The effect of non-pharmacological sleep interventions on glycaemic measures in adults with sleep disturbances and behaviours: A systematic review and meta-analysis

Samiul A. Mostafa*, Wasim Hanif, Francesca Crowe, George Balanos, Krishnarajah Nirantharakumar, Jason G. Ellis, Abd A. Tahrani

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Background
Sleep insufficiency is known to negatively impact on glucose metabolism. Consequently, there is interest in determining the impact of improving sleep on glucose metabolism. We conducted a meta-analysis of studies that aimed at improving sleep using cognitive behavioural therapy for insomnia (CBT-I) and/or sleep hygiene or sleep extension on glucose metabolism.

Methods
Searches were performed on MEDLINE, EMBASE, CINAHL and Cochrane. We included studies featuring adults≥18years, a sleep intervention and glycaemic measurements. The pooled mean differences were calculated by the inverse variance method.

Results
24 studies (15 CBT-I and/or sleep hygiene; 9 sleep extension) were included. Meta-analysis of 12 studies (n = 2,044) of CBT-I and/or sleep hygiene demonstrated a significant reduction in HbA1c of 0.27% (95% CI 0.07, 0.47, I2 74%, p = 0.008) compared to control. In T2DM (n = 1,911; 9 studies), HbA1c level decrease was 0.43% (0.19, 0.67, I2 59%, p = 0.0004). There were no significant changes in fasting blood glucose analyses nor in any sleep extension intervention. For quality assessment, only 9 studies had low concern.

Conclusions
Using CBT-I and/or sleep hygiene interventions led to significant reductions in HbA1c levels, which were clinically meaningful in T2DM. Addressing sleep insufficiency should be an integral part of diabetes care.

Registration
PROSPERO Identification number: CRD42022376606.
Original languageEnglish
Pages (from-to)1-17
Number of pages17
JournalDiabetes & Vascular Disease Research
Volume22
Issue number1
Early online date23 Jan 2025
DOIs
Publication statusPublished - Jan 2025

Keywords

  • intervention
  • Sleep disorder
  • systematic review and meta-analysis
  • glucose metabolism
  • type 2 diabetes mellitus

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