Impact of screen-based sedentary behaviour among Type 2 Diabetes Mellitus patients on their quality of sleep and glycaemic control: a systematic review

Introduction: Nowadays, screen-based sedentary behaviors (SBSB) have become a notably concerning subset of sedentary behavior among all age groups. SBSB is linked to disrupted sleep quality, negatively affecting Type 2 Diabetes Mellitus (T2DM) management. Poor sleep exacerbates insulin resistance and glycaemic control, emphasizing the need for targeted intervention. This review investigates the impact of SBSB on sleep quality in T2DM patients. Methods: A systematic review followed PRISMA guidelines, using databases such as PubMed, Scopus, ScienceDirect, Google Scholar, and Cochrane Library. Studies published between 2019 and 2024 assessing SBSB and sleep quality in T2DM patients were included. The snowball technique was used to enhance the thoroughness of the literature search. The retrieved papers were screened separately by three reviewers according to the eligibility criteria in three phases: title, abstract, and full text. The potential for bias in the included papers was evaluated separately using the critical evaluation checklist from the Joanna Briggs Institute critical appraisal tools. Data from the included studies were extracted and presented in the table for analysis by the authors. Results: Out of 360 articles, including abstracts searched and retrieved from the database, 16 studies were reviewed, revealing that prolonged SBSB contributes to poor sleep quality through mechanisms such as circadian rhythm disruption and delayed sleep onset. Poor sleep was associated with reduced insulin sensitivity and worsened glycaemic control. Interventions like reducing sedentary time and incorporating physical activity or sleep hygiene practices significantly improved health outcomes. However, the studies displayed variability in methodologies, and many findings relied on self-reported data, limiting direct comparisons. Conclusion: This review highlights the impact of prolonged exposure to SBSB, especially before bedtime, on sleep quality and T2DM management. Multifactorial interventions, including reducing screen time, promoting physical activity, and improving sleep hygiene, are essential for improving health outcomes.