Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Operating activities
Net income (loss)	$ 145,422	$ 53,509	$ (21,153)
Adjustments to reconcile net income (loss):
Depreciation and amortization	13,957	6,550	2,846
Accretion of investment discount	(2,889)	(8,859)	(2,469)
Stock-based compensation expense	130,259	116,007	82,470
Deferred income taxes (benefit)	(88,749)	0	0
Provision (benefit) for estimated credit losses	200	(768)	1,612
Impairment of strategic investment	4,046	0	0
Other non-cash expenses	2,111	1,517	2,128
Changes in operating assets and liabilities:
Accounts receivable	(26,233)	(2,602)	(30,218)
Inventories	(65,175)	(46,233)	(21,999)
Prepaid expenses and other current assets	1,651	(2,344)	(4,758)
Accounts payable	(3,747)	604	9,296
Accrued expenses and other liabilities	6,123	12,865	6,898
Net cash provided by operating activities	116,976	130,246	24,653
Investing activities
Purchases of property and equipment	(38,499)	(39,123)	(23,629)
Purchases of investments	(240,318)	(418,354)	(281,189)
Proceeds from sales or maturities of investments	310,381	344,605	10,246
Purchases of strategic investments	(10,118)	(250)	(250)
Net cash provided by (used in) investing activities	21,446	(113,122)	(294,822)
Financing activities
Proceeds from the exercise of stock options	9,595	22,167	25,809
Accelerated share repurchase of common stock	0	(75,000)	0
Share repurchase of common stock	(175,019)	0	0
Payment of taxes on net share settlement of equity awards	(23,044)	(5,165)	(17,158)
Proceeds from the issuance of common stock from employee stock purchase plan	5,019	5,605	5,299
Net cash (used in) provided by financing activities	(183,449)	(52,393)	13,950
Effect of exchange rate on cash	(310)	(118)	164
Decrease in cash and cash equivalents	(45,337)	(35,387)	(256,055)
Cash and cash equivalents at beginning of year	150,150	185,537	441,592
Cash and cash equivalents at end of year	104,813	150,150	185,537
Supplemental cash flow information
Cash paid for interest	137	22	0
Property and equipment included in accounts payable and accrued expenses	4,773	3,386	4,018
Excise taxes accrued but not paid	$ 1,004	$ 0	$ 0

Inspire Medical Systems, Inc. 10-K