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Reduced body mass correlates with fewer breathing events per hour in relevant populations. 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Any additional compounds in a broader stack would target separate degeneration layers such as direct neural repair or inflammation without overlap in this single-compound scope.","status":"active","vx_hash":"ba18ff11bd579cce0a86f9f8af0dc4181a2c076cd968d2abc3e8d52831323357","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"7fb0823c91b8ebfedce868460289839a1fc66936633239d92cc757e64c1e7d85","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"e146edeb5248dbd0f9766591e83de02d7733e35bb8b3f9301580181a0db97f74","detail":{"divided_from":"body","block":9,"kind":"p"},"prev":"genesis","hash":"7fb0823c91b8ebfedce868460289839a1fc66936633239d92cc757e64c1e7d85"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d9"},{"id":"d10","kind":"h","type":null,"order":10,"text":"## What the evidence actually shows","status":"active","vx_hash":"1f3addc2ca983d5d128712ff3d49b6582606c543a6cf9b89cb4a27314cd8110c","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"f672e2c37981b4a228dc36ebcecbae636ad400ab86bfa9d39b7a6721fddf207c","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"a7a051e6a294dc45c15b7d4859b7020d561e719fe73844f03e3a8f9e7fed8de1","detail":{"divided_from":"body","block":10,"kind":"h"},"prev":"genesis","hash":"f672e2c37981b4a228dc36ebcecbae636ad400ab86bfa9d39b7a6721fddf207c"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d10"},{"id":"d11","kind":"p","type":null,"order":11,"text":"Human trials: Two phase 3 randomized double-blind placebo-controlled trials (SURMOUNT-OSA) enrolled adults with moderate-to-severe obstructive sleep apnea and obesity. In trial 1, tirzepatide changed AHI by −25.3 events per hour versus −5.3 with placebo at week 52 (treatment difference −20.0, p<0.001). In trial 2, tirzepatide changed AHI by −29.3 versus −5.5 (difference −23.8, p<0.001). Both trials showed reductions in hypoxic burden, hsCRP, systolic blood pressure, and body weight (approximately 18-20%). Patient-reported outcomes improved on PROMIS sleep disturbance and sleep-related impairment scales. These are human data from 469 participants across the two trials.","status":"active","vx_hash":"ec2cf15d8904d0afd965564e3ab6bb91f85fca3c5fd22b561d638a72b13ccd6c","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"f08aa1748d71d2cde25616525d29750c47dd873b9fd77938113d0e588dafb1dc","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"5652063545cec1601e34b504211cb9944aed592d2b2cb70e69c1dd93c907099d","detail":{"divided_from":"body","block":11,"kind":"p"},"prev":"genesis","hash":"f08aa1748d71d2cde25616525d29750c47dd873b9fd77938113d0e588dafb1dc"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d11"},{"id":"d12","kind":"p","type":null,"order":12,"text":"Preclinical: No relevant animal insomnia or OSA models are cited in the primary sources for this compound.","status":"active","vx_hash":"59ad8d9d5e26f2fbae781efccc98e881c24b77aebb16f46802e782d791420cb5","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"5ddc56383f1cc886ce2d8f3ea67844cd7538905236e0fbb25a7fd37451e3d52b","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"2a85ca50e19911c2530d3a2431265b36a28f3b304cc19a5c6949a7546162adb5","detail":{"divided_from":"body","block":12,"kind":"p"},"prev":"genesis","hash":"5ddc56383f1cc886ce2d8f3ea67844cd7538905236e0fbb25a7fd37451e3d52b"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d12"},{"id":"d13","kind":"p","type":null,"order":13,"text":"Anecdotal: Reddit threads in r/tirzepatidecompound and r/GLP1microdosing describe insomnia or sleep disruption, often in the first weeks or after dose increases, sometimes linked by users to gastrointestinal effects or blood sugar changes. Some users report transient issues that lessen over time; others note better sleep from reduced nighttime hunger.","status":"active","vx_hash":"9075e65ba04b5e39cfb292e9f31a3bf24ed9bd9aac853a93290115d3d9203521","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"b81b648257c8307e7fb4ee4c3716c6fb88679118a0b8bbaaf5f983bdfac429f3","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"8c974391b7376b076794ccc9b2d41ad5a462ed8a02cb76654de8d105de4f558d","detail":{"divided_from":"body","block":13,"kind":"p"},"prev":"genesis","hash":"b81b648257c8307e7fb4ee4c3716c6fb88679118a0b8bbaaf5f983bdfac429f3"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d13"},{"id":"d14","kind":"p","type":null,"order":14,"text":"X posts mention insomnia in passing, often as transient or alongside other effects, with mixed reports of improved or disrupted sleep.","status":"active","vx_hash":"6204672cbe31cea76a0f6d02b0473146ec8ac5a48f6b955880e619dddca039d7","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"8cfc30c49143e9e410de9ef516b10ac18a0aae0f22bd6042eb91447a42e09ac1","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"217032c373a1e51ed3afa4edaea378c8a997b47a8512eead28fbfad2c749bcdf","detail":{"divided_from":"body","block":14,"kind":"p"},"prev":"genesis","hash":"8cfc30c49143e9e410de9ef516b10ac18a0aae0f22bd6042eb91447a42e09ac1"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d14"},{"id":"d15","kind":"h","type":null,"order":15,"text":"## What scientists say","status":"active","vx_hash":"ef0bf4b4000f803be5926296730a5ee14e0dea3d478f56a7f3dc67e3828ab3d1","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"7c11a8a1f008a9f5d383a83bd4d5950ef3e08bb218bedcd291254fde5e7ad9fd","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"2f1dd55083de1fa734f2f06a8337a050d5a0b3f635bfc8bb709abab75705a1ef","detail":{"divided_from":"body","block":15,"kind":"h"},"prev":"genesis","hash":"7c11a8a1f008a9f5d383a83bd4d5950ef3e08bb218bedcd291254fde5e7ad9fd"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d15"},{"id":"d16","kind":"p","type":null,"order":16,"text":"The SURMOUNT-OSA investigators concluded that tirzepatide reduced AHI, body weight, hypoxic burden, hsCRP, systolic blood pressure and improved sleep-related patient-reported outcomes in persons with moderate-to-severe OSA and obesity. Secondary analyses link magnitude of AHI improvement to achieved weight reduction. Additional research is noted as needed to separate direct drug effects from weight loss alone. FDA approval of Zepbound for moderate-to-severe OSA in adults with obesity occurred in December 2024 based on these trials.","status":"active","vx_hash":"bdea9fa12d46c2bafedb59f22af1e773af8643e76b085742b940d28756dd920b","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"759f8464504985e5187f2ca68fe963babccdd7530b9a8a2c4ffa9a823856e737","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"f43f5bebbd835a1e14d6a29f54a658a4a4bd84a43ffc15067ce06f0477c7de92","detail":{"divided_from":"body","block":16,"kind":"p"},"prev":"genesis","hash":"759f8464504985e5187f2ca68fe963babccdd7530b9a8a2c4ffa9a823856e737"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d16"},{"id":"d17","kind":"h","type":null,"order":17,"text":"## What people say on Reddit","status":"active","vx_hash":"04122fd25bc568ed4184f9363b2f7acf17eaa66d3a5c67f1e027e13fdbe3b27c","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"8d0309bbb9613050785aca0daa6226b4cd418a9f622817cf8516d04fac2edad1","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"feb303756a303788527cf602bf2c3c6b00ab8c384fb9fff4baa9ffc53e0049c3","detail":{"divided_from":"body","block":17,"kind":"h"},"prev":"genesis","hash":"8d0309bbb9613050785aca0daa6226b4cd418a9f622817cf8516d04fac2edad1"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d17"},{"id":"d18","kind":"p","type":null,"order":18,"text":"Users report insomnia as a side effect, particularly early in treatment or at higher doses. Examples include difficulty sleeping 2-4 days after injection or persistent issues on microdoses. Magnesium, melatonin, and dose adjustments are discussed as self-experiments. Some threads contrast this with overall benefits like reduced hunger-related awakenings.","status":"active","vx_hash":"12e586c1650d8d3798a3141a10676a752459e049efe274d15e8589f25be5cb50","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"affd1831ef68e5a0444139c6cbdec1a1e4b55d8a8dda087d8daed9d9bccf5f80","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"7d468057c5fbc86d146407b2d6fd7de970b37b638652e2a478affecaf9f1567e","detail":{"divided_from":"body","block":18,"kind":"p"},"prev":"genesis","hash":"affd1831ef68e5a0444139c6cbdec1a1e4b55d8a8dda087d8daed9d9bccf5f80"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d18"},{"id":"d19","kind":"h","type":null,"order":19,"text":"## What people say on X","status":"active","vx_hash":"2abf57772247ed7b1c63ffcafe06ba824b4ba3e9c029a7afef947b2e8d77c59f","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"e9386f9a9758f50f7963d12f5a1395c34b7d3270a030d90699d782d2fb29129c","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"4dd8bbfdb0452cc6235c2300209b5132daba3913b8f54ab179b1a73109c298dd","detail":{"divided_from":"body","block":19,"kind":"h"},"prev":"genesis","hash":"e9386f9a9758f50f7963d12f5a1395c34b7d3270a030d90699d782d2fb29129c"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d19"},{"id":"d20","kind":"p","type":null,"order":20,"text":"Anecdotes include transient insomnia on tirzepatide or related GLP-1/GIP agents. One user listed it among other medications tried for sleep maintenance. Others speculate on hunger reduction aiding sleep or note it as a potential early effect that may not persist.","status":"active","vx_hash":"b155d76950e8d0633d5cc332688260cf1645a7dee23387ee03a66e63c46111ed","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"d4e8ff62a58a51de1114bfe401a89106f7013844958507021507609a753435cd","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"ffd1006773d5cd8850183a8546b8078cbfce53b31b526965cef36299469c1e53","detail":{"divided_from":"body","block":20,"kind":"p"},"prev":"genesis","hash":"d4e8ff62a58a51de1114bfe401a89106f7013844958507021507609a753435cd"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d20"},{"id":"d21","kind":"h","type":null,"order":21,"text":"## What we do not know","status":"active","vx_hash":"e3a1a3adade1221f2c29af3fbda9f1d56b90bcb647886468fd304cd807958db6","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"12245cef3310e7d8965be8b1186af0dceb68aafed71e9b78ec86d1ddec82c11f","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"7d96a49fba77f6a48c0321db2ae4180a902beae62e2aac0d23408fbf8333a177","detail":{"divided_from":"body","block":21,"kind":"h"},"prev":"genesis","hash":"12245cef3310e7d8965be8b1186af0dceb68aafed71e9b78ec86d1ddec82c11f"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d21"},{"id":"d22","kind":"p","type":null,"order":22,"text":"No dedicated human trials exist for tirzepatide in primary insomnia without obesity or OSA. Long-term data beyond 52 weeks on sustained sleep architecture changes are limited. The relative contribution of weight loss versus any direct incretin effects on sleep remains under study. Individual response variability, including reports of worsened sleep, lacks predictive biomarkers in published data.","status":"active","vx_hash":"36d4022401d61cb884532166ac76b170dfd0a500984d46036cd347904e8b4760","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"023aae17c8b27c967a0e1c998c30e225aee7bbe24fc81ac3e796a39d074f9969","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"3796a379de910e3fbb54d6ccbf294a828f2df27107a75bd97be19b5d1c49cafd","detail":{"divided_from":"body","block":22,"kind":"p"},"prev":"genesis","hash":"023aae17c8b27c967a0e1c998c30e225aee7bbe24fc81ac3e796a39d074f9969"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d22"},{"id":"d23","kind":"h","type":null,"order":23,"text":"## Safety and limits","status":"active","vx_hash":"e6e9c49af50641e289fde8606919a6549904ed960b0d3651b086332d0d8a0deb","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"de6af7d72ea00f0cb33ca87adccb4ba44c040fe4a00a00d23d8e22a7ae03baca","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"404f7427c043c6ec7a5cb4416bbec9ec336e19f8757fb217be5c5c2161ff8cb6","detail":{"divided_from":"body","block":23,"kind":"h"},"prev":"genesis","hash":"de6af7d72ea00f0cb33ca87adccb4ba44c040fe4a00a00d23d8e22a7ae03baca"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d23"},{"id":"d24","kind":"p","type":null,"order":24,"text":"In the SURMOUNT-OSA trials the most common adverse events were gastrointestinal and mostly mild to moderate. Insomnia is not listed as a common adverse reaction in the prescribing information or trial safety tables. Post-marketing reports include sleep disturbances at low frequency. Tirzepatide is approved for specific indications including OSA with obesity when used with diet and exercise. All observations remain study-specific; individual results vary.","status":"active","vx_hash":"3564d12caabcffa7921311fe15181931d934d3bba70805f9227869b323945d39","semantic_hash":null,"version_hash":null,"version":1,"sources":[],"falsifiers":[],"tier":null,"backed":null,"transcludes":null,"chain_head":"4fde5e9feb562bd468e2e6f48e60d76f758f5491154710de8e433e7d4dc5285b","chain_length":1,"chain":[{"n":1,"op":"genesis","ts":"2026-07-17T02:43:17.132Z","actor":"owner","text_sha":"3ce87946efbe4335fec499ea7d3c914381afbf0862e3792c43ea6dbf4cdf362b","detail":{"divided_from":"body","block":24,"kind":"p"},"prev":"genesis","hash":"4fde5e9feb562bd468e2e6f48e60d76f758f5491154710de8e433e7d4dc5285b"}],"claim_ids":[],"last_op":{"op":"genesis","actor":"owner","ts":"2026-07-17T02:43:17.132Z"},"consolidated_into":null,"stable_url":"https://miscsubjects.com/i/div/tirzepatide-insomnia/d24"}],"voxels":[{"id":"c1","div_id":"claim:c1","kind":"claim","text":"In SURMOUNT-OSA trial 1, tirzepatide changed AHI by −25.3 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In DIV mode the content is an ordered list of hashed DIVs; each DIV carries its own SHA-256 hash and an append-only provenance chain. Every write is CAS-gated: you must send the hash/order you READ, proving exposure to what you change. Every successful write returns a clickable human permalink.","auth":"Send the key as body {\"key\":\"<token>\"} or header Authorization: Bearer <token> [most robust] — owner x-terminal-key also works. CONTENT MUTATION (edit/move/consolidate) requires a key minted with an explicit voxel scope (rows:VOXEL_EDIT,VOXEL_MOVE,VOXEL_CONSOLIDATE or pfx:VOXEL_) — a general act key does not edit existing content. Filing a challenge or attestation needs no key at all.","web_runtime":"WEB CHATGPT: open https://miscsubjects.com/api/model-lane first. Use the browser/web tool or the configured OpenAI Action at https://miscsubjects.com/api/openai/actions.json. Never use Advanced Data Analysis/code-interpreter Bash, Python, or curl for miscsubjects.com. 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Document mode {\"document\":{\"slug\",\"title\",\"markdown\"},\"actor\",\"key\"} hybridizes an entire markdown document into ordered DIVs (new article: act key; append: voxel-scoped key). Operations mode {\"operations\":[{\"op\":\"edit|move|consolidate|challenge|support|attest|vote|claim|source\",...}],\"key\"} runs up to 300 ops with per-op receipts. Append your session's output to the ledger, not the chat. Format precedent: https://miscsubjects.com/a/append-protocol","vote":"POST https://miscsubjects.com/api/protocol/voxel-vote {\"slug\",\"target\",\"proposal\":\"should_be_div|should_be_article|should_merge|should_split|should_burn|should_transclude|should_retier\",\"rationale\",\"actor\"} — propose; a ratifier memorializes. 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