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Does Rybelsus Make You Tired? It May, Here’s Why

Tiredness isn’t a listed side effect of Rybelsus, but users have reported it. The research we have is on type 2 diabetics, and more is needed as use increases.
Published
2024-01-30
Updated
13 MINS
Written by
Jeff Kahn, M.S., Rise Science Co-Founder
Reviewed by
Chester Wu, MD, Rise Science Medical Reviewer
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We bring sleep research out of the lab and into your life. Every post begins with peer-reviewed studies — not third-party sources — to make sure we only share advice that can be defended to a room full of sleep scientists.
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We regularly update our articles to explain the latest research and shifts in scientific consensus in a simple and actionable way.
man taking rybelsus and wondering if it will make him tired

Does Rybelsus Make You Tired?

  • Tiredness isn’t listed as a side effect of Rybelsus, but users have reported it online.
  • You may feel tired on Rybelsus because you’re eating fewer calories, have low blood sugar, or experiencing sleep loss because of side effects like anxiety and gastrointestinal issues.
  • The RISE app can help you feel less tired on Rybelsus by helping you lower your sleep debt, get in sync with your body clock, and improve your sleep hygiene.

Rybelsus, a daily tablet manufactured by Novo Nordisk, can help adults with type 2 diabetes manage their blood glucose. It’s one brand name for semaglutide, the same active ingredient in the injectable diabetes and weight loss drugs Ozempic and Wegovy. 

Clinical trials didn’t find tiredness as a side effect, but there’s plenty of anecdotal evidence suggesting otherwise. 

Below, we’ll cover why Rybelsus can make you tired and how you can use the RISE app to boost your energy levels and get better sleep. 

Heads-up: Rybelsus was approved by the Food and Drug Administration (FDA) in 2019, so it’s a relatively new drug. More research is needed into its side effects, especially as more people use the drug.

Advice From a Sleep Doctor

Advice From a Sleep Doctor

“From the studies we have so far, fatigue isn’t a common side effect of Rybelsus. But some users report tiredness. We’re not sure why Rybelsus may cause tiredness, but it may be because you’re cutting calories or side effects like GI issues and anxiety are disrupting your sleep,” says Rise Science medical reviewer Dr. Chester Wu, a double board certified doctor in psychiatry and sleep medicine.

Does Rybelsus Make You Tired? 

Rybelsus may make you feel tired. Tiredness isn’t listed as a side effect of Rybelsus, but common side effects like GI issues and anxiety may disrupt your sleep. Plus, users have reported that Rybelsus makes them tired. 

Fatigue wasn’t reported as a side effect in a handful of clinical trials, but the FDA states these trials were done under “widely varying conditions” and side effect rates “may not reflect the rates observed in practice.” In everyday life, there are many variables that could affect side effects, like medical conditions and medications. 

Plus, these trials were done on type 2 diabetics. It’s unclear whether Rybelsus can cause fatigue in other groups. For example, Rybelsus can be prescribed off-label for weight loss and obesity. 

And side effects need to be reported by 5% or more of users to be listed as common. Fatigue may affect a smaller percentage of users, but as use increases, this can still add up to a lot of people. 

Fatigue is a side effect of semaglutide drugs like Wegovy — 11% of Wegovy users reported fatigue in trials.

As more people use Rybelsus, there’s more anecdotal evidence that it can make you tired. 

A 2023 study published in Brain Sciences analyzed Reddit, Youtube, and TikTok posts about the side effects of glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists), a class of medication Rybelsus belongs to. 

Users mentioned sleep-related issues the most, including insomnia, anxiety, depression, and general mental health issues. 

Rybelsus can also cause side effects that may disrupt your sleep — like GI issues and anxiety.  

Heads-up: Did you know there’s a difference between feeling tired and feeling sleepy? Tiredness is when you feel fatigued — like after a workout — but you may not be able to fall asleep. Sleepiness is when you could fall asleep if you tried. Rybelsus may make you both tired and sleepy. 

If you’re comparing weight loss and diabetes medications, know that some others can make you tired, too. 

We’ve covered other GLP-1 receptor agonists (active ingredient: semaglutide): 

And drugs that are dual-acting GLP-1 receptor agonists and glucose-dependent insulinotropic polypeptides (GIP) receptor agonists (active ingredient: tirzepatide):  

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Why Does Rybelsus Make You Tired? 

More research is needed to know why Rybelus makes you tired. It could be due to eating fewer calories, low blood sugar, changes in dopamine or exercise, or side effects like GI issues, anxiety, and increased heart rate causing sleep loss. 

Here’s what we mean: 

  • Eating fewer calories: Rybelsus decreases your appetite. As you eat fewer calories, your body has less fuel and you can feel fatigued. You might feel it more if you’re not used to being in a caloric deficit.  
  • Hypoglycemia (low blood sugar): Rybelsus can increase your risk of hypoglycemia if you take it with sulfonylurea or insulin. Hypoglycemia can cause drowsiness, mood changes, fast heartbeat, feeling weak and shaky, anxiety, and restless sleep. If you get nocturnal hypoglycemia (low blood sugar at night) you can wake up tired.
  • Changes in exercise: You may exercise more on Rybelsus (which is usually recommended), but doing so in a caloric deficit can cause fatigue. Or you may exercise less on Rybelsus if fatigue and GI issues get in the way. A lack of exercise can cause sleep problems and sluggishness. 
  • Changes in dopamine: More research is needed, but some 2023 research suggests GLP-1 receptor agonists could affect dopamine, the neurotransmitter involved in mood and motivation. You may feel low and unmotivated, which can affect your energy levels and sleep. For example, a lower mood is linked to lower alertness.
  • GI side effects: The most common side effects of Rybelsus include GI issues like nausea, abdominal pain, and constipation. These problems can keep you up at night. Plus, vomiting and diarrhea can cause dehydration, which can lead to fatigue. 
  • Anxiety: Anxiety isn’t listed as a side effect of Rybelsus, but some users have reported increased anxiety and even claustrophobia and paranoia at night. Plus, 2023 research found reports of semaglutide (the active ingredient in Rybelsus) triggering depression and suicidal thoughts. Even if you don’t experience mental health changes, you might feel stressed about taking a new medication, drug interactions, or dealing with GI issues. This can make it harder to sleep, and sleeplessness can worsen mental health problems. You’re not alone if so: RISE users say stress and anxiety are their biggest challenges when it comes to sleep.  
  • Increased heart rate: Rybelsus can cause an increase in heart rate of one to three beats per minute. But Dr. Peter Attia, a renowned physician and longevity expert, says his practice has seen adults on semaglutide with an increase in overnight heart rate of eight to 10 beats per minute. This may impact your sleep, but more research is needed. 

Rybelsus may not be to blame. Sleep debt and circadian misalignment are common causes of tiredness. More on how to fix these soon. 

Does Rybelsus Affect Sleep? 

Rybelsus can affect sleep by causing side effects like GI issues and anxiety. You may also change your lifestyle on Rybelsus, which can impact your sleep, both positively and negatively. For example, eating healthier, smaller meals may help you drift off, but eating fewer calories may cause hunger pangs, which can wake you up at night.

Does Rybelsus Cause Insomnia? 

Rybelsus may cause insomnia. Some users have reported insomnia when they first start the drug, and a 2023 study found social media reports of semaglutide drugs improving insomnia for some, but worsening it for others. 

Rybelsus can cause sleep problems that look like insomnia. But it’s not clear whether these problems can be classified as clinical insomnia. 

The International Classification of Sleep Disorders (ICSD-3) defines insomnia as having: 

  • Trouble falling asleep or staying asleep, or waking up too early 
  • Trouble sleeping despite having the opportunity to sleep 
  • Daytime distress or impairment from sleep problems 
  • Sleep issues that are not better explained by another sleep disorder or health condition 

If you have these sleep problems at least three nights a week for at least three months, it could be a sign of insomnia. If you have them for one to three months, it could be a sign of episodic insomnia.

Get medical advice if you think you have insomnia. You may need different, or additional, treatments compared to other Rybelsus sleep problems.

Does Rybelsus Improve Sleep? 

Rybelsus may improve sleep, if not right away, then over time. It can help type 2 diabetics get lower blood sugar levels and lose weight. Both diabetes and being overweight are linked to sleep disturbances and sleep disorders like sleep apnea

We’ve covered more on whether Ozempic can potentially help sleep apnea here.

Losing weight also lowers your odds of conditions like high blood pressure and heart disease — which have been linked to sleep disorders like insomnia. 

You may also make lifestyle changes on Rybelsus that improve your sleep, like eating healthier and exercising. And Rybelsus may even reduce your cravings for alcohol and cigarettes, and cutting down on these can also improve your sleep.

And the 2023 research we mentioned earlier found reports of insomnia, anxiety, and depression improving for some people taking GLP-1 receptor agonists.

Learn how your sleep affects weight loss here.

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How Long Does Rybelsus Fatigue Last? 

It’s unclear how long Rybelsus fatigue lasts. Some users have reported trouble sleeping in the first week or so of taking Rybelsus, with their sleep problems improving after that. 

In clinical trials, GI issues, like nausea and diarrhea, happened when the dose of Rybelsus increased. You may stay on your starting dose of Rybelsus for 30 days before increasing to a higher dose. Side effects may get better as your body gets used to the drug, but it’s not clear how quickly your body adapts to a higher dose. 

More long-term studies are needed. 

What Are the Side Effects of Rybelsus? 

Side effects of Rybelsus include: 

  • Nausea 
  • Abdominal pain 
  • Diarrhea 
  • Decreased appetite 
  • Vomiting 
  • Constipation 

Other possible side effects include bloating, burping, and flatulence, as well as more serious side effects like pancreatitis (inflammation of the pancreas), serious allergic reactions, kidney problems, diabetic retinopathy (which can cause vision loss), gallbladder problems, and kidney failure. 

Animal studies found an increased risk of thyroid tumors and a type of thyroid cancer called medullary thyroid carcinoma (MTC). 

Look out for symptoms of thyroid cancer and tumors such as hoarseness, shortness of breath, trouble breathing, and trouble swallowing. 

Seek medical attention if you experience serious or life-threatening side effects. 

How to Improve Rybelsus Fatigue? 

You can improve Rybelsus fatigue by lowering your sleep debt, getting in sync with your circadian rhythm, improving your sleep hygiene, managing GI issues and anxiety, eating a balanced diet, and getting some exercise. 

Here’s what to do:

  • Lower your sleep debt: Sleep debt is the amount of sleep you owe your body. The higher this number, the more tired you’ll feel — both on and off Rybelsus. Take afternoon naps, head to bed a little earlier, or sleep in a little later to pay back sleep debt. RISE works out how much sleep debt you have and helps you chip away at it.
  • Get in sync with your circadian rhythm: Your circadian rhythm is your body’s internal clock. Getting in sync can boost your energy. Do this by keeping a regular sleep schedule and eating your meals at roughly the same times. Check RISE for a daily prediction of your circadian rhythm to see when your body wants to wake up and go to sleep. 
  • Improve your sleep hygiene: Sleep hygiene is the set of daily behaviors that help you fall faster and wake up less often. It’s even more important to have good sleep hygiene if Rybelsus is disrupting your nights. Follow RISE’s 20+ sleep hygiene habit reminders, personalized to your circadian rhythm. For example, you’ll find out when to have your final coffee each day and when you should be putting on blue-light blocking glasses.
  • Manage GI issues: Eat bland foods like rice or crackers, avoid anything fried or fatty, and try smaller, more frequent meals. Stay hydrated and try sleeping on your left if you have heartburn. Research from 2022 suggests left-side sleeping may reduce acid reflux. We’ve covered how to sleep with acid reflux and stomach pain here.
  • Manage anxiety: A relaxing bedtime routine can help you unwind and drift off. Try meditating, journaling, or doing breathing exercises. RISE has some guided relaxation exercises to help. Learn how to sleep with anxiety here.
  • Eat a balanced diet: Make sure you’re eating nutrient-dense foods, even if you have a loss of appetite. Fruits, veggies, fiber, complex carbs, and plenty of protein can help fuel your body. Learn which foods give you energy here. 
  • Get some exercise: Even if fatigue or GI issues are leaving you drained, try to get some physical activity to improve your mood, energy, and sleep. It doesn’t take much to make a difference. Research shows a 10-minute walk can increase your energy more than a sugary snack. 
  • Talk to a healthcare professional: Your prescribing healthcare provider may suggest changes to any prescription drugs or over-the-counter supplements you take. They may also recommend treatment options for GI issues. Medication guides usually advise you to take Rybelsus first thing on an empty stomach, but a doctor may suggest taking it at a different time of day (drug timing can make a difference). 

We’ve covered more ways to stop feeling tired here.

RISE app screenshot showing sleep hygiene habit reminders
RISE tells you when to do 20+ sleep hygiene behaviors.

Expert tip: Find out how much sleep you need and aim for this number each night. This is the best way to get more energy in the long run. RISE works out how much sleep you individually need — it varies more than you think. When we looked at how much sleep 1.95 million RISE users aged 24 and over needed, we found it ranged from five hours to 11 hours 30 minutes. 

The RISE app can tell you how much sleep you need
How much sleep RISE users need.

Get More Energy on Rybelsus 

Tiredness isn’t a listed side effect of Rybelsus, but users have reported it online. Rybelsus may disrupt your sleep through other side effects like GI issues and anxiety. 

There are some steps you can take to feel less tired on Rybelsus. Use the RISE app to lower your sleep debt, sync up with your circadian rhythm, and fall asleep faster and wake up less often with bullet-proof sleep hygiene.  

RISE users notice a big difference in how they feel.  

“This app has been life-changing. I’ve always been irresponsible with sleep but I wanted to see some change...The difference I feel in terms of energy is night and day.” Read the review

And it can happen fast — 80% of RISE users feel more energy within five days.

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