Does Zepbound cause insomnia?

Tossing and turning since starting Zepbound? You might be experiencing what's known as Zepbound insomnia, which is difficulty falling or staying asleep while taking the weight loss medication. While it’s not a widely recognized side effect — nor is it even reported in clinical trials — understanding why sleep disturbances and issues might happen during treatment can help you manage them better.

Here’s what you need to know about Zepbound’s potential effects on sleep (and how to deal with them).

Put simply: No, there’s no scientific evidence to suggest that Zepbound directly causes insomnia. In fact, there’s more research to suggest the opposite. Clinical trials show that tirzepatide (the active ingredient in Zepbound) can actually cause fatigue. 

For background, insomnia is a sleep disorder that makes it hard to fall or stay asleep. It can lead to daytime fatigue,  irritability, and trouble concentrating. 

But while Zepbound hasn’t been shown to cause insomnia directly, some people still report difficulty sleeping after starting the medication. This could be an indirect result of other effects of the medication, such as nausea, gastrointestinal discomfort, or changes in blood sugar levels.

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Insomnia was not reported in clinical trials of Zepbound and is not known to be a common side effect of the drug. In fact, some people find that tirzepatide can make them tired. That said, there are still several reasons why some people may notice sleep disturbances while taking it. Here’s the breakdown of these factors to help you understand and hopefully better manage any sleep issues that may arise during treatment. 

Nausea and gastrointestinal side effects

Digestive issues are the most common Zepbound side effects. In clinical trials, up to 29% of people taking Zepbound reported nausea, up to 23% reported diarrhea, and up to 13% reported vomiting. Patients also frequently dealt with constipation, abdominal pain, and dyspepsia (indigestion). 

While these side effects are often temporary, they can be disruptive day or night. So if your sleep takes a hit while your body is initially adjusting to the medication, your gut might be part of the reason. After all, sleep can be hard to come by if you’re curled up with a sour stomach or frequently running to the bathroom. 

Hormonal shifts 

Zepbound works in part by suppressing appetite, which may shift how much and when you eat. While this can support weight loss overall, it may also affect your body’s natural hunger cues and eating rhythms. 

Indeed, research shows that appetite-regulating hormones like leptin and ghrelin align with your circadian rhythm. Ghrelin levels peak during the day to stimulate your appetite, while leptin levels peak at night to promote satiety and support sleep.

But when your sleep or meal timing is irregular, these hormones can become dysregulated. As a result, your energy balance and sleep quality can take a hit. 

Changes in blood sugar levels

Zepbound lowers blood sugar levels, which can help people with type 2 diabetes manage their condition. Sometimes it may lower blood sugar levels too much. In clinical trials, about 4.2% of participants with type 2 diabetes experienced low blood sugar (hypoglycemia) while taking the medication. 

Although this side effect is relatively rare, hypoglycemia can cause symptoms like tremors, confusion, and anxiety. Altogether, this may disrupt your sleep and lead to nighttime awakenings.

If you have type 2 diabetes and are starting Zepbound, make sure to tell your healthcare providers about all other medications you are taking, as they may want to lower dosages of your other medications to avoid hypoglycemia. 

According to current research, sleep problems and insomnia are not considered common side effects of Zepbound. Instead, the most frequently reported side effects are gastrointestinal, including nausea, diarrhea, and constipation. 

That said, these commonly reported side effects can sometimes interfere with sleep, particularly if they occur at night. In other words, while there’s no evidence that Zepbound directly causes insomnia, it may indirectly impact your sleep through other symptoms or lifestyle shifts.

If you’re having trouble sleeping while taking Zepbound, the good news is that there are several ways to manage it. Here are a few strategies that may help.

Create a nighttime routine

Sticking to a regular bedtime routine can signal your body that it’s time to wind down, which may make it easier to fall and stay asleep. Research suggests that good sleep hygiene is one of the best treatments for improving your sleep in the long term. 

Some evidence-backed strategies you might include in your nighttime ritual to support better sleep quality are:

• Maintaining a consistent bedtime and wake-up time

• Meditating or mindfulness practices to help calm your mind and body before sleep

• Limiting light exposure and screen time before bed

Eat lighter in the evening

Eating heavy meals late at night can get in the way of restful sleep, whether you're taking Zepbound or not. 

If you are on Zepbound, eating heavy meals late at night may be especially impactful on your sleep (or lack thereof).  That’s because Zepbound slows the rate at which your stomach empties. While this effect can help keep you fuller longer and, in turn, promote weight loss, it may also further contribute to nighttime discomfort or disrupted sleep — especially if you consumed a big or rich dinner. 

Shifting your larger meals to earlier in the day or opting for lighter meals overall as a part of your Zepbound diet plan may help minimize these effects and support more restful sleep.

Avoid caffeine and alcohol close to bedtime

If you’re struggling with Zepbound insomnia, you may want to cut your coffee routine earlier in the day and skip out on an evening glass or two of wine. Research shows that these substances can interfere with your natural sleep cycle by reducing sleep quality and efficiency (the amount of time you’re actually asleep while in bed). 

More specifically, caffeine (which is a stimulant) can delay your sleep if consumed too late in the day and reduce the amount of deep sleep you get, which can interfere with shut-eye. And while a nightcap might make you sleepy, alcohol ultimately leads to poorer sleep quality and more fragmented rest. 

Talk to your healthcare provider

If any side effects, including sleep issues, persist or worsen, check in with your healthcare provider. They can help identify what might be causing your sleep issues or insomnia on Zepbound and recommend strategies to support better rest. Sometimes, they might even recommend further testing to find and treat other conditions that are responsible for difficulty sleeping, such as sleep apnea. 

Getting ample zzz’s is not only crucial for feeling alert and focused during the day, but it can also support weight loss — one of the reasons you might have wanted to be on Zepbound in the first place. 

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Though there isn’t research to suggest that insomnia is a direct side effect of Zepbound, some people may experience sleep disturbances or issues while taking the medication. Here’s what to keep in mind:

• Factors like nausea, hormone shifts, and changes in blood sugar may all play a role in sleep issues while taking Zepbound. While these effects can be disruptive, they’re typically manageable with the right strategies.

• There are steps you can take to ease your sleep problems. From creating a consistent nighttime routine to avoiding big meals and stimulants before bed, small changes can make a big difference.

• If your sleep troubles persist, talk to your healthcare provider. They can help you get to the bottom of your sleep issues and learn how to manage them.