Insomnia - Proximate Causes & Sourcing

[AYarter]

Hi all,

I know there are already some posts on insomnia and tirzepatide, but I wanted to break off discussion a little bit based on source.

All that to say, I have been using a compounded version and it has definitely disrupted my sleep. What's interesting though, well, I adjust, similar doses mixed with different additives seem to disrupt my sleep more. My first compounds had B12 and glycine, the next ones had l carnite -- The latter of which destroyed my sleep.

I'm curious, for those people having sleep problems if they have found a correlation between it being compounded with extra additives, gray market, or name brand.

I know this is deeply personal, but I figured I would ask.

 

[chunkyTN]

I'm interested to read the comments. My sleep has been messed up for awhile now.

 

[Dogmandu]

Hi all,

I know there are already some posts on insomnia and tirzepatide, but I wanted to break off discussion a little bit based on source.

All that to say, I have been using a compounded version and it has definitely disrupted my sleep. What's interesting though, well, I adjust, similar doses mixed with different additives seem to disrupt my sleep more. My first compounds had B12 and glycine, the next ones had l carnite -- The latter of which destroyed my sleep.

I'm curious, for those people having sleep problems if they have found a correlation between it being compounded with extra additives, gray market, or name brand.

I know this is deeply personal, but I figured I would ask.

I had sleep problems when I first started with Tirz. I went through the same exercise of comparing branded versus grey. It made no difference.

My specific problem was that I was becoming wide awake (almost energetic) at 2 or 3 AM and then unable to fall back asleep. I have a theory that Tirz can lower blood sugar overnight while you’re asleep. In some people, that drop goes just low enough for the brain to treat it as a stress signal. Your body then releases 'wake up' stress hormones like cortisol and adrenaline to bring sugar back up. Those hormones are arousing by design, so instead of sleeping through it, you wake up around 2–3 AM feeling alert.

To keep my blood glucose flatter, I ate a half cup of greek yogurt before bed. Also, tried Extend bars, which slow release carbs over several hours. Both seemed to help. But frankly, what helped even more for me was switching to Reta, which did not cause the 2 am wakings and is not as disruptive to my sleep as Tirz was. Anyway, that was my experience.

 

[chunkyTN]

To keep my blood glucose flatter, I ate a half cup of greek yogurt before bed. Also, tried Extend bars, which slow release carbs over several hours. Both seemed to help. But frankly, what helped even more for me was switching to Reta, which did not cause the 2 am wakings and is not as disruptive to my sleep as Tirz was. Anyway, that was my experience.

Yep. I can control some of the problem by having a snack before bed. Doesn't always work tho.

 

[Candaril]

I've noticed that insomnia only occurs when I've drunk alcohol. Even a small beer is enough, and I know that I'll wake up after a maximum of three hours of sleep and won't be able to fall back asleep.

 

[Mounjamen]

Why many people wake up between 2:00 and 3:00 a.m.:
Many people—especially older adults—wake up between 2:00 and 3:00 a.m. During this phase, the sleep hormone melatonin decreases, while the brain more easily slips into a waking state. At the same time, blood sugar levels can drop.
Low blood sugar is interpreted by the body as a stress signal and activates the wakefulness system in the brain (orexin). This system actually ensures that we stay awake during the day. With increasing age, however, it becomes less effective at night, so that even small stimuli are enough to wake us up.
Modern medications such as daridorexant address this issue: they dampen this overactive wakefulness signal and can help you sleep better at night without artificially forcing sleep.
In short:
Waking up at 2–3 a.m. is often a combination of lower melatonin levels, fluctuating blood sugar, and an overactive wakefulness system in the brain.

 

[AYarter]

I had sleep problems when I first started with Tirz. I went through the same exercise of comparing branded versus grey. It made no difference.

My specific problem was that I was becoming wide awake (almost energetic) at 2 or 3 AM and then unable to fall back asleep. I have a theory that Tirz can lower blood sugar overnight while you’re asleep. In some people, that drop goes just low enough for the brain to treat it as a stress signal. Your body then releases 'wake up' stress hormones like cortisol and adrenaline to bring sugar back up. Those hormones are arousing by design, so instead of sleeping through it, you wake up around 2–3 AM feeling alert.

To keep my blood glucose flatter, I ate a half cup of greek yogurt before bed. Also, tried Extend bars, which slow release carbs over several hours. Both seemed to help. But frankly, what helped even more for me was switching to Reta, which did not cause the 2 am wakings and is not as disruptive to my sleep as Tirz was. Anyway, that was my experience.

I have that issue as well, but I can work with that. I'm having sleep onset issues too, and sometimes the sleep aides get me there and sometimes I have to go to prescription antihistamines.

I have a storied history with insomnia anyways, so...

When I started my doc put me on Ramelteon, which took a bit but worked. I could get to sleep, which has always been tough for me, arguably better than I had in awhile. But I would always wake at 3.

Now though, switching to L Carnite, I am just unable to sleep for like 5 days after. Worth noting only two months in, but still.

Didn't want to do reta because tirz was already working -- and being that I just bought 7 kits of it.... I'm kind of stuck awhile =P

 

[DragonOfTheSea]

I know this thread is a little old but wanted to bring it up top to see if there are any new contributions to be made?

My wife and I are 8 weeks in on Tirz- I’m sleeping harder than I’ve slept in years(seemingly a little too hard perhaps sometimes), but she is in the complete opposite camp and only getting 2-3 hours of very broken /fragmented sleep a night at this point. This has been going on for about 3 weeks for her and is simply not sustainable for her mental health.
I have been playing with her dosage which helps with other sides but does not seem to be helping much with her sleep. She’s on pure Tirz btw, she didn’t like any of the compounded ones we tried.
Also we’re on our first week of stacking Reta- will definitely play with her threshold of that and am completely open to switching her fully to Reta if that is more optimal for her.

I’m going to try making her snack before bed, but any other solutions would be wonderful to hear.

 

[lessthanhalf]

I thankfully had zero problems with insomnia from any of the GLP's. Trying to sleep while starving hungry while losing weight without GLP's was much more of a issue.
I find it interesting that people are saying reta did not cause this though tirz did. Reta definitely causes more sympathetic nervous system activation and increases heart rate more than the other GLP's , but they all do that to some degree, and I would assume that is a likely culprit for the insomnia. This does seem to be something that improves over time, or at least the heart rate increase does. Not a solution just an observation.
Melatonin is a pretty safe and available option.

 

[UpDownLeftRightAS*]

Sleep, the eternal frontier. Reta did keep me awake for a bit initially so I switched that to a morning pin. I added a small dose of Telmisartan to help in the evenings on those days to keep the bp down a bit. that seemed to help. Getting cold turkey off of any sleep aids helped but took some time, I let chatgpt talk me though what I was experiencing--also worth having a cheap watch that monitors your sleep / temp/ heart etc.

 

[olehandro]

I also couldn't sleep with tirzepatid. I tried everything DSIP, Selank, HTP5, Gaba, Phenibut, Melatonin, Korvalol, Valeriana, sleeping teas, Taurine, Antiallergic tablets and much more.
The result is minimal. Eating before bed helped a little better.
As a result, I replaced tirzepatid with retatrutid and everything fell into place. I sleep well again.

 

[DragonOfTheSea]

I also couldn't sleep with tirzepatid. I tried everything DSIP, Selank, HTP5, Gaba, Phenibut, Melatonin, Korvalol, Valeriana, sleeping teas, Taurine, Antiallergic tablets and much more.
The result is minimal. Eating before bed helped a little better.
As a result, I replaced tirzepatid with retatrutid and everything fell into place. I sleep well again.

The more I see this said, the more I hope moving her off Tz and fully on Rt will do the trick.. I feel so bad for her, and guilty for the sleep I get.

She too does not get much from things like melatonin, sleep gummies, teas.

Previous to the current situation, if she took some Advil PM it would usually get her at least a solid 4-5hrs but that doesn’t work for her now either.

 

[RetCurious]

Melatonin is a pretty safe and available option.

Not peer reviewed but gave me pause when I read it.

Among adults with insomnia, those whose electronic health records indicated long-term melatonin use (12 months or more) had about a 90% higher chance of incident heart failure over 5 years compared with matched non-users (4.6% vs. 2.7%, respectively).

Long-term use of melatonin supplements to support sleep may have negative health effects

Research Highlights: A review of 5 years of health records for more than 130,000 adults with insomnia who had used melatonin for at least a year found they were more likely to be diagnosed with heart failure, require hospitalization for the condition ...

newsroom.heart.org

 

[lessthanhalf]

Yes that trial is concerning and suggests that long term melatonin use may not be as safe as people think. It is not a prospective trial , it is after the fact statistical analysis, that in general does not prove causation, just that there may be a link that needs further investigation. As any person taking melatonin may have differences to those not taking it that make the measured event more likely, a confounding variable. Maybe people who are more stressed, are both more likely to take melatonin and develop heart failure for example. There have been a lot of studies on melatonin that have not shown similar concerning findings, so it is far from conclusive, but is probably enough to suggest that long term and especially high dose long term use should be avoided. But most other medications that induce sleep have much more significant adverse effects on cognition the next day or can be addictive, so it is still possible it is the safest option available.

 

[RetCurious]

Thank you for breaking it down.