Zepbound Patient Monitoring: Our Role in Your Treatment
Comprehensive sleep medicine monitoring during Zepbound therapy. Diagnostic testing, OSA improvement tracking, and physician-supervised care.
Our Collaborative Care Model
We do NOT prescribe or manage Zepbound medication. We coordinate with board-certified obesity medicine physicians who handle all prescribing and medication management.
Our Role: Sleep Medicine Expertise
- • Our Team: Orders diagnostic sleep studies for insurance coverage approval and monitors OSA improvement
- • Our Team: Tracks AHI reduction and hypoxic burden during treatment
- • Collaborative Care: Works with obesity medicine physician to optimize outcomes
Note: Zepbound prescribing, dose titration, and medication side effect management is handled by the obesity medicine physician. We focus on what we do best: comprehensive sleep apnea monitoring and treatment optimization.
Monitoring Timeline: What to Expect
Baseline: Insurance Coverage Documentation
Before starting Zepbound therapy
Our Team Orders Diagnostic Sleep Study:
Our team will:
- • Order comprehensive sleep study to establish baseline AHI
- • Document moderate-severe OSA (required for insurance coverage)
- • Coordinate with obesity medicine physician for Zepbound approval
- • Our physicians review study and confirm OSA diagnosis
Why This Matters:
Insurance companies require documented moderate-severe OSA (AHI greater than or equal to 15) and obesity for Zepbound coverage. Our team ensures all documentation is complete before the obesity medicine physician submits prior authorization.
Months 1-3: Medication Titration Phase
Obesity medicine physician manages medication
During This Phase:
- • Obesity medicine physician: Prescribes Zepbound, manages dose titration, monitors side effects
- • Patient: Weekly injections at home, regular visits with obesity physician
- • Our team: Available for OSA symptom questions and CPAP adjustments if needed
Continue CPAP if currently using: Do not stop CPAP therapy during Zepbound titration unless advised by our physicians. Weight loss takes time, and your OSA still requires treatment during this phase.
Month 3: First OSA Improvement Assessment
Critical monitoring checkpoint
Our Team Orders Follow-Up Sleep Study:
Our team will:
- • Order follow-up sleep study to measure AHI improvement
- • Schedule study once weight loss is significant (typically 15-20 lbs lost)
- • Our physicians review study and compare to baseline
- • Determine if OSA is improving as expected based on SURMOUNT-OSA trial data
What Our Physicians Evaluate:
- • AHI Reduction: Tracking toward 55% reduction seen in clinical trials
- • Hypoxic Burden: Improvement in oxygen deprivation metrics
- • Sleep Architecture: Overall sleep quality changes
- • CPAP Adjustment: Can we reduce pressure or change modality?
Key Decision Point: If OSA is significantly improved, we may adjust CPAP settings or discuss transitioning to different therapy. If minimal improvement, we continue monitoring and coordinate with obesity physician on treatment plan.
Month 6: Comprehensive OSA Reassessment
Maximum OSA improvement typically reached
Second Follow-Up Sleep Study:
Our team orders comprehensive sleep study to:
- • Measure final AHI improvement (most weight loss achieved by Month 6)
- • Determine if OSA is in remission (AHI less than 5)
- • Assess if CPAP can be discontinued or therapy modified
- • Identify if additional sleep interventions needed
Possible Outcomes:
- OSA Remission (AHI less than 5): CPAP may be discontinued. Continue annual monitoring to prevent recurrence.
- Significant Improvement (AHI 5-15): Adjust CPAP settings or consider alternative therapies like oral appliance.
- Moderate Improvement (AHI still greater than 15): Continue CPAP, consider combination therapy or alternative options like Inspire/Genio.
- Minimal Improvement: Coordinate with obesity physician and discuss next-step treatment options.
Month 12+: Ongoing OSA Monitoring
Annual sleep studies to prevent recurrence
Long-Term Monitoring Protocol:
- • Annual sleep studies: Verify OSA remains controlled
- • Weight monitoring: Weight regain often leads to OSA recurrence
- • Symptom tracking: Return of snoring, daytime sleepiness, or gasping
- • CPAP adjustment if needed: Reinitiate therapy if OSA returns
Important:
Stopping Zepbound typically leads to weight regain and OSA recurrence. If you discontinue medication, close OSA monitoring is critical. We'll order repeat sleep studies to ensure your apnea doesn't return to dangerous levels.
CPAP Management During Zepbound Treatment
Adjusting Therapy as OSA Improves
Our Team's Role:
- • Monitor CPAP data: Track pressure needs, leak rates, residual AHI
- • Adjust pressure settings: Reduce CPAP pressure as OSA improves
- • Change modalities: Transition from BiPAP to CPAP or CPAP to APAP as appropriate
- • Consider discontinuation: Safely stop CPAP if sleep studies show remission
- • Alternative therapies: Discuss oral appliances or positional therapy for mild residual OSA
Safe CPAP Discontinuation Protocol:
We do NOT simply tell patients to stop CPAP because they lost weight. That's dangerous.
- • Verify AHI less than 5 on follow-up sleep study
- • Review symptom improvement (Epworth Sleepiness Scale)
- • Educate on weight maintenance importance
- • Schedule annual follow-up sleep studies to monitor for recurrence
- • Keep CPAP equipment available in case of weight regain
Critical Point: CPAP discontinuation is a medical decision based on objective sleep study data, not subjective symptom improvement alone. Our physicians make this determination after reviewing comprehensive sleep study results.
Why Sleep Medicine Monitoring Matters
Our Approach:
- ✓ Board-certified sleep medicine physician oversight
- ✓ Baseline and follow-up sleep studies at Month 3, 6, and annually
- ✓ Track AHI and hypoxic burden objectively
- ✓ CPAP adjustments based on improving OSA severity
- ✓ Safe CPAP discontinuation protocol when appropriate
- ✓ Alternative therapy options if Zepbound insufficient (Inspire, Genio)
- ✓ Long-term OSA monitoring to prevent recurrence
Weight Loss Clinic Approach:
- ✗ Prescribe Zepbound for weight loss only
- ✗ No follow-up sleep studies to verify OSA improvement
- ✗ Assume weight loss equals OSA cure (dangerous)
- ✗ No CPAP adjustment guidance
- ✗ No protocol for safe CPAP discontinuation
- ✗ No backup plan if weight loss doesn't improve OSA
- ✗ Discharge patient after weight loss goal reached
The Difference: Weight loss clinics treat obesity. We treat obstructive sleep apnea. Weight loss is the mechanism, but OSA control is the goal. Follow-up sleep studies are the only way to verify you're truly improving.
When to Contact Our Team
Call Us If You Experience:
- Worsening OSA symptomsIncreased snoring, gasping, or daytime sleepiness
- CPAP issues during weight lossExcessive leaks, discomfort, or pressure intolerance
- Significant symptom improvementWant to discuss reducing CPAP or transitioning therapy
- Weight regain after stopping ZepboundNeed repeat sleep study to check OSA status
- Questions about sleep study resultsUnderstanding AHI changes and next steps
- Considering alternative OSA treatmentsInspire, Genio, or oral appliances
Comprehensive Sleep Apnea Monitoring During Zepbound Therapy
Coordinated care with obesity medicine physicians. Expert sleep apnea monitoring by board-certified sleep medicine team.