug rather than a compounded-GLP-1 seller. Each clinician's credentials are published individually (MD, NP or PA-C, specialty, rating, review count), which is unusually transparent for this category.

  Pricing: Read from Sesame's own inventory API as a new patient: a telehealth visit is $46 to $50 depending on the state — CA $49, TX $46, NY $49, FL $47, IL $47, GA $49, AZ $46, WY $50, MT $47, AK $50 across the ten states we swept, so $46 is the floor. An online skin consult is $46 in Texas and $50 in California; an in-person skin consult is $130 in Texas; a testosterone lab test is $60 in Texas with no listings at all in California. The medication is a separate purchase at a pharmacy — none of these figures is the cost of a GLP-1.

  Caveats: The "$37" headline on the affiliate landing page does not reproduce in any of the ten states we checked, and the lander does not qualify it; the member-rate field is unreadable without an account, so treat $46 as the real floor. Because pricing is per clinician there is no single state list and no single price — "Sesame's price" is whatever somebody listed. For a peptide or longevity reader it sells essentially nothing: its own search API returns an empty result for sermorelin, peptide, NAD+, glutathione, B-12, longevity and BPC-157, and "NAD" returns only nadolol, a beta-blocker. Its "anti-aging treatment" category is dermatology — the page's own header says anti-aging skincare and it resolves to skin consults — so do not read it as longevity medicine. Testosterone resolves to visits and a lab test, not to a prescription pathway. Cancellation is per appointment; there is no subscription to cancel and no ongoing care included.

  Visit Sesame Care ↗

• Found Health

  A weight-loss-only telehealth program with the most senior named advisory bench in this module — a senior medical advisor who formerly directed a board-certification program in obesity medicine, a named medical director, and Columbia and Stanford faculty on the advisory side. Fourteen medications: compounded semaglutide, tirzepatide and liraglutide, brand Wegovy, Ozempic, Zepbound, Mounjaro, Saxenda, Victoza and Trulicity, oral Foundayo (orforglipron) and Rybelsus, and four non-GLP-1 orals.

  Pricing: From the binding Offer Terms, which publish the real table: the compounded GLP-1 plan is $199/mo with commercial insurance or $299/mo cash month-to-month, falling to $149 and $199 on a twelve-month commitment. The oral non-GLP-1 "generics" plan is $89/mo insured or $149 cash month-to-month, falling to $49 and $99 on twelve months. Brand cash prices are roughly $1,100/mo for Ozempic and Mounjaro, from $650/mo for Wegovy and Zepbound, and about $149/mo for Foundayo. Every plan is billed every four weeks.

  Caveats: The "$49" figure this company is quoted at needs both a twelve-month commitment and commercial insurance; month-to-month and cash-pay it is $149. Its own binding Offer Terms and its marketing pricing page disagree on three of the four compounded-GLP-1 cells, so the number you were shown may not be the number you agreed to. Billing runs every four weeks — thirteen cycles a year — and its "twelve months" is defined as forty-eight weeks, roughly eleven calendar months of medication. Insurance is accepted in 41 states, with two contradictions on that same page: one state shows an available-plans panel while being absent from the state selector, and another is listed as accepted while its own panel reads that no plans are available. The pharmacy is not named — Found states only that it "partners exclusively with 503A-licensed pharmacies", which is at least a specific claim about who fills the prescription rather than a general compliance sentence. Found itself discloses that its most senior named advisor does not interact directly with patients. Membership is refundable only within three days or before the first consult; medication and lab kits are non-refundable once shipped and renewals are not refundable at all. And there is nothing here for a peptide reader — no sermorelin, no GH peptide, no NAD+, nothing for sleep, cognition or longevity.

  Visit Found Health ↗

• Breeze Meds

  A transparent, all-50-state compounded GLP-1 telehealth with NPI-verifiable named physicians (Lion MD group) and named compounding pharmacies, offering weekly injectable semaglutide plus oral semaglutide and tirzepatide tablets.

  Pricing: Company-stated: injectable semaglutide from $199/mo; oral semaglutide ~$299/mo and oral tirzepatide ~$399/mo. FSA/HSA eligible.

  Caveats: Compounded medications are not FDA-approved. Oral tirzepatide is pricey and the $199 headline is the entry-dose injectable; it is a small, newer brand with a short public track record. Its named physicians and named pharmacies are real and its NPIs verify, but they are the same names, in the same wording, that every brand on its shared white-label backend publishes — including Care Bare Rx and Synergy Rx in our sermorelin ranking. Read them as a fact about that platform, not as independent corroboration of this brand.

  Visit Breeze Meds ↗

If you came here from the peptide side

Sermorelin and the other growth-hormone secretagogues this site covers are a different intervention entirely, and none of them has an apnea indication or an apnea trial behind it. If you want the evidence on those, our sermorelin ranking is the honest place to start — including where the evidence for them runs thin.

Educational information, not medical advice. Obstructive sleep apnea is a diagnosis that requires a sleep study, and treatment decisions — including whether to change or stop CPAP — belong with the clinician managing it.