Research has demonstrated that several lifestyle factors contribute to the development and progression of diabetes. The American Diabetes Association (ADA) has developed a set of clinical recommendations and guidelines addressing factors such as sleep, exercise, nutrition, and medication, among others, which are known as the “standards of care in diabetes.” This year, sleep was further emphasized in these standards due to growing evidence that demonstrates its involvement in diabetes management and prevention.

While We Sleep

The ADA Standards of Care recommend 6 to 8 hours of quality sleep each night. This amount of time is essential since it provides the body with an opportunity to self-repair and recover. Functions that take place during sleep include, but are not limited to:

• Strengthening the immune system.
• Improving cognition and mood.
• Aiding in growth and development.
• Supporting metabolic processes.
• Decreasing the risk of developing chronic diseases, including diabetes.

In diabetes management, sleep is now recognized as being just as important as other lifestyle factors of diet and physical activity, specifically regarding its impact on high blood sugar levels (hyperglycemia). This includes its contribution to insulin resistance, glucose tolerance, disruption of appetite hormones leading to increased hunger and food intake, and release of hormones like cortisol that raise blood sugar levels.

Elements of Good or Bad Sleep

Three elements of an individual’s sleep are highlighted in the standards:

• Circadian preferences, or the body’s natural liking for time spent awake and asleep.
• Total time spent asleep.
• Overall sleep satisfaction, or the quality of sleep

Disruptions to these elements of sleep can negatively impact glucose metabolism, leading to characteristics associated with type 2 diabetes such as insulin resistance and excess body fat accumulation.

In terms of circadian preference, individuals who are “night owls,” or favor evenings and a late start to the day, have been shown to have higher odds of developing type 2 diabetes than those who are “early birds,” or prefer waking up and going to bed earlier.

In terms of total time of sleep, evidence now shows that both too little and too much sleep are linked to an increased likelihood of prediabetes advancement and development of type 2 diabetes. Too little is defined as less than 6 hours of sleep while too much is defined as more than 8 hours.

Furthermore, data indicates that sleep dissatisfaction, or poor quality sleep, is correlated to an increased risk of developing type 2 diabetes. Some conditions that impact quantity and quality of sleep are obstructive sleep apnea, insomnia and restless leg syndrome. Persons living with diabetes and experiencing sleep disturbances should talk to their healthcare provider for referral to a sleep specialist.

Getting Better Zzzs

For better sleep, implement some of these tips:

• Follow a regular sleep schedule. Go to bed and wake up at the same time every day, even on weekends.
• Limit or avoid caffeine and alcohol intake in the afternoon and evening.
• Avoid eating large meals right before bed.
• Avoid napping later in the day, and avoid long naps. Limit naps to 20 to 30 minutes.
• Establish a bedtime routine.
• Create a relaxing bedroom environment by keeping the space quiet, dark, decluttered and cool. The ideal room temperature during sleep for adults is between 60 and 67 degrees Fahrenheit.
• Restrict screen time before bed. Turn off electronics at least 30 minutes before bed.
• Always talk to a doctor if you are experiencing any sleep problems.

Remember — sleep allows the body to get needed rest and make repairs in the present moment while also affecting long-term health outcomes.

More Information

For more information on sleep and the standards of care for diabetes, visit https://diabetes.org. Search for Standards of Care 2025.

For general information on sleep for adults without diabetes, visit https://www.cdc.gov/sleep/about.