Does Zepbound Make You Tired? Yes, Sleep Doctor Explains Why

Zepbound can cause fatigue as a side effect and cause sleep loss due to side effects like GI issues and anxiety. More research is needed as use increases.
Published
2024-01-16
11 MINS
Written by
Jeff Kahn, M.S., Rise Science Co-Founder
Reviewed by
Chester Wu, MD, Rise Science Medical Reviewer
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Does Zepbound Make You Tired? 

  • Zepbound can make you tired. Fatigue is listed as a common side effect, affecting 5% or more of users. This may be due to eating fewer calories.
  • Zepbound can also cause low blood sugar, GI issues, and anxiety, which can cause sleep problems and tiredness. 
  • To feel less tired while taking Zepbound, use the RISE app to lower your sleep debt, get in sync with your body clock, and improve your sleep hygiene. These steps can help you get a better night’s sleep and feel more energy each day.

Zepbound — one brand name for the drug tirzepatide — can help overweight and obese adults lose weight. But alongside weight loss, it can cause fatigue, and users report feeling drowsy and lethargic on the drug. 

Below, we’ll dive into why Zepbound can make you feel tired and how you can use the RISE app to get better sleep and more energy — both when you’re on and off the drug.

Heads-up: Zepbound was FDA-approved in November 2023 for weight loss and chronic weight management in adults with at least one weight-related health condition, like high cholesterol, obstructive sleep apnea, cardiovascular disease, or type 2 diabetes. It’s a very new drug, and more research is needed into the side effects. As more people use the drug, there’s more anecdotal evidence suggesting that Zepbound fatigue may be more widespread than understood from studies, and it may even cause insomnia.

Advice From a Sleep Doctor

Advice From a Sleep Doctor

"From what we know from the manufacturer so far, fatigue is a common side effect of Zepbound," says Dr. Chester Wu, Rise Science medical reviewer and double board certified doctor in psychiatry and sleep medicine.

“We know a lot less as to why, but you might feel tired as you’re cutting your calories and exercising more while on the drug, and other side effects like nausea or diarrhea can make it hard to get enough sleep.”

Can Zepbound Make You Feel Tired? 

Zepbound can make you feel tired. The FDA lists fatigue as a common side effect of Zepbound, affecting 5% or more of users. The drug may also disrupt your sleep.

The higher the dose of Zepbound you take, the more likely you are to feel tired. In placebo-controlled clinical trials, the drug caused fatigue in 5% of those taking 5 mg of Zepbound, 6% of those taking 10 mg, and 7% of those taking 15 mg, the highest dose. 

Fatigue is defined here as including feelings of weakness, lethargy, and malaise. It’s not clear whether fatigue is ongoing, fleeting, or compared to pre-Zepbound fatigue levels. 

Beyond fatigue, users are reporting sleep problems. 

A 2023 study published in Brain Sciences analyzed Reddit, Youtube, and TikTok posts about the side effects of GLP-1 receptor agonists and GLP-1/GIP receptor agonists. In the study, users mentioned sleep-related issues the most, including insomnia, anxiety, depression, and general mental health issues. 

Online, users have also reported side effects like dizziness, irritability, and feeling weak and panicky on Zepbound, which can add to feeling drained.

Zepbound can also cause side effects like gastrointestinal issues and anxiety that make it hard to get enough sleep.

Heads-up: Believe it or not, there’s a difference between feeling tired and feeling sleepy. Tiredness is when you feel fatigued, but you might not be able to fall asleep. Sleepiness is when your eyelids are drooping and you could fall asleep if you tried. Zepbound may make you feel both tired and sleepy. 

Other diabetes and weight loss drugs can make you tired, too. 

We’ve covered GLP-1 receptor agonists and GLP-1/GIP receptor agonists in more detail:

Because this gets confusing: Tirzepetide — the active ingredient in the drugs Mounjaro and Zepbound — is a dual-acting glucagon-like peptide-1 receptor agonist (GLP-1 receptor agonist) and a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, or GLP-1/GIP receptor agonist. Semaglutide — the active ingredient in Ozempic, Wegovy, and Rybelsus — is only a GLP-1 receptor agonist. More research is needed on how both could make you tired.

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Why Does Zepbound Make You Tired? 

More research is needed to know why Zepbound makes you tired. It may be down to eating fewer calories, low blood sugar, changes in dopamine levels or exercise, or side effects like GI issues, anxiety, and depression causing sleep loss.

Here’s more on why Zepbound could make you tired and sleepy: 

  • Eating fewer calories: Zepbound reduces your appetite, helping you eat a reduced-calorie diet to aid weight loss. You may feel tired as your body has less fuel. This may feel worse if you’re not used to being in a caloric deficit or you’ve started exercising more on fewer calories, which is usually recommended. 
  • GI issues causing sleep loss: Zepbound can cause GI issues like nausea, diarrhea, vomiting, stomach pain, and heartburn, all of which can easily keep you up at night. Plus, vomiting and diarrhea can cause dehydration, which can lead to fatigue. 
  • Anxiety and depression causing sleep loss: You might feel anxious about taking Zepbound for the first time, changing your eating habits, or from GI issues and struggle to fall asleep as a result. RISE users say stress and anxiety are the biggest factors disrupting their sleep. Zepbound can also cause depression or thoughts of suicide, which can lead to sleep problems. And sleep loss can make these mental health problems worse. 
  • Hypoglycemia (low blood sugar): Zepbound can cause hypoglycemia when used with drugs like sulfonylurea or insulin. Symptoms of hypoglycemia include drowsiness, mood issues, feeling tired and weak, and restless sleep. If you experience nocturnal hypoglycemia (low blood sugar overnight), you may wake up tired
  • Doing less exercise: If you’re tired or dealing with GI distress, you might exercise less than usual or skip workouts altogether. This can make it harder to fall asleep at night and being sedentary all day can leave you feeling sluggish. 
  • Changes in dopamine making you feel low: The neurotransmitter dopamine is linked to mood and motivation. A 2023 study suggests GLP-1 receptor agonists may change your dopamine levels. This may leave you feeling low and unmotivated, which can affect your sleep and energy. More research is needed to know if GLP-1/GIP receptor agonists, like Zepbound and Mounjaro, affect dopamine. 

You may also feel tired due to the common culprits of high sleep debt and circadian misalignment, which can tank your energy whether you’re on Zepbound or not. We cover how to fix those soon.

Heads-up: As a dual-acting receptor agonist, Zepbound may help people lose more weight than drugs like Ozempic and Wegovy, as it targets multiple pathways involved in glucose regulation and weight management, compared to single-acting receptor agonists like Ozempic. But this may mean it comes with more fatigue and other side effects. More research is needed into all of these weight loss and diabetes medications.

Does Zepbound Affect Sleep? 

Zepbound may affect sleep by causing side effects like nausea, vomiting, diarrhea, anxiety, and depression — all of which can make it harder to sleep. 

You may also change your eating and exercise habits while on Zepbound, which can affect your sleep. For example, skipping workouts may make it harder to drift off and hunger pangs from cutting calories may wake you up at night. 

Does Zepbound Cause Insomnia? 

It’s unclear whether Zepbound can cause insomnia. Research from 2023 found social media reports of GLP-1 receptor agonists worsening insomnia in some, but improving it in others.

It’s not clear whether this is true insomnia, however. 

According to the third edition of the International Classification of Sleep Disorders (ICSD-3), insomnia is when you have: 

  • Difficulty falling asleep, staying asleep, or you wake up too early 
  • Difficulty sleeping despite having the opportunity to sleep 
  • Daytime impairment or distress from sleep problems 
  • Sleep problems that are not better explained by another sleep disorder or medical condition 

Having these sleep problems at least three nights a week for at least three months could be a sign of insomnia. Having them for one to three months could be a sign of episodic insomnia.

Zepbound may cause sleep problems that look a lot like insomnia, but they may not be true insomnia. 

If you have these symptoms, you may need different or additional treatments for insomnia compared to the sleep problems Zepbound can cause. Seek medical advice if you think you have insomnia. 

Can Zepbound Improve Sleep? 

Zepbound may improve your sleep, if not at first, then over time. The drug can help you lose weight, and losing weight can reduce your odds of snoring and sleep apnea. Having a healthy body weight also lowers your odds of health conditions like type 2 diabetes, high blood pressure, and heart disease — which have been linked to sleep disorders like insomnia. 

While on Zepbound, you’re encouraged to make healthy diet and exercise changes, and these can improve your sleep. And weight reduction can give you more energy to exercise, creating a virtuous circle.

Zepbound may even reduce your cravings for alcohol and cigarettes, and cutting down on these can also improve your sleep.

There’s also some evidence that GLP-1 receptor agonists may improve sleep apnea. We’ve covered more on whether Ozempic can potentially help sleep apnea here.

A 2023 study found anecdotal reports of tirzepatide helping some users wake up feeling refreshed and rested. GLP-1 receptor agonist weight loss medications were reported to improve insomnia, anxiety, and depression, too. 

You can learn more about sleep and weight loss here.

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How Long Does Zepbound Fatigue Last? 

More research is needed to find out how long Zepbound fatigue lasts. Fatigue may go away as your body gets used to the medication. It also depends on what’s causing your fatigue. For example, GI side effects can happen when your dose of Zepbound increases and they should get better as your body adjusts.

Zepbound is a new weight loss drug, so long-term studies on fatigue are needed.

What Are the Side Effects of Zepbound? 

The side effects of Zepbound include: 

  • Fatigue 
  • Nausea 
  • Diarrhea
  • Vomiting
  • Constipation 
  • Abdominal pain
  • Burping 
  • Indigestion 
  • Injection site reactions 
  • Allergic reactions 
  • Hair loss 
  • Gastroesophageal reflux disease 

Most of these side effects can contribute to feeling tired or having sleep problems. These side effects are reported in 5% or more of people on Zepbound. 

More serious side effects include pancreatitis (inflammation of the pancreas), gallbladder disease, diabetic retinopathy complications (which can cause vision loss) in those with type 2 diabetes, and thyroid cancer and tumors.

How to Improve Zepbound Fatigue? 

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

Here’s what to do: 

  • Lower sleep debt: Sleep debt is the amount of sleep you owe your body. The more sleep debt you have, the more tired you’ll feel — whether you’re on Zepbound or not. Take short afternoon naps, head to bed a little earlier, or sleep in a little later to catch up on any lost sleep. RISE works out how much sleep debt you have and keeps track as you pay it back. 
  • Get in sync with your circadian rhythm: Your circadian rhythm is your body’s internal clock. Get in sync to feel more energy. You can do this by keeping a regular sleep schedule, even on weekends, and eating your meals at regular times. Check RISE for a prediction of your circadian rhythm each day to see when your body wants to wake up and go to sleep.  
  • Improve your sleep hygiene: These are the daily habits that help you fall and stay asleep. Use RISE’s personalized reminders for 20+ habits, including when to stop drinking coffee and when to get and avoid bright light. 
  • Manage GI issues: Try eating bland foods, like toast or rice, and smaller, more frequent meals. Avoid anything too fried and fatty, and stay hydrated. Research from 2022 suggests sleeping on your left side may help with acid reflux. We’ve shared more tips on sleeping with acid reflux and stomach pain here.
  • Reduce anxiety: During the day, exercise can help keep anxiety in check. Before bed, take plenty of time to unwind and try RISE’s breathing exercises and relaxation techniques. We’ve covered how to sleep with anxiety here.
  • Eat a balanced diet: Make sure your reduced food intake still includes enough protein and fiber, and make healthy choices to keep energy high. Learn which foods give you energy here. 
  • Get some exercise: Physical activity can boost your energy and mood, and help you drift off at night. If fatigue or GI issues are making it hard to do a full workout, try a short walk or gentle yoga session instead. 
  • Talk to a healthcare professional: A healthcare provider can recommend changes to any prescription drugs or supplements you take or taking Zepbound at a different time of day (the timing of drugs can make a difference). They may prescribe other treatments for sleep or GI problems. Just be wary of sleep aids, which can cause rebound insomnia when you stop taking them. 

Learn more ways to wake yourself up when tired here.

RISE app screenshot showing sleep hygiene habit reminders
RISE can guide you through daily sleep hygiene habits.

Heads-up: It may not be Zepbound alone making you tired — you may need more sleep than you think. RISE works out how much sleep you uniquely need. Looking at 1.95 million users aged 24 and older, we found 48% need eight hours or more. 

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

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Feel Less Tired on Zepbound

Fatigue is a common side effect of Zepbound, and the drug may cause sleep problems.  

You can make changes to feel less tired, though. Use the RISE app to catch up on lost sleep and get in sync with your circadian rhythm to boost your energy. Follow RISE’s 20+ personalized sleep hygiene reminders for an easier time falling and staying asleep. 

RISE users say the app helps boost their energy and health.

“It’s really helped me be a morning person and enjoy my day more…After figuring out how I should sleep with this app, I feel a lot better and my health is better too!” Read the review.   

RISE can help you feel better on your weight loss journey — 80% of users feel more energy within five days. 

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