Inspire Medical Systems, Inc. Announces Second Quarter 2026 Financial Results, Raised 2026 Guidance, and Strategic Growth Plan
Rhea-AI Summary
Inspire Medical Systems (NYSE: INSP) reported second quarter 2026 revenue of $200.6 million, down 7.6% year over year, with lower U.S. sales partly offset by international growth. Gross margin improved 150 bps to 85.5%. Operating loss narrowed to $0.5 million, with adjusted operating income of $3.2 million (1.6% margin). Net earnings were $0.3 million, or diluted EPS of $0.01, and adjusted diluted EPS was $0.14.
Operating cash flow rose to $23.2 million, and cash, cash equivalents, and investments were $415.2 million at June 30, 2026. The company raised 2026 revenue guidance to $835–$875 million, with expected adjusted operating margin of 4%–6%. Inspire also launched Project Horizon, a strategic growth plan expected to create about $30 million of annualized investment capacity, supported by $20–$25 million in projected pre-tax restructuring charges through 2026.
Positive
- Gross margin 85.5%, up 150 bps year over year
- Operating expenses down 7.4% to $172.0 million
- Operating loss narrowed to $0.5 million; adjusted operating income $3.2 million (1.6% margin)
- Net earnings of $0.3 million vs prior-year net loss
- Operating cash flow increased to $23.2 million from $2.7 million
- 2026 revenue guidance raised to $835–$875 million with 4%–6% adjusted operating margin target
Negative
- Revenue down 7.6% year over year to $200.6 million
- U.S. revenue decline driven by evolving coding and reimbursement environment
- High effective tax rate of 89.9% in Q2 2026
- Projected restructuring charges of $20–$25 million under Project Horizon
- Six-month 2026 net loss of $11.0 million despite Q2 profit
- Interest and dividend income decreased by $0.7 million year over year
News Explained
Project Horizon remains unfinished: most restructuring actions are expected in the third quarter, with substantial completion targeted by year-end.
On
The first phase is expected to incur
The release frames the
The material change is therefore an announced operating reorganization with near-term restructuring charges and a stated plan to redirect resulting capacity toward revenue-growth initiatives; no completion has been reported.
The next concrete checkpoints are the expected majority completion in the third quarter and the target for all actions to be substantially complete by the end of
Market Reaction – INSP
Following this news, INSP has gained 10.32%, reflecting a significant positive market reaction. Argus tracked a peak move of +11.9% during the session. Our momentum scanner has triggered 14 alerts so far, indicating notable trading interest and price volatility. The stock is currently trading at $57.61.
Data tracked by StockTitan Argus (15 min delayed). Upgrade to Gold for real-time data.
Key Figures
Previous Earnings Reports
| Date | Event | Sentiment | 24h Move | Catalyst |
|---|---|---|---|---|
| May 04 | Q1 earnings report | Negative | -12.0% | Revenue guidance narrowed amid coding and reimbursement disruption and ongoing 2026 headwinds. |
| Feb 11 | Q4 earnings report | Positive | -12.6% | Strong fourth-quarter and full-year results accompanied by lower 2026 revenue guidance. |
| Jan 12 | Initial earnings guidance | Positive | -1.5% | Preliminary 2025 revenue exceeded expectations while initial 2026 guidance was provided. |
| Nov 03 | Q3 earnings report | Positive | +15.3% | Revenue growth and raised diluted earnings guidance accompanied strong Inspire V adoption. |
| Aug 04 | Q2 earnings report | Negative | -32.4% | Slower Inspire V rollout drove significant reductions to full-year revenue and EPS guidance. |
24h Move is the share-price change in the day after each event; other market factors may also have contributed.
Earnings-tagged events averaged a -8.61% 24-hour reaction over five events; four reactions were negative, including two positive announcements that diverged from the news tone.
Key Terms
non-gaap financial measures financial
adjusted operating margin financial
effective tax rate financial
AI-generated analysis. How Rhea-AI works. Not financial advice.
- Generated second quarter revenue of
$200.6 million - Second quarter diluted EPS of
$0.01 ; adjusted diluted EPS of$0.14 - Second quarter operating cash flow of
$23.2 million - Announced strategic growth plan designed to unlock and redeploy
$30 million for growth initiatives
MINNEAPOLIS, Aug. 03, 2026 (GLOBE NEWSWIRE) -- Inspire Medical Systems, Inc. (NYSE: INSP) (Inspire, or the Company), a medical technology company focused on the development and commercialization of innovative, minimally invasive solutions for patients with obstructive sleep apnea, today reported financial results for the quarter ended June 30, 2026.
“Our second quarter results reflect the increased discipline and focus we are bringing to the business as we continue to support customers through the evolving coding and reimbursement environment and invest in the long-term adoption of Inspire therapy,” said Tim Herbert, Chairman and CEO of Inspire Medical Systems. “We are also announcing a strategic growth plan designed to generate approximately
Second Quarter 2026 Financial Results (Second Quarter 2026 compared to Second Quarter 2025)
- Revenue decreased
7.6% to$200.6 million , primarily driven by a decline in U.S. revenue, partially offset by growth in International revenue. The U.S. decline was driven primarily by the impacts of evolving coding and reimbursement environment. - Gross margin increased 150 bps to
85.5% , primarily due to increased sales mix of the Inspire V system, which has a higher gross margin than the Inspire IV system. - Operating expenses decreased
$13.8 million , or7.4% , to$172.0 million , primarily driven by lower stock-based compensation costs due to accelerated stock-based compensation expenses recognized in the prior year period as well as lower marketing expenses. - Operating earnings increased
$2.8 million to an operating loss of$0.5 million , and operating margin of (0.3)%. Adjusted operating income was$3.2 million , and adjusted operating margin was1.6% . - Interest and dividend income, net decreased by
$0.7 million , primarily due to lower average interest rates and lower average cash, cash equivalents, and investment balances. - Other expense, net decreased by
$3.4 million , primarily due to a$4.0 million impairment charge recognized in the prior year period, partially offset by a decrease in interest and dividend income in the current period due to lower average interest rates and lower average cash, cash equivalents, and investment balances in the current period. - The effective tax rate was
89.9% compared to (54.0)%. The increase in the effective tax rate was primarily driven by tax shortfall related to stock-based compensation. For the three months ended June 30, 2025, the Company maintained a full valuation allowance against federal and state deferred tax assets, which was subsequently released at December 31, 2025. - Net earnings was
$0.3 million and adjusted net earnings was$4.0 million . - Diluted EPS was
$0.01 and adjusted diluted EPS was$0.14 .
Financial Condition
- Net cash provided by operating activities for the three months ended June 30, 2026 was
$23.2 million , compared to$2.7 million in the prior year period. The change was primarily driven by improved working capital, primarily in receivables and inventories. - As of June 30, 2026, cash, cash equivalents, and investments increased
$10.6 million to$415.2 million as compared to December 31, 2025.
Full Year 2026 Guidance
The Company is raising its previously announced revenue outlook to be in the range of
The Company’s outlook assumes an effective tax rate of approximately
Strategic Growth Plan
On August 3, 2026, the Company announced a strategic growth plan, named Project Horizon, intended to create additional investment capacity to accelerate revenue growth through:
- Aligning resources to revenue growth initiatives;
- Streamlining the organization; and
- Optimizing the Company’s supply chain by consolidating production to support quality, scale, and efficiency.
The Company expects to incur a total of
Webcast and Conference Call
The Company's management will host a conference call after market close today, Monday, August 3, 2026, at 5:00 p.m. Eastern Time to discuss these results and answer questions.
To access the conference call, please preregister on https://register-conf.media-server.com/register/BI05401f2d26b24d47a1416936675b79be. Registrants will receive confirmation with dial-in details.
A live webcast of the event can be accessed on https://edge.media-server.com/mmc/p/qu4ekmuy/. A replay of the webcast will be available on https://investors.inspiresleep.com starting approximately two hours after the event and archived on the site for two weeks.
About Inspire Medical Systems
Inspire Medical Systems is a medical technology company focused on the development and commercialization of innovative, minimally invasive solutions for patients with obstructive sleep apnea. Inspire’s proprietary Inspire therapy is the first FDA, EU MDR, and PDMA-approved neurostimulation technology that provides a safe and effective treatment for moderate to severe obstructive sleep apnea.
For additional information about Inspire, please visit www.inspiresleep.com.
Use of Non-GAAP Financial Measures
This press release includes non-GAAP financial measures, including without limitation, adjusted operating income, adjusted operating margin, adjusted earnings before income taxes, adjusted income tax expense, adjusted effective tax rate, adjusted net earnings, adjusted net earnings per diluted share ("EPS"), adjusted EBITDA, and adjusted EBITDA margin, which differ from financial measures calculated in accordance with U.S. generally accepted accounting principles (“GAAP”).
We define adjusted operating income as operating income or loss adjusted for items that are not indicative of our ongoing operations. Operating income is the most directly comparable GAAP financial measure to adjusted operating income. We define adjusted operating margin in this release as adjusted operating income divided by revenue. Operating margin is the most directly comparable GAAP financial measure to adjusted operating margin. Adjusted earnings before income taxes is defined as earnings before income taxes, adjusted for items that are not indicative of our ongoing operations. Earnings before income taxes is the most directly comparable GAAP financial measure. Adjusted income tax expense is defined as income tax expense, adjusted for items that are not indicative of our ongoing operations. Adjusted effective tax rate is adjusted income tax expense divided by adjusted earnings before income taxes. Income tax expense is the most directly comparable GAAP financial measure. Adjusted net earnings is defined as net earnings or loss, adjusted for items that are not indicative of our ongoing operations. Net earnings or loss is the most directly comparable GAAP financial measure to adjusted net earnings. Adjusted net earnings per diluted share is calculated as adjusted net earnings divided by the diluted weighted average shares outstanding. Net earnings or loss per diluted share is the most directly comparable GAAP financial measure to adjusted net earnings per diluted share. We define adjusted EBITDA as net earnings or loss, less interest and dividend income, net, plus income tax expense, plus depreciation and amortization, plus stock-based compensation expense, adjusted for items that are not indicative of our ongoing operations. Net earnings or loss is the most directly comparable GAAP financial measure to adjusted EBITDA. We define adjusted EBITDA margin in this release as adjusted EBITDA divided by revenue. Net earnings or loss margin is the most directly comparable GAAP measure to adjusted EBITDA margin. Reconciliations of these non-GAAP financial measures to their most directly comparable GAAP measures are included in this press release.
These non-GAAP financial measures are presented because we believe they are useful indicators of our operating performance and facilitate a more meaningful trend analysis without the distortion of various adjustment items. Management uses these measures principally as measures of our underlying operating performance, trends, and for planning purposes, including the preparation of our annual operating plan and financial projections. We believe these measures are useful to investors as supplemental information and because they are frequently used by analysts, investors, and other interested parties to evaluate companies in our industry. We also believe these non-GAAP financial measures are useful to our management and investors as a measure of comparative operating performance from period to period.
These non-GAAP financial measures should not be considered as an alternative to, or superior to, the most directly comparable GAAP financial measures, as measures of financial performance or cash flows from operations, as a measure of liquidity, or any other performance measure derived in accordance with GAAP, and they should not be construed to imply that our future results will be unaffected by unusual or non-recurring items. In addition, Adjusted EBITDA is not intended to be a measure of cash flow for management’s discretionary use, as it does not reflect certain cash requirements such as tax payments, capital expenditures, and certain other cash costs that may recur in the future. Adjusted EBITDA contains certain other limitations, including the failure to reflect our cash expenditures, cash requirements for working capital needs, and cash costs to replace assets being depreciated and amortized. In evaluating our non-GAAP financial measures, you should be aware that in the future we may incur expenses that are the same as or similar to some of the adjustments in this presentation. Our presentation of non-GAAP financial measures should not be construed to imply that our future results will be unaffected by any such adjustments. Management compensates for these limitations by primarily relying on our GAAP results in addition to using non-GAAP financial measures on a supplemental basis. These measures and their definitions are discussed in more detail below and our definition of these non-GAAP financial measures is not necessarily comparable to other similarly titled captions of other companies due to different methods of calculation.
Forward Looking Statements
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements other than statements of historical facts are forward-looking statements, including, without limitation, statements regarding estimated financial and non-financial impacts from our strategic growth plan (including without limitation the expectations for pre-tax charges in connection with the growth plan, annual growth investment capacity, the extent and manner of the use of investments in revenue growth initiatives as well as the time to complete the strategic growth plan) and potential impacts to our business (including potential actions and solutions as well as timing of these impacts) associated with coding and reimbursement, and our expectations regarding our full year 2026 financial outlook (including without limitation expectations for the impacts of coding and reimbursement, revenue, expected growth, adjusted operating margin, net earnings or loss per diluted share, adjusted net earnings per diluted share, effective tax rate, adjusted effective tax rate, weighted average diluted shares outstanding and capital expenditures). In some cases, you can identify forward-looking statements by terms such as ‘‘may,’’ ‘‘will,’’ ‘‘should,’’ ‘‘expect,’’ ‘‘plan,’’ ‘‘anticipate,’’ ‘‘could,’’ “future,” “outlook,” “guidance,” ‘‘intend,’’ ‘‘target,’’ ‘‘project,’’ ‘‘contemplate,’’ ‘‘believe,’’ ‘‘estimate,’’ ‘‘predict,’’ ‘‘potential,’’ ‘‘continue,’’ or the negative of these terms or other similar expressions, although not all forward-looking statements contain these words.
These forward-looking statements are based on management’s current expectations and involve known and unknown risks and uncertainties that may cause our actual results, performance, or achievements to be materially different from any future results, performance, or achievements expressed or implied by the forward-looking statements. Such risks and uncertainties include, among others: our dependency on our Inspire system for revenues; fluctuations in our financial results and the market price of our common stock; our ability to sustain or increase our profitability and our history of operating losses; commercial success and market acceptance of our Inspire therapy; our ability to achieve and maintain adequate and clear levels of coverage or reimbursement for our Inspire system or any future products we may seek to commercialize; competitive companies, technologies, and pharmaceuticals in our industry; our ability to expand our indications and develop and commercialize additional products and enhancements to our Inspire system; our ability to forecast demand and manage our inventory; our dependence on third-parties; risks related to consolidation in the healthcare industry; our ability to expand, manage, and maintain our direct sales and marketing organization, and to market and sell our Inspire system in markets outside of the United States; our ability to manage our growth; risks related to product liability claims and warranty claims; our ability to address quality issues that may arise with our Inspire system; any failure of key information technology systems, processes, or sites or damage to or inability to access our physical facilities; any violations of anti-bribery, anti-corruption, and anti-money laundering laws; future needs for additional financing; risks related to our tax assets and changes in tax laws; our ability to timely commercialize or obtain regulatory approvals or certifications for our Inspire therapy and system; U.S. Food and Drug Administration (FDA) or other United States or foreign regulatory actions affecting us or the healthcare industry generally; our ability to establish and maintain intellectual property protection for our Inspire therapy and system or avoid claims of infringement; and our strategic growth plan may not achieve our intended outcome.
Other important factors that could cause actual results, performance or achievements to differ materially from those contemplated in this press release can be found under the captions “Risk Factors” and "Management's Discussion and Analysis of Financial Condition and Results of Operations“ in our Annual Report on Form 10-K for the fiscal year ended December 31, 2025, and as such factors may be updated from time to time in our other filings with the SEC, which are accessible on the SEC’s website at www.sec.gov and the Investors page of our website at www.inspiresleep.com. These and other important factors could cause actual results to differ materially from those indicated by the forward-looking statements made in this press release. Any such forward-looking statements represent management’s estimates as of the date of this press release. While we may elect to update such forward-looking statements at some point in the future, unless required by applicable law, we disclaim any obligation to do so, even if subsequent events cause our views to change. Thus, one should not assume that our silence over time means that actual events are bearing out as expressed or implied in such forward-looking statements. These forward-looking statements should not be relied upon as representing our views as of any date after the date of this press release.
Investor & Media Contact
Ezgi Yagci
Vice President, Investor Relations
ezgiyagci@inspiresleep.com
617-549-2443
| Inspire Medical Systems, Inc. Consolidated Statements of Operations (unaudited) (in thousands, except share and per share amounts) | ||||||||||||||||
| Three Months Ended | Six Months Ended | |||||||||||||||
| June 30, | June 30, | |||||||||||||||
| 2026 | 2025 | 2026 | 2025 | |||||||||||||
| Revenue | $ | 200,581 | $ | 217,086 | $ | 405,164 | $ | 418,403 | ||||||||
| Cost of goods sold | 29,122 | 34,672 | 56,793 | 65,381 | ||||||||||||
| Gross profit | 171,459 | 182,414 | 348,371 | 353,022 | ||||||||||||
| Operating expenses: | ||||||||||||||||
| Research and development | 24,698 | 26,209 | 50,524 | 54,012 | ||||||||||||
| Selling, general and administrative | 147,275 | 159,521 | 299,479 | 303,811 | ||||||||||||
| Total operating expenses | 171,973 | 185,730 | 350,003 | 357,823 | ||||||||||||
| Operating (loss) | (514 | ) | (3,316 | ) | (1,632 | ) | (4,801 | ) | ||||||||
| Interest and dividend (income), net | (3,739 | ) | (4,482 | ) | (7,480 | ) | (9,548 | ) | ||||||||
| Other expense, net | 110 | 3,498 | 336 | 2920 | ||||||||||||
| Earnings (loss) before income taxes | 3,115 | (2,332 | ) | 5,512 | 1,827 | |||||||||||
| Income tax expense | 2,801 | 1,260 | 16,492 | 2,427 | ||||||||||||
| Net earnings (loss) | $ | 314 | $ | (3,592 | ) | $ | (10,980 | ) | $ | (600 | ) | |||||
| Basic earnings (loss) per share | $ | 0.01 | $ | (0.12 | ) | $ | (0.38 | ) | $ | (0.02 | ) | |||||
| Diluted earnings (loss) per share | $ | 0.01 | $ | (0.12 | ) | $ | (0.38 | ) | $ | (0.02 | ) | |||||
| Weighted average shares outstanding: | ||||||||||||||||
| Basic | 28,835,058 | 29,506,807 | 28,768,163 | 29,604,043 | ||||||||||||
| Diluted | 28,940,846 | 29,506,807 | 28,768,163 | 29,604,043 | ||||||||||||
| Inspire Medical Systems, Inc. Consolidated Balance Sheets (unaudited) (in thousands, except share and per share amounts) | ||||||||
| June 30, 2026 | December 31, 2025 | |||||||
| Assets | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 127,761 | $ | 104,813 | ||||
| Investments, short-term | 192,923 | 203,455 | ||||||
| Accounts receivable, net of allowance for credit losses of | 103,340 | 119,692 | ||||||
| Inventories, net | 170,451 | 145,293 | ||||||
| Prepaid expenses and other current assets | 14,199 | 10,399 | ||||||
| Total current assets | 608,674 | 583,652 | ||||||
| Investments, long-term | 94,480 | 96,330 | ||||||
| Property and equipment, net | 104,330 | 97,872 | ||||||
| Operating lease right-of-use assets | 22,599 | 23,532 | ||||||
| Deferred tax assets | 77,582 | 88,667 | ||||||
| Other non-current assets | 18,328 | 17,264 | ||||||
| Total assets | $ | 925,993 | $ | 907,317 | ||||
| Liabilities and stockholders' equity | ||||||||
| Current liabilities: | ||||||||
| Accounts payable | $ | 27,102 | $ | 36,565 | ||||
| Accrued expenses | 44,080 | 59,490 | ||||||
| Total current liabilities | 71,182 | 96,055 | ||||||
| Operating lease liabilities, non-current portion | 29,093 | 29,998 | ||||||
| Other non-current liabilities | 136 | 104 | ||||||
| Total liabilities | 100,411 | 126,157 | ||||||
| Stockholders' equity: | ||||||||
| Preferred Stock, | — | — | ||||||
| Common Stock, | 29 | 29 | ||||||
| Additional paid-in capital | 983,670 | 927,159 | ||||||
| Accumulated other comprehensive (loss) income | (645 | ) | 464 | |||||
| Accumulated deficit | (157,472 | ) | (146,492 | ) | ||||
| Total stockholders' equity | 825,582 | 781,160 | ||||||
| Total liabilities and stockholders' equity | $ | 925,993 | $ | 907,317 | ||||
| Inspire Medical Systems, Inc. GAAP to Non-GAAP Reconciliations (unaudited) (in thousands, except per share amounts) | ||||||||||||||||||||||||||||||||||||||
| Three Months Ended June 30, 2026 | ||||||||||||||||||||||||||||||||||||||
| Gross Profit | Operating Expenses | Operating (Loss) Income | Operating Margin | Other (Income) | Earnings Before Income Taxes | Income Tax Expense | Effective Tax Rate | Net Earnings | Diluted EPS | |||||||||||||||||||||||||||||
| Reported | $ | 171,459 | $ | 171,973 | $ | (514 | ) | (0.3 | )% | $ | (3,629 | ) | $ | 3,115 | $ | 2,801 | 89.9 | % | $ | 314 | $ | 0.01 | ||||||||||||||||
| Non-GAAP adjustments: | ||||||||||||||||||||||||||||||||||||||
| Legal fees1 | — | (3,697 | ) | 3,697 | 1.9 | % | — | 3,697 | 1,296 | 2,401 | 0.09 | |||||||||||||||||||||||||||
| Tax impact of stock-based compensation2 | — | — | — | — | % | — | — | (1,288 | ) | 1,288 | 0.04 | |||||||||||||||||||||||||||
| Adjusted | $ | 171,459 | $ | 168,276 | $ | 3,183 | 1.6 | % | $ | (3,629 | ) | $ | 6,812 | $ | 2,809 | 41.2 | % | $ | 4,003 | $ | 0.14 | |||||||||||||||||
| Three Months Ended June 30, 2025 | ||||||||||||||||||||||||||||||||||||||
| Gross Profit | Operating Expenses | Operating (Loss) Income | Operating Margin | Other (Income) | (Loss) Earnings Before Income Taxes | Income Tax Expense | Effective Tax Rate | Net (Loss) Earnings | Diluted EPS | |||||||||||||||||||||||||||||
| Reported | $ | 182,414 | $ | 185,730 | $ | (3,316 | ) | (1.5 | )% | $ | (984 | ) | $ | (2,332 | ) | $ | 1,260 | (54.0 | )% | $ | (3,592 | ) | $ | (0.12 | ) | |||||||||||||
| Non-GAAP adjustments: | ||||||||||||||||||||||||||||||||||||||
| Stock-based compensation expense3 | — | (11,155 | ) | 11,155 | 5.1 | % | — | 11,155 | 2,770 | 8,385 | 0.28 | |||||||||||||||||||||||||||
| Legal fees1 | — | (1,736 | ) | 1,736 | 0.8 | % | — | 1,736 | 431 | 1,305 | 0.04 | |||||||||||||||||||||||||||
| Asset impairment charge4 | — | — | — | — | % | (4,046 | ) | 4,046 | — | 4,046 | 0.14 | |||||||||||||||||||||||||||
| Adjusted | $ | 182,414 | $ | 172,839 | $ | 9,575 | 4.4 | % | $ | (5,030 | ) | $ | 14,605 | $ | 4,461 | 30.5 | % | $ | 10,144 | $ | 0.34 | |||||||||||||||||
1 These costs represent legal-related expenses related to (a) a civil investigative demand from the Department of Justice, (b) a patent infringement suit that we filed against Nyxoah S.A. and its wholly-owned subsidiary, Nyxoah, Inc. ("Nyxoah"), and (c) a patent infringement suit brought against us by Nyxoah.
2 The accounting standards codification guidance governing employee stock-based compensation requires that any excess or deficient tax deduction for stock-based compensation be immediately recorded within income tax expense. Employee stock-based compensation activity, including the exercise of stock options, can be unpredictable and can significantly impact our net earnings, net earnings per diluted share, and effective tax rate. These amounts represent the discrete tax expense recorded as excess tax expense for stock-based compensation.
3 Represents accelerated stock-based compensation expense for certain employees who were retirement eligible in accordance with the implementation of changes to the treatment of equity awards under the Inspire Medical Systems, Inc. 2018 Incentive Award Plan upon the holder's death, disability, or retirement.
4 Represents a non-cash impairment of a strategic investment.
| Inspire Medical Systems, Inc. GAAP to Non-GAAP Reconciliations (unaudited) (in thousands, except per share amounts) | ||||||||||||||||||||||||||||||||||||||
| Six Months Ended June 30, 2026 | ||||||||||||||||||||||||||||||||||||||
| Gross Profit | Operating Expenses | Operating (Loss) Income | Operating Margin | Other (Income) | Earnings Before Income Taxes | Income Tax Expense | Effective Tax Rate | Net (Loss) Earnings | Diluted EPS | |||||||||||||||||||||||||||||
| Reported | $ | 348,371 | $ | 350,003 | $ | (1,632 | ) | (0.4)% | $ | (7,144 | ) | $ | 5,512 | $ | 16,492 | 299.2 | % | $ | (10,980 | ) | $ | (0.38 | ) | |||||||||||||||
| Non-GAAP adjustments: | ||||||||||||||||||||||||||||||||||||||
| Legal fees1 | — | (5,133 | ) | 5,133 | 1.3 | % | — | 5,133 | 1,676 | 3,457 | 0.12 | |||||||||||||||||||||||||||
| Tax impact of stock-based compensation2 | — | — | — | — | % | — | — | (14,375 | ) | 14,375 | 0.50 | |||||||||||||||||||||||||||
| Adjusted | $ | 348,371 | $ | 344,870 | $ | 3,501 | 0.9 | % | $ | (7,144 | ) | $ | 10,645 | $ | 3,793 | 35.6 | % | $ | 6,852 | $ | 0.24 | |||||||||||||||||
| Six Months Ended June 30, 2025 | ||||||||||||||||||||||||||||||||||||||
| Gross Profit | Operating Expenses | Operating (Loss) Income | Operating Margin | Other (Income) | Earnings Before Income Taxes | Income Tax Expense | Effective Tax Rate | Net (Loss) Earnings | Diluted EPS | |||||||||||||||||||||||||||||
| Reported | $ | 353,022 | $ | 357,823 | $ | (4,801 | ) | (1.1 | )% | $ | (6,628 | ) | $ | 1,827 | $ | 2,427 | 132.8 | % | $ | (600 | ) | $ | (0.02 | ) | ||||||||||||||
| Non-GAAP adjustments: | ||||||||||||||||||||||||||||||||||||||
| Stock-based compensation expense3 | — | (11,155 | ) | 11,155 | 2.6 | % | — | 11,155 | 2,770 | 8,385 | 0.28 | |||||||||||||||||||||||||||
| Legal fees1 | — | (1,736 | ) | 1,736 | 0.4 | % | — | 1,736 | 431 | 1,305 | 0.04 | |||||||||||||||||||||||||||
| Asset impairment charge4 | — | — | — | — | % | (4,046 | ) | 4,046 | — | 4,046 | 0.14 | |||||||||||||||||||||||||||
| Adjusted | $ | 353,022 | $ | 344,932 | $ | 8,090 | 1.9 | % | $ | (10,674 | ) | $ | 18,764 | $ | 5,628 | 30.0 | % | $ | 13,136 | $ | 0.44 | |||||||||||||||||
1 These costs represent legal-related expenses related to (a) a civil investigative demand from the Department of Justice, (b) a patent infringement suit that we filed against Nyxoah S.A. and its wholly-owned subsidiary, Nyxoah, Inc. ("Nyxoah"), and (c) a patent infringement suit brought against us by Nyxoah.
2 The accounting standards codification guidance governing employee stock-based compensation requires that any excess or deficient tax deduction for stock-based compensation be immediately recorded within income tax expense. Employee stock-based compensation activity, including the exercise of stock options, can be unpredictable and can significantly impact our net earnings, net earnings per diluted share, and effective tax rate. These amounts represent the discrete tax expense recorded as excess tax expense for stock-based compensation.
3 Represents accelerated stock-based compensation expense for certain employees who were retirement eligible in accordance with the implementation of changes to the treatment of equity awards under the Inspire Medical Systems, Inc. 2018 Incentive Award Plan upon the holder's death, disability, or retirement.
4 Represents a non-cash impairment of a strategic investment.
| Reconciliation of GAAP Net Earnings (Loss) to Non-GAAP Adjusted EBITDA | ||||||||||||||||
| Three Months Ended | Six Months Ended | |||||||||||||||
| June 30, | June 30, | |||||||||||||||
| 2026 | 2025 | 2026 | 2025 | |||||||||||||
| Net earnings (loss) | $ | 314 | $ | (3,592 | ) | $ | (10,980 | ) | $ | (600 | ) | |||||
| Interest and dividend income, net | (3,739 | ) | (4,482 | ) | (7,480 | ) | (9,548 | ) | ||||||||
| Income tax expense | 2,801 | 1,260 | 16,492 | 2,427 | ||||||||||||
| Depreciation and amortization | 4,597 | 3,414 | 9,707 | 6,458 | ||||||||||||
| EBITDA | 3,973 | (3,400 | ) | 7,739 | (1,263 | ) | ||||||||||
| Stock-based compensation expense1 | 31,226 | 41,724 | 61,915 | 72,780 | ||||||||||||
| Legal fees2 | 3,697 | 1,736 | 5,133 | 1,736 | ||||||||||||
| Asset impairment charge3 | — | 4,046 | — | 4,046 | ||||||||||||
| Adjusted EBITDA | $ | 38,896 | $ | 44,106 | $ | 74,787 | $ | 77,299 | ||||||||
1 Total stock-based compensation expense.
2 These costs represent legal-related expenses related to (a) a civil investigative demand from the Department of Justice, (b) a patent infringement suit that we filed against Nyxoah S.A. and its wholly-owned subsidiary, Nyxoah, Inc. ("Nyxoah"), and (c) a patent infringement suit brought against us by Nyxoah.
3 Represents a non-cash impairment of a strategic investment.
| Reconciliation of GAAP Net Earnings (Loss) Margin and Non-GAAP Adjusted EBITDA Margin | ||||||||||||
| Three Months Ended | Six Months Ended | |||||||||||
| June 30, | June 30, | |||||||||||
| 2026 | 2025 | 2026 | 2025 | |||||||||
| Net earnings (loss) margin1 | 0.2 | % | (1.7 | )% | (2.7 | )% | (0.1 | )% | ||||
| Interest and dividend income, net | (1.9 | )% | (2.1 | )% | (1.8 | )% | (2.3 | )% | ||||
| Income tax expense | 1.4 | % | 0.6 | % | 4.1 | % | 0.6 | % | ||||
| Depreciation and amortization | 2.3 | % | 1.6 | % | 2.4 | % | 1.5 | % | ||||
| Stock-based compensation expense2 | 15.6 | % | 19.2 | % | 15.2 | % | 17.4 | % | ||||
| Legal fees3 | 1.8 | % | 0.8 | % | 1.3 | % | 0.4 | % | ||||
| Asset impairment charge4 | — | % | 1.9 | % | — | % | 1.0 | % | ||||
| Adjusted EBITDA margin | 19.4 | % | 20.3 | % | 18.5 | % | 18.5 | % | ||||
1 Net earnings (loss) margin is calculated as net earnings (loss) divided by total revenue.
2 Total stock-based compensation expense.
3 These costs represent legal-related expenses related to (a) a civil investigative demand from the Department of Justice, (b) a patent infringement suit that we filed against Nyxoah S.A. and its wholly-owned subsidiary, Nyxoah, Inc. ("Nyxoah"), and (c) a patent infringement suit brought against us by Nyxoah.
4 Adjusted EBITDA margin is calculated as Adjusted EBITDA divided by total revenue.
| Full Year 2026 Outlook Reconciliation of Full Year 2026 Outlook of Estimated Net Earnings per Diluted Share to Adjusted Net Earnings per Diluted Share | ||||||||||||||
| Outlook Full Year 2026 | Tax Rate Outlook Full Year 2026 | |||||||||||||
| Low Range | High Range | Low Range | High Range | |||||||||||
| Net earnings per diluted share | $ | (0.42 | ) | $ | 0.17 | 95.0 | % | 100.0 | % | |||||
| Legal fees1 | 0.25 | 0.23 | ||||||||||||
| Restructuring charges2 | 0.64 | 0.51 | ||||||||||||
| Tax impact of stock-based compensation3 | 0.58 | 0.54 | ||||||||||||
| Adjusted net earnings per diluted share | $ | 1.05 | $ | 1.45 | 30.0 | % | 35.0 | % | ||||||
1 These costs represent legal-related expenses related to (a) a civil investigative demand from the Department of Justice, (b) a patent infringement suit that we filed against Nyxoah S.A. and its wholly-owned subsidiary, Nyxoah, Inc. ("Nyxoah"), and (c) a patent infringement suit brought against us by Nyxoah.
2 Restructuring costs related to Project Horizon.
3 Represents the estimated tax impact of permanent differences that arise between the expense recognized for financial reporting of stock-based compensation awards and the tax deduction the Company receives (tax windfall or shortfall). Accounting standards codification guidance requires that any excess or deficient tax deduction for stock-based compensation be immediately recorded within income tax expense. These amounts represent the estimated discrete tax impact for stock-based compensation during the period presented.
