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ForumsSide Effects & ManagementInsomnia on semaglutide — circadian rhythm disruption or weight loss related? Page 2

Insomnia on semaglutide — circadian rhythm disruption or weight loss related?

Dr.SleepRoch Thu, May 7, 2026 at 12:08 AM 21 replies 761 viewsPage 2 of 5
NicoleRaleigh
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May 7, 2026 at 5:53 AM#6

Adding the numbers, since they settle part of this. Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.

Last edited: May 7, 2026 at 6:53 AM
9 4InsuranceTom, WendyG_ATL, SaraMom3 and 6 others
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raj_cambridge
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May 7, 2026 at 8:09 AM#7

Following on from VanRx_Mike — and this may be the naive question:

How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?

8 3DoseLogDan, SleepFixSam, PurityPaulOR and 5 others
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PharmD_Rodriguez
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May 7, 2026 at 10:24 AM#8
NicoleRaleigh said:
Worth knowing that the injection site changes very little.

Coming at NicoleRaleigh’s question from a different direction. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.

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Dr.SleepRoch
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May 7, 2026 at 12:40 PM#9

OP back with an update, since a thread like this is useless without one.

Six weeks on from posting: I stopped reading the weekly number and started reading a four-week average, and the "stall" I opened this thread about was a 1.8kg loss I could not see.

Last edited: May 7, 2026 at 4:40 PM
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MikeFit_NJ
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May 7, 2026 at 11:31 PM#10
PharmD_Rodriguez said:
Steady state is the thing most people miss.

PharmD_Rodriguez has the substance of this right. The condition it depends on is worth stating. The mechanism that matters here is not stomach emptying, it is central. GLP-1 receptor agonism in the arcuate nucleus stimulates POMC neurons and suppresses AgRP/NPY signalling, which is why the effect is appetite and food salience rather than physical fullness. Delayed gastric emptying largely tachyphylaxes over the first months; the appetite effect does not.

20 18Dr.EndoIndy, tom_AK, josh_phd_bmore and 17 others
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