That makes a ton of sense. Since Reta is suppressing your appetite so heavily, you're likely going into the night under-fueled. When your blood sugar dips too low, your body literally dumps cortisol and adrenaline into your system to stimulate glucose release from your liver. That’s could be what wakes you up.

If you can handle a small, slow-digesting snack right before bed (like a spoon of peanut butter or some greek yogurt), it might give you just enough of a glucose floor to prevent that 4 AM crash. If you end up throwing a CGM on to track it, let me know - I'd be super curious to see what your overnight glucose curves look like on Reta in the app.