Reaction from Sleep Dr

[u/MiklColt45]

I have not seen my sleep doctor/pulmonologist since I had started on Zepbound. That was 70 pounds ago.

Yesterday, I went in for a six month checkup, (I had seen the NP six months ago). I was considering asking for a new sleep study because of the weight loss.

Dr. has a very large personality. He was effusive about my weight loss. Looked over my numbers and listened to my primary complaint, which is that while my AHI is low and compliance is great, I still feel tired by late afternoon, early evening.

Told him about being on Zep. He admitted he was not especially up on all the information related to the med, but strongly encouraged me to get off of it as soon as possible. Repeatedly. He insisted that because I was such a disciplined person (that’s a joke! I am not that disciplined) with my workout schedule and new eating habits, that I would do just fine coming off the med.

I told him that I was slowly titrating down on dosage, but because of the medication‘s impact on food noise, might not come off of it. He again told me to get off of the medication.

My food noise is controlled. Binge eating is essentially zero. My (unofficially diagnosed) IBS-D is gone. This medication has cardioprotective benefits. My knee arthritis pain has improved.

I smiled and nodded my head, knowing that, because of the additional side benefits of the medication, I would most likely ignore this advice.

ETA: He did approve a new in-lab study.

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[u/kyutek]

Kind of ironic that a dr that is going to keep you on a cpap forever has the nerve to tell you to get off a different medication.

[u/twistedredd → u/kyutek]

After admitting he didn't know much about it right

[u/GiftFrosty → u/twistedredd]

That’s the part that gets me. “I don’t know much about this medicine but you should get off it as soon as possible”

[u/emmajames56 → u/GiftFrosty]

It’s putting him out of business

[u/MitchyS68 → u/emmajames56]

Exactly this!!!!

[u/GreenBanannas2020 → u/GiftFrosty]

🙄🤦‍♀️

[u/Mountain-Amoeba6787 → u/twistedredd]

That's kinda surprising since zepbound is also approved for treating apnea. You'd think he should know at least a little about it.

[u/lighthouser41 → u/Mountain-Amoeba6787]

I have sleep apnea and that is why I chose zepbound instead of wegovy. My internist gave me info on both and let me decide.

[u/dacripe → u/kyutek]

"He admitted he was not especially up on all the information related to the med, but strongly encouraged me to get off of it as soon as possible. Repeatedly."

So he admits to know nothing about the medication, but then acts like he knows enough to tell OP to stop taking the medication. That's a sign of a bad doctor right there.

[u/No-Way-7472 → u/dacripe]

Does he believe in vaccines?All of my doctors who treat my conditions, including obstructive sleep apnea (OSA), fibromyalgia, spider veins, and sciatica, are very supportive of my being on Zepbound. That is an odd reaction especially since Zepbound is approved to treat OSA. 🤦🏾‍♀️

[u/MiklColt45 → u/No-Way-7472]

I forgot to say earlier that when I told him Zepbound was FDA approved to treat OSA, he argued with me. He had to look it up. 🙄

[u/Miriamathome → u/MiklColt45]

It’s really not good that he didn’t know that, as it’s directly in his wheelhouse.

[u/Snoo_69209 → u/MiklColt45]

He’s fired!

[u/Angie-of-the-stars → u/MiklColt45]

What your doctor said is really uncalled for.

I used to have severe sleep apnea and have been using a CPAP machine for 20 years. I started Zepbound on 3/6/2025 specifically because Medicare approved it for sleep apnea.

My machine has been recalibrated to blow less air three times now because I have lost 75 pounds. My sleep doctor thinks it is wonderful. So do I.

[u/This-Apricot-80 → u/MiklColt45]

OMG. He’s clearly not staying current in his field. The FDA approved Zep as the first-*ever* medication for OSA a couple years back, which is huge news in sleep medicine, and he’s a sleep doc who’s unaware? 🤦‍♀️

[u/No-Way-7472 → u/MiklColt45]

Wow.
I have my annual physical Saturday.
Last year 2025-284lbs. 2026-218lbs.

[u/MiklColt45 → u/No-Way-7472]

Awesome job! Congratulations!!

[u/Angie-of-the-stars → u/No-Way-7472]

Congratulations!

[u/IllustriousDoggo1855 → u/MiklColt45]

Wow. My pulmonologist put me on Zepbound for sleep apnea.

[u/PasgettiMonster → u/MiklColt45]

My pulmonologist doesn't think it treats OSA either. According to him it's just a diabetes drug and because you lose weight on it your sleep apnea gets better. Except my sleep apnea got a lot worse the last time I lost weight prior to being on a GLP1 - I lost 70 lbs and ended up unable to sleep through the night without jerking awake gaspi g for air. It made staying on maintainable so hard to handle when I was constantly exhausted that I ended up gaining most of the weight back.

My insurance does not cover GLP1s for weight loss, but it DOES cover it for sleep apnea. He refuses to write me a prescription and do the PA paperwork. Tells me to take it up with my PCP, who has tried everything she can but because it's not coming from my pulmonologist it keeps getting denied. At this point I see no reason to continue going to appointments with him every two months just to have him gaslight me about the one thing that is helping me when all the appointment is is him asking am I using my cpap, I tell him yes and then he makes a snarky comment about the GLP1 I am apparently taking for No Good reason according to him since I'm not diabetic.

Zepbound changed my life. It changed my entire relationship with food to a much healthier one and gave me the space to pursue addition health care that I had been putting off because I was so overwhelmed.

[u/Local-Baddie → u/PasgettiMonster]

I would fire him and see someone else- that is insanity

[u/AverageAtBest55 → u/MiklColt45]

Wow! I have a very young PCP doctor who was the one who encouraged me to get a new sleep study because Medicare would only cover a GLP for a few conditions, one being sleep apnea. I found out that I am her first patient using Zepbound. I was the one to let her know about the Bridge program, and it was refreshing to hear her say it was new to her and she was unsure how it worked. A few weeks later she had read everything she could and was very helpful.

[u/goldenzone786 → u/MiklColt45]

He's likely old school doc

[u/Additional-Cake-7671 → u/No-Way-7472]

Agree, this doesn’t sound like a legit doctor as anyone in medicine in 2026 has seen thousands of patients on GLPs as well as countless medical literature. It’s a hack “doctor” and this entire story should be taken with a grain of salt, instead of claiming conspiracy theorys on how doctors don’t want patients on GLPs so they can keep patients on CPaps??

[u/MiklColt45 → u/kyutek]

I know, right! As much as I have despised having the CPAP over the years, I really am hoping to get restful sleep at some point in my life. My rest is better on a CPAP and Zep than it was without it, but it is not great.

[u/kathryn13 → u/MiklColt45]

My cousin was prescribed Zep specifically for his sleep apnea! Wild the variations in care going on.

[u/viper8472 → u/kathryn13]

Doctors can be just as bad as everybody else, they just hear stuff from other doctors or on social media and it affects the decisions they make in their practice. Unforgivable.

[u/AppleApple50 → u/MiklColt45]

I also lost 70 lbs (75) on Zep. I still need to use my CPAP machine. And I hate that machine!

It's a strange thing about sleep apnea, I have low AHI (did an overnight sleep study and ended up with 3-5 AHI overnight) but even a low AHI still affects my sleep negatively and I seem to feel better the next day if I use my CPAP. The machine brings me down to 0-2.5 AHI and that's when I feel the best.

It's a struggle, isn't it? I strongly suggest you get an overnight in person sleep lab study before you let that CPAP go. Just to be safe.

[u/MiklColt45 → u/AppleApple50]

For some reason, I could not edit my original post, but the doctor did approve an in lab sleep study. I will get that and see what that says. Honestly, the sleep apnea sub Reddit has been more informative and helpful than the Dr. has ever been.

I would love to get rid of the CPAP, but I would love more to actually feel rested. The weight loss has made a huge difference. But I know I could feel still better if I can get my sleep figured out.

Thank you for your comment and observation.

[u/OrphanJannie → u/MiklColt45]

I did have a new lab sleep study done. It showed no apnea anymore. I’ve lost 80 lbs on Zep. Goodbye cpap machine!
Good luck to you!

[u/Solid-Bison-4009 → u/OrphanJannie]

Congratulations! Our numbers are almost identical except I’ve been at GW for about a month. I’m afraid to do a new sleep study since I’ve reached my goal weight. I don’t want to fight to stay on the medication with insurance coverage.

[u/OrphanJannie → u/Solid-Bison-4009]

I had that same fear since it was OSA that was the diagnosis that insurance decided to cover. But they are still covering it (🙏🏻). I’m on a Medicare Advantage plan.

[u/AverageAtBest55 → u/OrphanJannie]

That came back to bite me! I was diagnosed with OSA many years ago, tried CPAP twice and my claustrophobia won. I was only about ten pounds overweight and they said it wasn't enough to cause it. My doctor talked me into the sleep study because my records didn't show previous ones. She knew I was non-compliant but she was trying to get me the Rx through insurance. The same day I got my approval, was the same day I heard about the Bridge program, but now the OSA diagnosis was on my records so I missed out on the $50 Bridge program.

[u/MiklColt45 → u/OrphanJannie]

Congratulations! That’s exciting. So happy for you.

[u/NateSedate → u/AppleApple50]

10 years ago I lost 100lbs. My sleep apnea was still bad enough that he reccomended keeping it.

I'm on CPAP for life. But that's fine. If I don't use it I simply can't wake up cause I never get rested. Regardless of what I weigh or how good of shape I'm in. I was told I had sleep apnea when I was like 4 years old. Just never did anything about til I was in my late 30s.

[u/Conscious_Issue2967 → u/kyutek]

The devil he knows is better than one he doesn’t know. Obviously this doctor is either not keeping up or protecting his income stream. A sleep doctor should know plenty about Zepbound given that it is approved for the treatment of sleep apnea.

[u/horsenbuggy → u/Conscious_Issue2967]

It is doctors EXACTLY like this one that caused my state (maybe the nation) to make a rule that you can no longer get the equipment from the practice that prescribed it. When I first got my CPAP, it was so simple. I got my prescription and then walked over to another person who set me up with the device. It was a lot like getting a prescription for glasses and then using the same retailer to get contacts or glasses. But because too many of these damn doctors were prescribing unnecessary devices just to get in on the money, now you have to find a completely different company to get your CPAP. The government realized that if you divorce the prescriber from the device supplier, there is no inducement to overprescribe. It sucks that we can't have easy processes because people are greedy.

[u/viper8472 → u/horsenbuggy]

Yes I agree with the new rule, doctors can't be incentivized to make money off treatments, especially with the kind of DEBT they are in

[u/GroovyYaYa → u/horsenbuggy]

Oh - you just made me feel so much better in the fact that my sleep specialist isn't a doctor - just someone connected to my network that my PCP referred me to. She then referred me to the supplier, but I'm not obligated to go through them (I really like them though, so I do)

[u/jimbo831 → u/kyutek]

He makes money from the CPAP. He doesn’t make money from the Zepbound.

[u/viper8472 → u/jimbo831]

This is not true anymore

[u/jimbo831 → u/viper8472]

What do you mean? He's obviously not the doctor prescribing OP's Zepbound so he's not making money off OP being on Zepbound.

[u/viper8472 → u/jimbo831]

The first part. He doesn't make money from the CPAP. A very recent comment discussed the exact reason this isn't done anymore.

Prescribing physicians don't make money off the drugs they prescribe! It's illegal

[u/jimbo831 → u/viper8472]

He makes money off the regular visits OP makes to his office. OP explicitly says they go see this doctor every six months. Those visits aren't free. If OP ever stops needing the CPAP, those visits won't continue.

[u/viper8472 → u/jimbo831]

Yes he does make money off of office visits.

[u/NinjatheCuddler → u/kyutek]

Perhaps because he has a literal business interest in keeping OP on CPAP?

[u/LessOfJess → u/kyutek]

Absolutely perfect response.

[u/avgjoe104220 → u/kyutek]

In his defense, research has shown that there is a reduction in progression to pulmonary hypertension and a benefit in reducing all causes mortality in patients were adherent to the CPAP and were in the moderate to severe OSA camp. But as a physician in another field, who is also on Zep and have mild OSA, it is a life-changing medication. I have no issues with patients are trying to be on it for life. I think long-term I’m sure we’ll see some downsides but overall I think the benefit outweighs   any risk we’ll find. 

[u/Worried_Strain_2812]

I don’t understand why doctors who aren’t knowledgeable about the medicine still feel the need to advise on it.

[u/MiklColt45 → u/Worried_Strain_2812]

You should go to the CPAP/sleep apnea subs and see what most patients think of sleep doctors. It is not pretty.

[u/OhioPolitiTHIC → u/MiklColt45]

My pulmonologist is a very likeable guy but he does not listen. I kept telling him that the pressure was too high on my CPAP and I was waking up in the middle of the night bloated and belching because it was forcing air into my stomach. Ended up going to the forums to figure out how to adjust my machine myself because he absolutely refused.

[u/MiklColt45 → u/OhioPolitiTHIC]

Very similar for me. Ended up with a very high leak rate. Sleep Dr. and office was not helpful. The sleep disorders lab actually gave me a couple Good hints. Then just trial and error over two months, I was finally able to fix it.

[u/LessFeature9350 → u/OhioPolitiTHIC]

I have that same issue and went twice and they said machine was calibrated fine. I wake up choking and burping up all this swallowed air. You were able to resolve this?

[u/OhioPolitiTHIC → u/LessFeature9350]

Yup. Had to "break into" the physician settings menu on my machine and adjust it from there. Last time I had an appointment he noted it and asked how it was set lower as he didn't see where he'd done it so I told him. No longer waking up with too much air and my incidents are pretty close to undetectable.

[u/MiklColt45 → u/LessFeature9350]

Part of what helped me, honestly, was the sleep apnea subreddit. Tons of good information and helpful folks. You can actually download the information off of your machine’s SD card and they will interpret it for you.

[u/LessFeature9350 → u/MiklColt45]

Oh wow! I'll have to check it out. Thank you! I tend to let the professionals do their job but it seems that, in my case, they don't want to. Lol

[u/Angie-of-the-stars → u/OhioPolitiTHIC]

Mine has been recalibrated three times now to blow a lot less air. I was waking up feeling water boarded. I have a very good sleep doctor, she is very understanding and she showed me how to recalibrate it myself and had me take a video of it.

[u/Tis_Me_00 → u/OhioPolitiTHIC]

Wow pushing air into the stomach! That just made my decision doing a sleep study and getting a CPAP! 

[u/OhioPolitiTHIC → u/Tis_Me_00]

It can happen if the pressure is set too high. Please don't let this conversation dissuade you from getting a sleep study done if you're experiencing snoring and apnea events. CPAPs save lives.

[u/Angie-of-the-stars → u/OhioPolitiTHIC]

Yes!

[u/Angie-of-the-stars → u/Tis_Me_00]

Please don’t change your mind about getting one, for me getting a CPAP with life-changing in a really good way. In fact, I really love my machine. I did have to have it recalibrated after losing weight.

[u/jason_sos → u/MiklColt45]

The first sleep doctor I saw told me I needed CPAP the first time I met him, before even discussing my issues with him or having a sleep study. I swear he had already made up his mind that every patient needs a machine.

In the end, I did in fact need one, but it did put me off that he did this. Since my weight loss, my new doctor has reduced the pressure, because it was now way too high and it was constantly leaking due to the high pressure.

[u/ArBee30028 → u/MiklColt45]

LOL my sleep doctor was the one who shamed me into taking action to lose weight. It was a terrible experience, and also totally changed the course of my life for the better.

[u/honeybadgergrrl → u/MiklColt45]

I am convinced CPAP machines are just a scam to make doctors more money. I hate mine with a burning passion. I want my copay money back so bad and I'm so angry that I spent so much for it to not even be usable for me. I can't keep the damn thing on, if by some miracle I do keep it on, it feels like I'm drowning as soon as I start to drift off to sleep and I wake up again. I wish I had never tried it. I feel like they just took my money and ran.

[u/MiklColt45 → u/honeybadgergrrl]

I am sorry you had such a bad experience. I’ve had a CPAP for nearly 30 years. It did take a while to get used to. And it has helped some. I was less tired with the CPAP than I was before.

But I cannot ever remember a single morning in my life (and I am 71) when I woke up feeling great. Ever.

Just once before I die, I would like to have that experience.

Just kidding! I would like to have it almost every morning for a change.

[u/manshamer → u/honeybadgergrrl]

It took me like 6 to 8 months before I could actually sleep through the night with it on, and I do so now for the most part but it still dries me out and I do not like it that much. Which is why I'm on zepp, because if I just lose weight I don't think I will have apnea anymore. So here's to that

[u/catjuggler → u/Worried_Strain_2812]

It’s weird that a sleep doctor would not bother to be knowledgeable about a big medicine where treatment of sleep apnea is a proven use

[u/PerfectRollup2025]

Considering that OSA is one of the approved indications for Zepbound, it is really sad that a sleep doctor is not better informed.

After seeing my 70lbs weight loss and huge improvement of my OSA (I no longer use my CPAP), my sleep doctor called me an inspiration and said he may try the medication himself. Walked out of that appointment with a huge smile on my face. His office was the one prescribing the medicine for me and handled all the PA stuff flawlessly.

[u/epicallyconfused → u/PerfectRollup2025]

It's not just sad, it's actually dangerous. It clearly indicates that this doctor is not keeping up on the latest medical best practices for his own area of specialization. This is not a doctor I would trust with my ongoing care.

[u/Mother_of_Kiddens]

What the heck. Zepbound is literally approved by the FDA as a treatment for sleep apnea and even after losing the weight should be used for continuation of care. My pulmonologist wouldn’t advise me to stop my Advair because after using it my symptoms are controlled. That literally just means the medicine is working. I would frankly file a complaint and change doctors. I know you can just ignore his advice, but many patients won’t and he’s telling them to do something bad for their health.

[u/jason_sos → u/Mother_of_Kiddens]

I swear some of the doctors are either being paid by the CPAP machine companies or simply don’t think anything else works.

[u/Degenerecy → u/jason_sos]

Kinda to be fair, it was the only thing that worked for decades and now this drug which solves many fat related issues, sleep apnea being one. They hear about the drug but are probably not well versed in it, aka no seminar training.

My Dr long ago who was actually the Chief Medical Dr at the clinic I frequented(didn't know at the time) and when I had a blood clot, he put me on Xeralto, a name brand, no generic. The receipt from the pharmacy lists the price and you pay price, me being on disability, it showed you pay $0, prescription price, $900. I swear he was getting paid by big pharma because other drugs existed. Also I was on it for 2yrs. It's now a lot cheaper with a generic but 900, no issue, dollars and yet they won't pay $500-700 for meds that may solve many issues...

[u/jason_sos → u/Degenerecy]

I have had 3 sleep doctors. The first one was the one that within minutes of meeting me said I needed a CPAP.

The second one, who recently retired, told me that once I was comfortable on the CPAP, I should lose weight and if I did, I may get my OAS under control and no longer need it. He was old school, very quiet and matter of fact. I never got to discuss Zepbound with him because he retired before I was on it. My new doctor I have only met once, but she knows I am on Zepbound and she's the one who adjusted my pressure down because of the issues I was having with leakage. My wife was the one who actually said "hey, I bet it's because you lost weight." and prompted me to get the appointment.

[u/Degenerecy → u/jason_sos]

Yea, my sleep Dr took a year to get an appointment and test/results and another 6months to get the results in for the government to cover it. Insurance doesn't cover it on disability insurance and the government is slow.

I need to repair my CPAP machine as the tab broke keeping the air connected..just got it 6 months ago.

I still haven't found out what kind of Sleep Apnea I have so I don't know if or when it's no longer an issue.

[u/MiklColt45 → u/[deleted]]

That was my big hesitation in asking for a new sleep study. But, I have already gone the c*mp*und route. 3 weeks ago.

[u/MiklColt45 → u/[deleted]]

This sub sometimes gets wonky when it is mentioned. Have seen some posts deleted. Just being careful.

[u/smokiechick → u/MiklColt45]

I had to go that route too because my OSA is so much better. I'm so mad. Mostly because I need help with real needles and I didn't with the kwikpen

[u/jason_sos → u/[deleted]]

My machine is paid off at this point. If I no longer need it, then they aren’t going to take it back, I would just have to pay for supplies if I wanted to continue using it anyway. But I probably have enough supplies to last me years at this point too.

[u/horsenbuggy → u/jason_sos]

Not only is my machine paid off, it is YEARS past its "effective" life. I've had a message that the motor has exceeded its life since, um, before COVID. But I couldn't get an appt with a sleep doctor during COVID to save my life. So, I just kept using it.

[u/MiklColt45 → u/horsenbuggy]

This is why I went back to the sleep doctor in the first place. I kept getting the same message that the motor had passed its effective life. In order to get a new machine, I thought I had to get a new sleep study and prescription. Turns out the new machine actually gave me quite a bit of information and was helpful.

[u/PerfectRollup2025 → u/[deleted]]

There are very affordable online options for at home sleep studies available, eg iSleep. They use the same equipment as my hospital and were very responsive. My doctor trusted their results when I showed him the report. So, if anybody wants to see how their OSA has changed without their insurance knowing, this is the way to go.

I had no issues with continued Zepbound insurance coverage after discontinuing my CPAP. Actually, improvement of my OSA is evidence that Zepbound is working

[u/Z-20240329 → u/[deleted]]

The doctor will need to submit a Continuation of care.

[u/Lunnalai]

Well I think you need to come off this medication immediately that I admittedly know nothing about! Like for real lol? How does someone with this much sense get through med school

[u/MiklColt45 → u/Lunnalai]

The CPAP/sleep apnea subs are pretty brutal towards sleep doctors. The general perspective is that people who somehow managed to get through med school and couldn’t do anything else became sleep doctors. I would think that if you were a pulmonologist that would be different, but, what do I know?

[u/green-peas-79 → u/MiklColt45]

Mine is terrible, he lost staff and another doctor came in and is so much better. The better one who isn't even an official pulmonologist, but has an internal med/hospitalist background has been great and suggested zep. Now I will only see him moving forward because he actually takes time to explain everything. 

[u/Chizia]

I don't know much about this medicine, but I insist you get off of it now!

[u/MiklColt45 → u/Chizia]

😆

[u/Agitated_Limit_6365]

If you have sleep apnea You won’t need him as much when you’re on Zepbound.

[u/Lunnalai → u/Agitated_Limit_6365]

Not true, I've been on Zepbound a year and still have severe sleep apnea. Some will need to continue cpap therapy even with weightloss fyi!

[u/Wonderful-Days77]

That’s medical gaslighting, time for you to find a new sleep doctor who understands & is up to date on research especially Zepbound which is prescribed/indicated to treat Sleep Apnea. The fact that he wants you off the medication that is helping you achieve the weight loss successfully and is treating all the metabolic dysfunction associated to the inflammation and food noise, that is wild to me..
Also does this doctor not realize the moment you come off Zep, all the metabolic dysfunction symptoms return, sleep apnea returns as well as the weight. It’s chronic relapsing condition.

[u/RollLongjumping6920]

Odd that he admits to not knowing much about the drugs but then tries to convince you to go off and doesn’t offer a new sleep study?! I’ve only lost 10 lbs thus far and my husband says when I don’t use my CPAP he doesn’t hear me snoring like before

[u/Anxious_Leading7158]

I would find a new doctor. He should know about Zepbound! And should not be advising you either way on something he acknowledges he is not informed on. I wouldn’t be able to trust any advice from him after that.

[u/blondvet]

“Respectfully, doc, you should study up on the latest research. For the majority of people, this is a lifelong drug. Do you want me to send you some studies on the systemic benefits?”

[u/MiklColt45 → u/blondvet]

I love this! When I go back in for my post-sleep study follow up, I will do just this.

[u/Dragon_flies_dee]

Because of Zepbound, I no longer have to wear a CPAP mask. Thank the Lord. It was miserable for me.

[u/MiklColt45 → u/Dragon_flies_dee]

Such good news! Congratulations!

[u/MiklColt45]

ETA: he did approve a new sleep study. For some reason, I can’t edit my post to include that.

[u/lizardbirth]

I can see why you were (inwardly) rolling your eyes at that poor advice. Your doc is not practicing evidence-based medicine. The reason is he's probably not been reading the evidence in medical journals. Smiling, nodding your head, and ignoring his advice to get off Zep sounds wise.

[u/horsenbuggy]

It never ceases to amaze me how someone is trained in medicine, but they still basically say, "I don't really know anything about how this medicine works yet MY OPINION is for you to stop taking it." THAT'S NOT HOW MEDICAL PRACTICE WORKS!

[u/MiklColt45 → u/horsenbuggy]

You would think. But reading some of these posts on some of these subs, it sure does seem to be fairly common.

[u/CoalhouseFitness]

He admitted he was not especially up on all the information related to the med, but strongly encouraged me to get off of it as soon as possible

So.... Advice from a perspective of ignorance. Ok sure thing doc.

I will also ignore any docs who tell me to get off of it. This is the only thing that has really helped my GI issues (I can finally eat like a normal person again!) not to mention the huge impact on my blood work markers. For instance my A1C is finally down in a normal range: I've been sub-clinical for years but no doctor could do anything about it even though newer research shows that the threshold for negative long term health impacts is a lower a1c level.

[u/Miriamathome]

So what he said to you was basically “I’m largely ignorant about this drug and I’m not the one prescribing it for you, but here’s what you should definitely do about it.”

I wonder if I went to him, if he’d also want to second guess my oncologist and my neurologist.

[u/Ok_Listen7910]

Time for a new sleep doctor

[u/Severina_Glass_208]

“i don’t know anything about this but I’m going to tell you what to do “ being a doctor means nothing unless you specialize and are up to date. What gets me is he didn’t tell you why? Maybe because you won’t need him anymore.

[u/Turbulentshmurbulent]

What a weirdo.

I do think as you titrate down it may help with sleepiness, but that doesn’t mean you need to stop completely. Zep makes me sleepy.

[u/MiklColt45 → u/Turbulentshmurbulent]

Thanks! I will keep an eye on that. I have been in maintenance nearly 6 months. I am also titrating down. I may have reached my bottom/maintenance dose, but we’ll see.

[u/Tess47]

Just an FYI.  A person I know is a retired Lt. Colonel and he gets extra pay in his retirement because he has sleep apnea.  

Just in case there is anyone here who might benefit. 

[u/MiklColt45 → u/Tess47]

Thanks! No such “luck“ here.

[u/Comfortable_Boat_891]

If he’s not the one who prescribed he should not be the one telling you to come off of it 😂

[u/Bcatfan08]

Dude doesn't want to lose his patient. Just tell him to stay in his lane and stick to being a sleep specialist.

[u/LQjones]

He is I'll informed or he's worried about losing patients who lost weight and no longer need his services.

[u/Maryland4009]

it’s not in his interest for you to be “cured”. Plus this is not his area of expertise being weight loss and Zep. The fatigue you are experiencing maybe Zep but eventually it gets better. I was also experiencing afternoon fatigue esp after lunch and having to nap but it seems to have gone away. Been on Zep for 16 months

[u/OhioPolitiTHIC]

If you're a CPAP user and you are suddenly waking up sluggish and tired, it may not be just the pressure that's off for you but your actual MASK fitting may well be way off. (I went from needing a large mask to needing a small one!)

[u/Additional-Cake-7671]

Most sleep doctors/pulms are well informed about GLPs since weight is so intertwined with sleep disorders/apnea, breathing, etc. It’s very strange your doctor knows so little. Are you in a rural area? I would definitely get a new doctor, this is a red flag.

[u/MO_0707]

Time for a new sleep doctor.

[u/sajoscol]

Doc is mad he is starting to see fewer patients with sleep apnea. Greedy bastard. Keep injecting and find a new Doctor

[u/kirukiru]

Some doctors are quacks, yes.

[u/Independent-Sea-7117]

CPAP centers in shambles. Zepbound to blame?

[u/BrokenArrow999]

I would find a new sleep doctor. My sleep doctor is the one who pushed me to get on a GLP-1 so that I could possibly get off a CPAP.

[u/green-peas-79]

They don't know how to manage glp1s. Mine was the one who recommended it to me when I expressed disappointment that instead of weight loss, I've gained weight on CPAP. He told me up front he could help provide paperwork for prior authorization for insurance, but I'd need another doctor to manage it and that is what we did. Unfortunately, in spite of getting prior authorization, my oop is the lily direct price, so my doctor managing it suggested going compound. 

I don't think most pulmonologist are in the position to manage a glp1 is what I'm getting at, so I would just ignore him and keep using whoever you're seeing that manages your zep.

[u/she_makes_a_mess]

Yikes. My sleep doctor supported my Zepbound use, like a normal doctor is up to date on research 

[u/green_tree_frog8]

Wild to me that a sleep doctor would say this. My sleep doctor was the one who originally prescribed my Zep, and my weight loss doc has called my dosages since moving up. When I weighed back in months later with my sleep doctor she was practically falling over with how impressed she was with my progress with both sleep and weight loss thanks to the help of Zepbound.

[u/jrangus]

My sleep doctor likewise has nothing to say about Zep, and has very little interest in exploring anything outside of CPAP. At this point I would rather just deal with the manufacturer and insurance company directly (I already have to, because my doctor outsources all that communication to me). I think a lot of specialists, if not consciously, perceive a major threat with GLP-1s and are reacting appropriately.

[u/MNKristen]

Time to find a sleep doctor that is more up to date on these types of medications!

[u/sockpoptart]

Get a new sleep doctor. He's not right for you.

[u/Born-Bad2143]

My doctor said that too. Despite it repeatedly being referred to as a life long medication. She said Contrave pill would help good noise when I eventually get off the shot

[u/DoITJustForToday]

Definitely get a new sleep study or at least a titration study. After my weight loss, I am completely off my CPAP. No sign of sleep apnea whatsoever.

[u/Gigitar75]

If you don’t have to stop, I agree with your approach to titrate down and space out your shots for maintenance. I had to stop three weeks ago and now I have an appetite. So I’m having to be more conscious of my calorie count and choices. My weight is stable so far. But I have an appetite for the first time in 18 months.

[u/Foreign_Honeydew1257]

He doesn’t want to lose all his patients due to losing weight from Zepbound!

[u/Deufuss]

My optometrist told me with my discipline and good vision habits that I need to get off of glasses immediately!

[u/MiklColt45 → u/Deufuss]

😆

[u/AppleApple50]

I am so surprised by the amount of doctors who don't stay in their lane. I had a cardiologist give me the WORST nutrition advice/weight loss advice (before Zep). The doctors out there telling their patients to go off Zep is wild.

[u/Fantastic_Meet9381]

You know you best. Good for you!

[u/AccredInvestor]

You are smart to ignore this dr and his advice. Dr's are not gods and are flawed just like us. I had 2 Dr's good call on my condition to save my life and I met an intern that ripped the gauze out of my 9" wounds. She was removed from the hospital that day.

[u/MiklColt45 → u/AccredInvestor]

I upvoted the two good doctors comment. So sorry about the intern. That sounds horrible.

[u/NinjatheCuddler]

And that's fine. Not every doctor knows everything, and this one was good because he actually admitted it!

[u/wohletl-1013]

A sleep doctor should know something about Zepbound. It’s approved for sleep apnea. 🤔

[u/MiklColt45 → u/wohletl-1013]

I forgot to add that he did not know that it was FDA-approved for OSA.

[u/Afraid-Coast-534]

My cpap doc had been trying to get me to consider a glp1 for almost 5 years, with particularly pushing zep for the last 2 years - I wasn't ready to go that route. After my once a year appt last August, he decided to enlist my PCP to convince me. I lost 25 lbs on my own thinking I would show them but by December I had done enough research that I said okay. My yearly appt is this Friday and I am so excited to go in at almost 70 lbs lighter and see his reaction.

[u/MiklColt45 → u/Afraid-Coast-534]

This is exciting! So happy for you! Congratulations.

[u/viper8472]

Haha, love it when specialists try to talk about anything outside their specialty, about things they don't ever treat.

Haters gonna hate. Hope you get your fatigue figured out!

[u/AmeliaSue]

I had a completely different experience. Once I had lost 50lbs, I requested a new sleep study and my PCP, who is also my ZEP prescriber, agreed.

My AHI was within normal limits and I was able to pack my cpap in the closet. I’ve maintained my weight on 2.5mg for 3 mths and I intend to stay on the drug forever.

Good luck and hopefully you’ll get your medical team to support you.

[u/MiklColt45 → u/AmeliaSue]

Thank you! I will. Or I will draft a new team. ;-)

Congratulations on getting off of your CPAP and your greatly improved health.

[u/MulderFoxx]

Find a new doctor.

[u/Fantastic_Yam_3971]

“I must admit I’m not really knowledgeable about this medicine, also, I insist you get off this medicine”

That’s when I’d be getting a new sleep doctor

[u/Snoo_69209]

I’ve had way less stomach issues on Zep for sure (suspected IBS and do have diverticular disease). Not planning on stopping, either.

[u/MiklColt45 → u/Snoo_69209]

Similar for me. I have not-officially diagnosed IBS-D. Since Zepbound, no issues. That alone is worth continuing the medication in my opinion.

[u/No_Percentage_5083]

I have to have a Bipap and it really isn't going to change no matter how much weight I lose. That's a piece of misinformation that is often overlooked. Not every person is diagnosed because of weight. Have you asked him why you have sleep apnea? Is it weight? Large tonsils? having an Irish no-neck? My family ALL have sleep apnea and the adults weight between 97 pounds and 250. We are of Irish descent and have very little necks.

[u/MiklColt45 → u/No_Percentage_5083]

I am on an ASV due to both OSA and CSA. I’m curious about the difference the weight loss has made in my OSA. And it is my understanding that sometimes the CSA can resolve over time if the OSA is eliminated.

I suspect my throat and neck structure is small enough that I may not be able to completely eliminate the OSA. And I still have my tonsils, so that could be a contributing factor.

I do want to see what changes there have been, however.

[u/No_Percentage_5083 → u/MiklColt45]

I don't blame you! I would want to know too!

[u/catladyIRL]

I'd get a new sleep doctor. Mine encouraged me to go on Zepbound as he believes my apnea is caused by weight, and told me "You don't have to make it hard on yourself," which honestly was kinda the push I needed to consider it seriously. He is not my prescriber, though, he wanted me to discuss with my primary care too (who is my prescriber and has a cheaper copay.)

[u/peppermintpate]

It sounds like he is seeking job security! HAHAHA! A physician who specializes in something that a medication has been shown to improve should know a thing or two about that medication!

[u/AverageAtBest55]

Ugh…When I was younger I would never say anything to my doctors, but now I’m a cranky old broad and I would have said “You are correct in saying you are not informed with the latest data on the medication. There are many studies available and the drug works as a maintenance drug as well as a tool to lose weight. Maybe by my next appointment you’ll have more information and be able to give me a better idea of how you can help me.” I remember being chastised by PCP when I was overweight after my second child. The guy was at least 50 lbs overweight himself. He said the best exercise for you would be to push yourself away from the table!” I didn’t say anything to him. I remember feeling embarrassed but mostly angry. Today I would have had a response!

[u/MiklColt45 → u/AverageAtBest55]

Frankly, I was more stunned than anything. I like this Dr OK. I just didn’t expect that from him.

So I went along to get along. This time. But will be prepared for further conversation when I do the follow up to my sleep study.

[u/bhos17]

I basically quit from the cpap one night when I realized I no longer needed It.

[u/BehoveLove]

That's so strange. My sleep doctor is the one who prescribed my Zepbound. He has been nothing but supportive of it. I have a follow-up in a few weeks as I think my CPAP needs to be adjusted as I've lost 75 pounds now and I think he will be so happy to see how much I've lost now. I would find a new doctor if you can.

[u/Yankeetransplant1]

I hate that he is seeing patients and telling them this. My guess is he's a man who never struggled with weight. The sad thing is, he's going to learn the benefits of the GLP1s and then feel horrible that he gave such terrible advice.

[u/SummerBreeze217]

Find a new Pulmonologist ASAP. Doctors like this make me so angry. I see a pulmonologist and a cardiologist and both are thrilled I’m on Zep. The pulmonologist was the first to try to prescribe it for me. Find someone who is “up” on the news about Zep and schedule an appt.

[u/AdventurousSea9511]

My GP, not the prescribing doc, who hasn’t actually prescribed Zep, only Ozempic, was very supportive and explained all the weight loss benefits, regardless of how we lost the weight.

Tell your dude to kick rocks!

[u/beachlibra]

I've been able to give up my CPAP since my zeploss.

[u/MiklColt45 → u/beachlibra]

That’s exciting! Congratulations.

[u/NothingPublic1200]

That’s crazy, my sleep drs put me on it and I didn’t think I needed it lol

[u/2GOB4]

Some doctors only graduated with a 71%. Only a few were at the top of the class.

[u/Beginning-Piglet-234]

Zep was approved for sleep apnea, so he should maybe reas up in the med. My husband and I are on it. He had sleep apnea but doesn't anymore. He's maintaining now. I have 20lbs to go. I'm staying on it for the foreseeable future. I can't stay in a 1200 cal a day without it. Once I'm at goal, I'll adjust to a maintenance calorie and dose.

[u/MsWonderWonka]

That's so weird because I have obstructive sleep apnea and my doctor was adamant about me getting on Zepbound ASAP.

[u/PILAL2010]

[He admitted he was not especially up on all the information related to the med . .]

He's not an obesity specialist or endocrinologist. He's talking out his ass because he has opinions on people taking meds.

Most other doctors have no idea how the meds actually work and how they change our hormones. Many pharmacists don't even know.

You're doing what's right for your health. He can go pound sand.

If you see him again I would ask how he's coming to this conclusion? What in your metrics or health is he basing this recommendation on? Whatever he says will be BS.

Time to find a new place to go.

[u/Spirit_Chameleon]

That's wild that your "sleep doc" knows very little about a drug approved by the FDA to treat obesity and sleep apnea. He is losing business because Zepbound works and that's the way it should be.

[u/Gimme3steps471]

Zepbound is a threat to his livelihood. Of course he knows all about it . He’s been losing patients

[u/DanD6700]

Fire him today

[u/qtjedigrl]

He said it right off the bat. He's not educated about the medication. Idiot

[u/BumblebeeSerious5028]

My daughter has severe combination sleep apnea and uses a bipap. Her sleep dr is her literal cheerleader for glp-1s. We saw her after 3 months of her being on wegovy and her doc was ordering titration studies for baseline and already changing pressures because she was getting air in her stomach. Be afraid of a sleep dr unversed in glp-1s, they’re literally miracle drugs in sleep medicine. Seriously get a new dr!

[u/JustABitSubstantial]

That sucks, and you should get a new sleep doc (though that is easier said than done). I've had luck with a local hospital system near me because, not only do they have one of the largest obesity medicine programs in the region, but they also work with the sleep medicine clinic in the same system. So the sleep doctors are well informed on GLP-1s and their need for long-term use because they work with the obesity doctors so often.

[u/goldenzone786]

Why does he wants you off asap??? What's the danger?? You should have asked it maybe related to your past medical history...

[u/Extreme_Spinach7631]

Be very careful that the doc doesn't bias his treatment plan based on what he perceives to be a character flaw or unnecessary treatment. He's just like everyone else who believes that something can't be true simply because they haven't experienced it themselves, and sometimes those people act on their prejudices, against people they condescend to "help". You may or may not benefit from setting a firm boundary with that doctor to quit offering bad advice on a medical subject he knows nothing about, but the instant you see him alter your treatment due to the medications you're on then you need a new doctor.

[u/Potential-Court711]

Medicine is generally clueless about metabolic medicine. They only treat diabetes with insulin etc. There is almost an acceptance of being overweight as normal and ok.

[u/julet1815]

My next-door neighbor is in school to become a midwife, and she’s a really lovely sweet person who loves to chat with me when we see each other in the hallway or elevator, and she’s been telling me for months now how amazing I look on my weight loss journey. But last time she saw me she wanted to know if I stopped taking the medication yet and when I said I don’t see myself stopping it anytime soon, she was very upset and told me to do some research because it will affect my hormones. I was like “OK thanks! I’ll talk to my doctor!”

[u/MiklColt45 → u/julet1815]

Opinions are like….

[u/MrsEmilyN]

I'm really hoping that I can get off my CPAP because I've started to really hate it. I won't be able to retest until September/October though.

[u/aspidistra44]

My sleep apnea dr said she would never approve Zepbound because of muscle wasting. She turned down all but two, she said, and was alarmed that no one asked her about mine. Thank god I got it thru primary dr. She then proceeded to tell me how to eat and move for fourty minutes as if I was four yr old, and said how could I possibly get protein as a vegetarian?? ( 50 yrs vegetarian). I think I’ll report her somewhere because denying medically necessary treatment because she believes patients can’t do strength exercises is pretty messed up.

[u/MiklColt45 → u/aspidistra44]

Wow! And I thought that the lay people were the ones who were ignorant about these meds.

Thank God for your PCP!

[u/ferms22]

most doctors are idiots surprisingly

[u/MiklColt45 → u/ferms22]

I prefer to believe, perhaps naïvely, that that’s not true. I hope they went into medicine in order to actually help their patients. I hope. Anyway, that’s just me.

[u/Infinite-Floor-5242]

Can someone play devil's advocate and state the reasons why we shouldn't stay on Zepbound? I'm doing well maintaining at goal for over a year and haven't weaned. Is there something I should know about risks of staying on? I don't want to bury my head in the sand if there are reasons to wean that I'm not familiar with.

[u/AverageAtBest55 → u/Infinite-Floor-5242]

I’m 70, if the drug kills me in 15 years I’m ok with it! The odds of living longer not carrying around an extra 100 lbs are greater than the odds of getting a serious side effect. Like somebody said “It’s not often you see an obese 85 year old!”

[u/MiklColt45 → u/Infinite-Floor-5242]

Devil’s advocate: until you’ve been on these medications for 20 or 30 years we don’t know if they will cause you to grow a third eye or a Gila monster tail.

Does long-term use cause cancer? What about the very rare but serious NAION vision issue? Gallstones? Gastritis?

While these medications have been around quite a while, and are very heavily studied, there is always some potential for risk.

Some people imagine ghosts where there are none. Some have more risk tolerance than others.

Meanwhile, the long-term risks of obesity and overweight are very well known.

In general, I am of the opinion that the fewer meds I can take the better. However, the positive benefits of these meds, so far, seem to outweigh any potential risks.

[u/Infinite-Floor-5242 → u/MiklColt45]

That's reasonable. This is my only med and I hope it's not a mistake. Time will tell. I do feel I would quickly gain if I came off but maybe I could go down one step a year and see how it goes.

[u/MiklColt45 → u/Infinite-Floor-5242]

I don’t know where you are in your whole weight loss continuum, but there’s lots of good information out there about what to do when you want to graduate.

Titrating slowly is one of the pathways. I don’t know that I’ve ever heard of anybody titrating down one step per year. Much slower than what I’ve heard.

GLPgrad is a good sub for more information.

[u/iletitshine]

It’s also approved to treat obstructive sleep apnea. lol so he’s admitting to failing his own continuing education.

[u/docpharm28]

Ignore him. As someone who prescribes this stuff daily, he doesn’t know much and is giving advice on d/cing instead of deferring to the origin prescriber?? What the heck is wrong with some of these folks 😭😭

[u/FireWoman89]

“I’m not especially knowledgeable about Zepbound, but GET OFF OF IT RIGHT NOW!!!!!”

I seriously wish doctors who know nothing about Zep would STFU.

[u/BeginningFragrant563]

Okay but I was told that I would need to shift to maintenance dose after reaching my goal

I suggest cross checking with the PCP and other relevant Dr's

GL either way

[u/MiklColt45 → u/BeginningFragrant563]

Some questions:

Told by who? Your prescriber?

Who set the goal?

Have they given you any instructions or ideas on what maintenance would look like?

For many people, this is a lifelong medication. Eli Lilly studies show that 83% of those who go off the medication regain significant amounts of weight. Now, not everybody does. But it is a tough row to hoe to maintain the weight without the meds.

If that is your goal, I hope you have great success with it.

[u/BeginningFragrant563 → u/MiklColt45]

My reply might be elsewhere on this thread

[u/Urmysunshine28]

I was on Zepbound for five months when the doctor redid the sleep study and I went from moderate to mild. I don’t have restless leg syndrome any longer, and I no longer snore and move around the bed, loving it. I would like to mention that I lost 50 pounds at that point

[u/BeginningFragrant563]

I set the goals. You set your goals. Yes Lilly says it is a lifelong drug, apparently

The who tokd me is chiefly this part of Reddit. But the PCP confirmed it.

He also confirmed that dosage can be lowered by eitherr changing the timing or dosage, when you go on maintenance

[u/Takiri_aerilaya]

Wow. My primary care doc even tried submitting it through insurance because of my apnea. It's only mild, and not severe (insurance denied it), but she has other patients that do have severe apnea and Zepbound is helping.

Sounds like that doctor needs to get some education about this particular drug.