The association between sleep and diabetes outcomes - A systematic review

Diabetes Res Clin Pract. 2020 Mar;161:108035. doi: 10.1016/j.diabres.2020.108035. Epub 2020 Feb 14.


Aim: This study aimed to systematically review the prevalence of diagnosed sleep disorders in people with diabetes and to determine the association between sleep disorders and blood glucose levels and diabetes outcomes.

Methods: We conducted a literature search in the following databases: MEDLINE (Pubmed), EMBASE, CINAHL, PsychInfo and Web of Science Citation Index. Meta-analysis (random-effects models) was conducted to estimate the prevalence of sleep disorders in people with diabetes.

Results: Forty-one articles measured the prevalence of sleep disorders in adults with diabetes. The estimated pooled prevalence of sleep disorders in diabetes was estimated to be 52% (95% CI 42-63%). The highest pooled prevalence was observed for unspecified sleep apnea (69%; 95% CI: 59-78%), followed by obstructive sleep apnea (60%; 95% CI 39-80%), and restless leg syndrome (27%; 95% CI 20-34%). Eleven studies examined the association between sleep disorders and diabetes control and complications. The presence of comorbid sleep disorders was associated with increased diabetes outcomes.

Conclusions: Diagnosed sleep disorders are highly prevalent in people with diabetes. Sleep disorders are associated with diabetes outcomes, though there was considerable heterogeneity across studies.

Keywords: Diabetes; Diabetes outcome; Sleep disorder.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Diabetes Complications / diagnosis
  • Diabetes Complications / epidemiology*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology*
  • Humans
  • Outcome Assessment, Health Care
  • Prevalence
  • Prognosis
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Wake Disorders / complications
  • Sleep Wake Disorders / epidemiology*