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Falling Asleep Earlier Linked to More Weight Loss in Adults With Prediabetes

A trial of 196 adults with prediabetes found adding a sleep program didn't beat lifestyle changes alone for blood sugar.

By Dr. Josh Axe · November 8, 2026 · 2 sources · Watch

At a glance

What they found: Both groups increased sleep and lost body weight, but neither change differed meaningfully between groups.
Who was studied: 196 adults with confirmed prediabetes and short sleep, randomly assigned to two 8-week programs.

A randomized trial first published October 22, 2026 in Nursing Research found that adding a behavioral sleep program to a lifestyle intervention did not improve blood sugar control any more than the lifestyle program alone, among 196 adults with prediabetes and short sleep duration.

196adults studied

8-weekprogram

The trial enrolled 196 adults with prediabetes confirmed by blood test and short sleep confirmed by wrist-worn activity trackers. Over 8 weeks, researchers compared a lifestyle program with the same program plus a behavioral sleep component, both delivered one-on-one by video. The main measured outcome was change in the percentage of time a glucose sensor read above 140 mg/dL, the top of a tight glucose range, and the two groups showed no meaningful difference there. Both groups increased sleep and lost body weight, but neither change differed meaningfully between groups. The sleep-plus group did report better sleep quality and less daytime sleepiness than the lifestyle-only group. Sleep onset, the time participants fell asleep, shifted earlier only in the sleep-plus group, though that group difference did not reach statistical significance.

A secondary, after-the-fact analysis found that falling asleep earlier was linked to greater weight loss, regardless of group assignment or total sleep hours. The authors point to circadian timing, the body's internal clock for sleep, as a modifiable target worth testing directly, separate from simply sleeping more. This is a link, not proof that an earlier bedtime causes weight loss.

196participants

Adults with prediabetes and short sleep duration enrolled in the 8-week trial comparing lifestyle versus lifestyle-plus-sleep programs

Nursing Research, 2026, Malone et al.

The earlier-bedtime and weight-loss connection came from a secondary analysis, not the trial's main planned comparison, so it is an early signal rather than a confirmed effect; a dedicated trial testing sleep timing directly is the logical next step.

Dr. Axe’s Take

The secondary signal on bedtime timing tracking with more weight loss, independent of total sleep hours, is the useful finding here, even though the main glucose result was null. That lines up with circadian biology: eating and sleeping out of sync with your body's internal clock can throw off hunger hormones and insulin sensitivity even when total sleep time looks fine. This week, I'd dim the lights and step away from screens an hour earlier, move dinner up, and get morning sunlight soon after waking to help anchor that clock. Those are free, low-risk moves worth making regardless of whether a larger trial confirms this specific link.

— Dr. Axe

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Study summary

Who: 196 adults with A1c-confirmed prediabetes and actigraphy-confirmed short sleep duration.
Design: Two-arm, parallel-group randomized controlled trial; published 2026-10-22 in Nursing Research.
Dose: 8-week one-on-one videoconference program: lifestyle intervention alone versus lifestyle plus a behavioral sleep component.
Primary result: No significant between-group difference in time spent with glucose above 140 mg/dL (tight glucose range).
Secondary: Both groups increased sleep and lost weight with no significant between-group difference; sleep-plus group had better self-reported sleep quality and daytime sleepiness; earlier sleep onset (regardless of group) was linked to greater weight loss.
Funding / conflicts: Competing interests: The authors have no conflicts of interest to report. Funding not reported in the abstract.
Date: Oct 22, 2026