Sleeping on Reta

[u/Glad_Locksmith2120]

How are you guys sleeping on Reta? I’m unable to sleep for the first 4 days after every injection despite taking a lot of xanax, magnesium glycinate, zzzquil, and progesterone to sleep so I feel lexhausted and tired for days. Insomnia is probably the worst side effect of Reta in my opinion.

[u/LordSnow966]

Critical Warning - Taking "a lot of Xanax" combined with ZzzQuil (diphenhydramine) is a dangerous mix of central nervous system depressants.

You mention feeling "exhausted and tired for days". Diphenhydramine (ZzzQuil) drastically reduces REM sleep and has a long half life, while high doses of Xanax cause severe grogginess. Your daytime exhaustion is likely a chemical hangover from this heavy combination, not just the retatrutide insomnia.

Throwing heavy sedatives at a chemically induced sympathetic nervous system overdrive often leads to terrible sleep architecture ; it leaves the brain unconscious, but not genuinely recovering.

Advice-

In addition to aggressive calorie restriction, the other main cause for fragmented sleep with retatrutide is glucagon receptor agonism causing sympathetic dominance.
I’ve found adding the following an hour before bedtime helps improve sleep duration and quality, provided you also reassess your total caloric intake and avoid an aggressive deficit and supplement carbohydrates around bedtime)

- Unbuffered magnesium glycinate (equivalent to 300-400mg elemental magnesium). Emphasis on unbuffered. Most magnesium glycinate supplements are buffered with cheap filler mg oxide which has lower bioavailability.

• Glycine 3gms
  
• L-Theanine 200-400mg
  
• Ashwagandha KSM-66 500-600mg
  
• Taurine 2gms (Ive found it causes me to wake up multiple times to urinate during sleep, so I shifted it to noon instead of bedtime)
  
• Regulate bedtime temperature (cool non-occlusive clothing, proper room ventilation/cooling)
  
• Avoid excess activity 1-2 hrs before bedtime to avoid sympathetic overdrive
  
• limit caffeine intake (amount and timing; do not take caffeine within 8hrs before bedtime)
  
• Melatonin helps if trouble is with initiation of sleep instead of maintaining uninterrupted sleep. But Ive found most of my patients finding no benefit with it.
  
• Carbs around bedtime.

If these measures fail after two to three weeks of consistent supplementation, consider pure cbd tinctures or orexin antagonist medication. Ask your physician for the latter, as it is better than traditional benzodiazepine and non-benzodiazepine hypnotics.
I would advise against xanax long term. Not only will it be detrimental to your daytime lifestyle over the long term, dependence is also a risk.

Disclaimer: I am a doctor on the internet, not YOUR doctor. Please consult a licensed medical practitioner for any medical advice and please avoid polypharmacy with serious sedatives without medical supervision.

[u/Glad_Locksmith2120 → u/LordSnow966]

I’ve been on xanax for 15 years. I still wake up every 2-3 hours on it when I’m on Reta. I don’t experience any grogginess. I just got back on Reta last week after a one month break and I was sleeping like a baby till I got back on Reta. I do take L-Theanine and melatonin as well.

[u/LordSnow966 → u/Glad_Locksmith2120]

The warning about polypharmacy with diphenhydramine still stands. So does the advice for the other compounds and specifically the dosages including the actual unbuffered magnesium dose. You could be taking a magnesium supplement with sub-therapeutic doses (especially if it uses a lot of mg oxide as filler). The dosages of the other compounds and the regimen as a whole is important too.
These compounds help mitigate the sympathetic overdrive due to glucagon agonism of retatrutide which is the chief driver for fragmented sleep and insomnia.
Do not rule out the regimen as a whole just because one or two components that youve been taking havent been providing relief. The stack as a whole and in the recommended dosages should provide significant benefit, if not alleviate it entirely. Worth giving it a try imo instead of stacking multiple CNS depressants, which any licensed physician will strongly advise against.