Purpose <p>Diabetes and chronic kidney disease (CKD) frequently co-occur and lead to high morbidity and mortality. Although sleep disturbances are linked to adverse glycemic and renal outcomes, their impact in individuals with both conditions remains unclear. This study systemically reviewed the impact of sleep disturbances on health outcomes in comorbid diabetes and CKD.</p> Methods <p>A systematic search of CINAHL, EMBASE, MEDLINE-Ovid, Web of Science was conducted in August 2024. Studies were included if CKD was defined as estimated glomerular filtration rate &lt; 60 mL/min/1.73&#xa0;m², urinary albumin-to-creatinine ratio &gt; 30&#xa0;mg/g, or clinical diagnosis, and diabetes by clinical diagnosis.</p> Results <p>Seven studies were selected (four cross-sectional and three randomized control trials). Individuals with comorbid diabetes and CKD who had sleep disturbances (obstructive sleep apnea, insomnia, short or long sleep duration) showed poorer renal function, higher body mass index, arterial stiffness and coronary calcification, inflammatory markers, anxiety and depression than those without sleep disturbances. Continuous positive airway pressure reduced albuminuria and improved glycemic outcomes in comorbid diabetes and CKD with OSA. Melatonin supplementation improved sleep quality, glycemic control, and reduced psychological distress in comorbid diabetes and CKD.</p> Conclusion <p>Individuals with comorbid diabetes and CKD who experience sleep disturbances have worse renal, cardiovascular, and psychological outcomes than those without sleep disturbances, and improving OSA and sleep quality has a positive impact on health outcomes. Addressing sleep disturbances may help slow disease progression and improve cardiovascular and mental health, supporting routine screening and targeted sleep management in this population.</p>