Effects of Disordered Sleep on Metabolic Indicators: A Combined and Updated Meta-analysis

Background Disordered sleep constitutes a global public health challenge and is closely associated with metabolic dysfunction, demanding a comprehensive quantitative assessment across the full spectrum of disorders and metabolic profiles. Methods A combined meta-analysis was performed including 45 eligible studies published before October 15th, 2025, identified through systematic searches of six publication database. Subgroup analysis additionally examined the influence of four parameters. The PROSPERO registration number is CRD420251168186. Results Compared to controlled individuals, participants with sleep apnea showed significantly elevated body mass index (SMD = 0.58, 95% CI 0.35–0.82), fasting glucose (SMD = 0.40, 95% CI 0.26–0.55), LDL (SMD = 0.25, 95% CI 0.08–0.41), and total cholesterol (SMD = 0.18, 95% CI 0.02–0.35), with particularly pronounced effects in elder individuals in Asian and North American populations. Sleep extension demonstrated protective effects on fasting glucose (RR = -1.16, 95%CI -1.84–0.48) and LDL (RR = 0.25, 95% CI 0.08–0.41). Little difference was observed between states before and after sleep intervention, while leptin levels increased significantly among male-dominant participants with sleep intervention (RR = 0.90, 95% CI 0.05–1.76). Effects of narcolepsy and idiopathic hypersomnia on metabolism remained uncertain. Significant heterogeneity, publication bias, and high bias of quality were determined in several studies, yet few changes after elimination and re-analyses were observed, possibly due to the general robustness and limited number of included studies. Conclusion Disordered sleep could adversely affect multiple metabolic indicators, and standardized, multi-ethnic, and multi-center cohorts are in need to further address such effects and detailed mechanism.