SLEEP health is increasingly recognised as a cornerstone of metabolic wellbeing, and new evidence suggests that blood sugar status and dietary composition play an important role in shaping how long and how well people sleep. An analysis of data from the US National Health and Nutrition Examination Survey (NHANES) spanning more than a decade provides new insight into the complex relationship between glycaemic status, diabetes control, diet, and sleep outcomes in adults.
Blood Sugar Strongly Linked to Sleep Problems
The study found that individuals living with diabetes experienced a significantly higher burden of sleep-related problems compared with those with normal blood glucose levels. Adults with diabetes were more likely to report diagnosed sleep disorders and frequent trouble sleeping, and they were also more likely to experience abnormal sleep durations. Both short sleep and extended sleep were more common in this group, highlighting a broader disruption of normal sleep patterns.
Interestingly, among people with diabetes, tighter glycaemic control was not necessarily associated with better sleep. Participants with HbA1c levels below 6.5% had higher odds of reporting trouble sleeping compared with those with moderately elevated HbA1c values. This finding suggests that factors beyond average glucose levels, such as treatment intensity, nocturnal hypoglycaemia, or lifestyle behaviours, may influence sleep quality in this population.
Diet Composition Influences Sleep in Diabetes and Prediabetes
Beyond glycaemic status, macronutrient energy distribution emerged as an important modifier of sleep outcomes. In individuals with diabetes, low protein intake was associated with a markedly higher likelihood of having a diagnosed sleep disorder. Conversely, diets lower in carbohydrates and higher in fat were linked to reduced odds of short sleep duration, suggesting that dietary composition may influence sleep regulation in metabolically vulnerable individuals.
Among people with prediabetes, dietary patterns appeared to have an even stronger association with sleep duration. Low-protein diets, particularly when combined with high fat intake, were associated with a two- to three-fold increase in the odds of extended sleep duration. These findings point to a potential interaction between early metabolic dysfunction and diet in shaping sleep behaviour.
In adults with normal glycaemic status, imbalanced macronutrient distributions were also associated with both short and long sleep durations, reinforcing the idea that diet quality plays a role in sleep health across the metabolic spectrum.
Metabolic Health Emerges as a Key Sleep Determinant
Taken together, the findings underscore the close interconnection between metabolic health, nutrition, and sleep. While the cross-sectional design limits causal inference, the results add to growing evidence that glycaemic status and dietary patterns should be considered when addressing sleep problems. The study suggests that targeted dietary strategies, alongside metabolic risk management, may represent a promising avenue for improving sleep outcomes in both clinical and public health settings.
Reference
Basiri R et al. Glycemic status and macronutrient intake as predictors of sleep outcomes: an analysis of NHANES 2007-2020 data. Front Nutr. 2025;12:1672631.
