DOI: https://doi.org/10.36347/sasjm.2026.v12i03.008

Pages: 196-201

Ramadan fasting represents a distinctive model of daytime intermittent fasting that involves substantial lifestyle changes, including modifications in meal timing, sleep patterns, and circadian rhythms. For individuals with diabetes mellitus, these behavioral shifts may interact with metabolic regulation and potentially affect glycemic stability. Sleep plays a key role in glucose homeostasis, and disturbances in sleep duration or architecture have been associated with reduced insulin sensitivity and increased glycemic variability. This narrative review aims to synthesize current evidence on sleep alterations during Ramadan and to explore their metabolic implications in patients with diabetes. A structured literature search was conducted in PubMed/MEDLINE, Scopus, and Google Scholar, complemented by manual screening of relevant references and international guidelines such as the IDF–DAR recommendations. Studies examining sleep patterns, circadian rhythm changes, and glycemic outcomes during Ramadan fasting were analyzed narratively. Available evidence suggests that Ramadan fasting is commonly associated with delayed sleep timing and reduced total sleep duration, sometimes accompanied by alterations in sleep architecture. While these changes appear relatively well tolerated in healthy individuals, patients with diabetes may be more vulnerable to adverse effects. Sleep restriction, nocturnal hypoglycemia, glycemic variability, and comorbid sleep disorders such as obstructive sleep apnea may contribute to sleep fragmentation and metabolic instability. These findings highlight the importance of integrating sleep evaluation into diabetes management during Ramadan, alongside glycemic monitoring, individualized therapeutic adjustments, and culturally adapted patient education.