Sleep disturbances have been increasingly recognized as potential risk factors for metabolic disorders, including metabolic dysfunction-associated steatotic liver disease (MASLD). To explore this association, a study evaluated the relationship between four sleep modes and MASLD risk in 1,900 patients with type 2 diabetes mellitus (T2DM). The sleep modes included good nocturnal sleep pattern with short or long nap (GNSP-SN/LN) and poor nocturnal sleep pattern with short or long nap (PNSP-SN/LN). During an average follow-up of 3.23 years, 379 new-onset MASLD events were identified based on ultrasound criteria.

Four nocturnal sleep factors and napping duration were positively associated with MASLD in patients with T2DM. Compared with GNSP-SN, GNSP-LN (HR, 1.88), PNSP-SN (HR, 2.54), and PNSP-LN (HR, 3.51) were associated with higher MASLD risk. Napping for more than 30 minutes was also…