diff --git a/LoopFollow/LiveActivity/LiveActivityManager.swift b/LoopFollow/LiveActivity/LiveActivityManager.swift
index 125ba4e09..b310b2fe3 100644
--- a/LoopFollow/LiveActivity/LiveActivityManager.swift
+++ b/LoopFollow/LiveActivity/LiveActivityManager.swift
@@ -176,8 +176,7 @@ final class LiveActivityManager {
     @objc private func handleWillResignActive() {
         guard Storage.shared.laEnabled.value, let activity = current else { return }
 
-        refreshWorkItem?.cancel()
-        refreshWorkItem = nil
+        refreshCoalescer.cancel()
 
         let provider = StorageCurrentGlucoseStateProvider()
         guard let snapshot = GlucoseSnapshotBuilder.build(from: provider) else { return }
@@ -437,7 +436,10 @@ final class LiveActivityManager {
     private var lastUpdateTime: Date?
     private var pushToken: String?
     private var tokenObservationTask: Task<Void, Never>?
-    private var refreshWorkItem: DispatchWorkItem?
+    private lazy var refreshCoalescer = RefreshCoalescer(delay: 20) { [weak self] reason in
+        self?.performRefresh(reason: reason)
+    }
+
     /// Set when the user manually swipes away the LA. Blocks auto-restart until
     /// an explicit user action (Restart button, App Intent) clears it.
     /// In-memory only — resets to false on app relaunch, so a kill + relaunch
@@ -640,12 +642,11 @@ final class LiveActivityManager {
     func refreshFromCurrentState(reason: String) {
         // No LA guard here — Watch and store must update regardless of LA state.
         // LA-specific gating (laEnabled, dismissedByUser) is applied inside performRefresh.
-        refreshWorkItem?.cancel()
-        let workItem = DispatchWorkItem { [weak self] in
-            self?.performRefresh(reason: reason)
+        guard Thread.isMainThread else {
+            DispatchQueue.main.async { self.refreshFromCurrentState(reason: reason) }
+            return
         }
-        refreshWorkItem = workItem
-        DispatchQueue.main.asyncAfter(deadline: .now() + 20.0, execute: workItem)
+        refreshCoalescer.request(reason: reason)
     }
 
     // MARK: - Renewal
diff --git a/LoopFollow/LiveActivity/RefreshCoalescer.swift b/LoopFollow/LiveActivity/RefreshCoalescer.swift
new file mode 100644
index 000000000..85af21c95
--- /dev/null
+++ b/LoopFollow/LiveActivity/RefreshCoalescer.swift
@@ -0,0 +1,54 @@
+// LoopFollow
+// RefreshCoalescer.swift
+
+import Foundation
+
+/// Coalesces refresh requests into one trailing call per window.
+///
+/// The first request schedules the call; requests that arrive while it is
+/// pending join it without moving its deadline. A steady stream of requests
+/// therefore flushes once per window. Not thread-safe: use from one queue.
+final class RefreshCoalescer {
+    typealias Scheduler = (TimeInterval, @escaping () -> Void) -> Void
+
+    private let delay: TimeInterval
+    private let scheduler: Scheduler
+    private let action: (String) -> Void
+    private var pendingReasons: [String] = []
+    private var generation = 0
+
+    init(
+        delay: TimeInterval,
+        scheduler: @escaping Scheduler = { delay, work in
+            DispatchQueue.main.asyncAfter(deadline: .now() + delay, execute: work)
+        },
+        action: @escaping (String) -> Void
+    ) {
+        self.delay = delay
+        self.scheduler = scheduler
+        self.action = action
+    }
+
+    var isPending: Bool { !pendingReasons.isEmpty }
+
+    func request(reason: String) {
+        let wasPending = isPending
+        if !pendingReasons.contains(reason) {
+            pendingReasons.append(reason)
+        }
+        guard !wasPending else { return }
+
+        let scheduledGeneration = generation
+        scheduler(delay) { [weak self] in
+            guard let self, self.generation == scheduledGeneration else { return }
+            let reason = self.pendingReasons.joined(separator: ",")
+            self.cancel()
+            self.action(reason)
+        }
+    }
+
+    func cancel() {
+        pendingReasons.removeAll()
+        generation += 1
+    }
+}
diff --git a/Tests/RefreshCoalescerTests.swift b/Tests/RefreshCoalescerTests.swift
new file mode 100644
index 000000000..046287b08
--- /dev/null
+++ b/Tests/RefreshCoalescerTests.swift
@@ -0,0 +1,96 @@
+// LoopFollow
+// RefreshCoalescerTests.swift
+
+import Foundation
+@testable import LoopFollow
+import Testing
+
+struct RefreshCoalescerTests {
+    final class ManualScheduler {
+        var scheduled: [(delay: TimeInterval, work: () -> Void)] = []
+
+        func schedule(_ delay: TimeInterval, _ work: @escaping () -> Void) {
+            scheduled.append((delay, work))
+        }
+
+        func runAll() {
+            let pending = scheduled
+            scheduled.removeAll()
+            pending.forEach { $0.work() }
+        }
+    }
+
+    @Test("first request schedules one call after the delay")
+    func firstRequestSchedules() {
+        let scheduler = ManualScheduler()
+        var fired: [String] = []
+        let coalescer = RefreshCoalescer(delay: 20, scheduler: scheduler.schedule) { fired.append($0) }
+
+        coalescer.request(reason: "bg")
+
+        #expect(scheduler.scheduled.count == 1)
+        #expect(scheduler.scheduled.first?.delay == 20)
+        #expect(fired.isEmpty)
+        scheduler.runAll()
+        #expect(fired == ["bg"])
+        #expect(!coalescer.isPending)
+    }
+
+    @Test("repeated requests while pending keep the original deadline")
+    func repeatedRequestsDoNotReschedule() {
+        let scheduler = ManualScheduler()
+        var fired: [String] = []
+        let coalescer = RefreshCoalescer(delay: 20, scheduler: scheduler.schedule) { fired.append($0) }
+
+        for _ in 0 ..< 10 {
+            coalescer.request(reason: "bg")
+        }
+        coalescer.request(reason: "overrideChanged")
+
+        #expect(scheduler.scheduled.count == 1)
+        scheduler.runAll()
+        #expect(fired == ["bg,overrideChanged"])
+    }
+
+    @Test("a request after a flush opens a new window")
+    func requestAfterFlushSchedulesAgain() {
+        let scheduler = ManualScheduler()
+        var fired: [String] = []
+        let coalescer = RefreshCoalescer(delay: 20, scheduler: scheduler.schedule) { fired.append($0) }
+
+        coalescer.request(reason: "bg")
+        scheduler.runAll()
+        coalescer.request(reason: "bg")
+
+        #expect(scheduler.scheduled.count == 1)
+        scheduler.runAll()
+        #expect(fired == ["bg", "bg"])
+    }
+
+    @Test("cancel drops the pending call")
+    func cancelDropsPending() {
+        let scheduler = ManualScheduler()
+        var fired: [String] = []
+        let coalescer = RefreshCoalescer(delay: 20, scheduler: scheduler.schedule) { fired.append($0) }
+
+        coalescer.request(reason: "bg")
+        coalescer.cancel()
+        #expect(!coalescer.isPending)
+        scheduler.runAll()
+        #expect(fired.isEmpty)
+    }
+
+    @Test("a request after cancel fires only once")
+    func requestAfterCancelFiresOnce() {
+        let scheduler = ManualScheduler()
+        var fired: [String] = []
+        let coalescer = RefreshCoalescer(delay: 20, scheduler: scheduler.schedule) { fired.append($0) }
+
+        coalescer.request(reason: "bg")
+        coalescer.cancel()
+        coalescer.request(reason: "notLooping")
+        scheduler.runAll()
+
+        #expect(fired == ["notLooping"])
+    }
+}