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

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, I 2 74%, p = 0.008) compared to control. In T2DM ( n = 1,911; 9 studies), HbA1c level decrease was 0.43% (0.19, 0.67, I 2 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.