Objective <p>Insufficient sleep quality is common among elderly adults with diabetes and can exacerbate existing health issues. Psychological factors, particularly self-assessed health status, play a key role in influencing sleep quality. This study aimed to examine the relationship between self-rated health status and sleep quality in older adults with diabetes.</p> Methods <p>Data were analyzed from the Indonesian Family Life Survey (IFLS-5), conducted between late 2014 and early 2015. Multivariate logistic regression analysis was conducted to identify key factors associated with sleep quality in elderly diabetics, with odds ratios (ORs) and 95% confidence intervals (CIs) reported.</p> Results <p>The study found that 15.2% of elderly participants reported poor sleep quality. A significant association was observed between poor self-rated health and diminished sleep quality (ORs = 0.15; 95% CI = 0.49–0.47, P &lt; 0.05), indicating that older adults with diabetes who perceive their health as poor are more likely to experience sleep disturbances. The findings emphasize the importance of improving health perceptions in this population through strategies like psychological support, health education, and stress management.</p> Conclusion <p>Sleep quality is a critical component of overall health. Addressing psychological and social factors that impact sleep may help mitigate the negative effects of poor sleep on the health of elderly adults with diabetes. Targeted interventions could improve health outcomes and enhance quality of life for this vulnerable group.</p>