X0306 4 2019-01-10 0 0001609550 Inspire Medical Systems, Inc. INSP 0001609405 Khuong Chau Quang C/O INSPIRE MEDICAL SYSTEMS, INC. 9700 63RD AVENUE NORTH, SUITE 200 MAPLE GROVE MN 55369 1 0 0 0 Common Stock 2019-01-10 4 A 0 254 46.58 A 725 D Common Stock 1829449 I See Footnotes Represents shares of vested, restricted common stock received in lieu of cash fees pursuant to the Issuer's Non-Employee Director Compensation Policy, which shares are subject to the Reporting Person's lock-up agreement entered into in connection with the Registrant's public offering of common stock consummated on December 11, 2018. These securities are held of record by OrbiMed Private Investments V, LP ("OPI V"). OrbiMed Capital GP V LLC ("GP V") is the sole general partner of OPI V, and OrbiMed Advisors LLC ("Advisors"), a registered adviser under the Investment Advisors Act of 1940, as amended, is the sole managing member of GP V. By virtue of such relationships, GP V and Advisors may be deemed to have voting and investment power with respect to the securities held by OPI V noted above and as a result may be deemed to beneficially own such securities for purposes of Rule 13d-3 under the Securities Exchange Act of 1934, as amended (the "Exchange Act"). Advisors exercises this investment and voting power through a management committee comprised of Carl L. Gordon, Sven H. Borho and Jonathan T. Silverstein, each of whom disclaims beneficial ownership of the securities held by OPI V. The Reporting Person is an employee of Advisors. Each of the Reporting Person, GP V and Advisors disclaims beneficial ownership of the securities reported herein for purposes of Rule 16a-1(a) of the Exchange Act, except to the extent of its or his pecuniary interest therein, if any. This report shall not be deemed an admission that any such entity or person, including the Reporting Person, is a beneficial owner of such securities for the purpose of Section 16 of the Exchange Act, or for any other purpose. /s/ Richard Buchholz, Attorney-in-Fact 2019-01-14