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Meta-Analysis
. 2025 Dec;57(1):2447422.
doi: 10.1080/07853890.2024.2447422. Epub 2025 Jan 2.

Sleep features and the risk of type 2 diabetes mellitus: a systematic review and meta-analysis

Hongyi Liu  1   2 , Hui Zhu  3 , Qinkang Lu  1 , Wen Ye  2 , Tao Huang  4 , Yuqiong Li  2 , Bingqi Li  2 , Yingxin Wu  2 , Penghao Wang  2 , Tao Chen  2 , Jin Xu  2   5 , Lindan Ji  1   5   6
Affiliations
Meta-Analysis

Sleep features and the risk of type 2 diabetes mellitus: a systematic review and meta-analysis

Hongyi Liu et al. Ann Med. 2025 Dec.

Abstract

Objective: This study aimed to assess the associations between multidimensional sleep features and type 2 diabetes mellitus (T2DM).

Methods: We conducted a systematic search across the PubMed, Embase, Web of Science, and Scopus databases for observational studies examining the association between nighttime sleep duration, nighttime sleep quality, sleep chronotype, and daytime napping with type 2 diabetes mellitus (T2DM), up to October 1, 2024. If I2 < 50%, a combined analysis was performed based on a fixed-effects model, and vice versa, using a random-effects model.

Results: Our analysis revealed that a nighttime sleep duration of less than 7 h (odds ratio [OR] = 1.18; 95% CI = 1.13, 1.23) or more than 8 h (OR = 1.13; 95% CI = 1.09, 1.18) significantly increased the risk of T2DM. Additionally, poor sleep quality (OR = 1.50; 95% CI = 1.30, 1.72) and evening chronotype (OR = 1.59; 95% CI = 1.18, 2.13) were associated with a notably greater risk of developing T2DM. Daytime napping lasting more than 30 min augments the risk of T2DM by 7-20%. Interactively, the incidence of T2DM was most significantly elevated among individuals with poor sleep quality and nighttime sleep duration of more than 8 h (OR = 2.15; 95% CI = 1.19, 3.91).

Conclusions: A U-shaped relationship was observed between sleep duration and type 2 diabetes mellitus (T2DM), with the lowest risk occurring at a sleep duration of 7 to 8 h. Additionally, poor sleep quality, evening chronotypes, and daytime napping exceeding 30 min emerged as potential risk factors for T2DM. These high-risk sleep characteristics interacted with one another, amplifying the overall risk of developing the disease.

Keywords: Nighttime sleep duration; daytime napping; sleep chronotype; sleep quality; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.
Flow diagram of literature search and study selection. T2DM: type 2 diabetes mellitus; IGT: impaired glucose tolerance.
Figure 2.
Figure 2.
The association between sleep features and risk of T2DM. Sleep features include sleep chronotype, daytime napping, nighttime sleep duration, and sleep quality. The age subgroups were analyzed in accordance with the average age of the participants from the original study.
Figure 3.
Figure 3.
Subgroup analysis of the association between nighttime sleep and T2DM. Nighttime sleep duration was stratified by gender, age, ethnicity and BMI. BMI: body mass index. Gender subgroups were derived from studies incorporating gender stratification, and data were extracted and pooled after adjustment for covariates. Age and BMI subgroups were analyzed according to the average age and BMI of the participants in the original studies.
Figure 4.
Figure 4.
The association between sleep chronotype subgroups and risk of T2DM. Sleep chronotype was stratified by age and BMI. BMI: body mass index. The age and BMI subgroups were analyzed in accordance with the average age and BMI of the participants from the original study.
Figure 5.
Figure 5.
The association between daytime napping and risk of T2DM. The daytime napping was stratified by gender, menopausal status, age and BMI. BMI: body mass index. The age and BMI subgroups were analyzed in accordance with the average age and BMI of the participants from the original study.
Figure 6.
Figure 6.
The joint effect of nighttime sleep and daytime napping on the risk of T2DM.
See this image and copyright information in PMC

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