Weight loss pills impact sleep variably by class—GLP-1 agonists (Ozempic/Wegovy) often disrupt via nausea/vivid dreams (10-20% report insomnia), while stimulants (phentermine) cause insomnia in 30%; some improve OSA indirectly via weight loss.
By Medication Type
GLP-1/GIP Agonists (Semaglutide, Tirzepatide)
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Negative: Nausea (20%), GERD, anxiety wake you; dopamine shifts cause vivid/nightmare dreams (anecdotal 15%).
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Positive: Weight loss reduces OSA AHI 20-24 events/hour (SURMOUNT-OSA trials).
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Duration: Side effects peak weeks 1-4, fade as body adjusts.
Stimulants (Phentermine)
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Insomnia: 25-30%—take mornings only.
Orlistat
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Minimal direct effect; GI upset indirectly disrupts.
Mitigation
Evening protein snacks, elevate head for reflux, magnesium 300mg pre-bed.
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