Author: Dr. Calvin Wu, Clinical Strategy Director, Cardiometabolic Health
Our new approach aligns with the American Heart Association and American Diabetes Association by educating members and connecting them to tools for better sleep.
In 2010, the American Heart Association (AHA) identified a set of seven modifiable health behaviors and factors aimed at promoting ideal cardiovascular health. Life’s Simple 7 included eating a healthy diet and exercising regularly—but not sleep. At the time, getting adequate sleep was considered but left out because of a need for more evidence.
A lot has changed since 2010. New research has come out linking poor sleep to a greater risk for cardiometabolic diseases and increased likelihood of mental distress. While we always knew the importance of sleep, research has deepened our appreciation of the essential functions that sleep serves—from regulating hormones to keeping our brain healthy.
It makes sense that when poor sleep interferes with these processes, it can have a negative impact on our health. Studies show this is the case for our cardiometabolic health. When people are sleep-deprived, their blood pressure worsens, as does insulin resistance. Poor sleep also has a compounding impact on other healthy behaviors: People tend to choose higher-calorie foods and eat larger portions.
Many organizations now recommend that adults sleep at least seven hours per day. With more evidence to support it, sleep was added to the AHA’s list of essential behaviors in 2022. The American Diabetes Association also updated its care guidelines in 2025 to place sleep on the same level as other lifestyle behaviors (physical activity and eating patterns) as central to managing prediabetes and diabetes.
As a practicing endocrinologist, I’ve seen firsthand how a focus on quality sleep can translate into better blood sugar and overall health outcomes. I had one gentleman with uncontrolled type 2 diabetes who was sleeping only three to four hours a night. Without adjusting any medication, we successfully lowered his A1c from the 8% to 9% range to a goal of less than 7% by prioritizing sleeping earlier every night.
It’s great to see sleep being more widely recognized by leading health organizations, but there is a real need to increase awareness of its importance to overall better health. For example, in obesity medication trials, all participants are required to focus on diet and exercise, regardless of whether or not they received the actual treatment or not. To better align with current thinking and increase awareness, my colleagues at Teladoc Health argue that even in research trials, we should expand this to include sleep.
Still, there’s a lot to learn. Today, most of what we know about sleep centers around sleep duration, but there are other dimensions, such as timing and regularity, worth exploring. There are also still questions about the impact of improving sleep on cardiometabolic health outcomes.
We anticipate future research will help answer these questions. However, we believe the available evidence is compelling enough for us to focus on quality sleep now as part of our comprehensive approach to cardiometabolic health.
Including sleep in our program is something Teladoc Health is proud to be doing. We can help patients identify when poor sleep is getting in the way of reaching their health goals—like it was for my patient—and connect them to resources for support.
At Teladoc Health, we’ve done this for years with other healthy behaviors. Connecting members with tools for meaningful behavior change in diet and activity has helped them achieve higher levels of cardiometabolic health.
We’re excited to be highlighting sleep in a similar way. Providing access to BetterSleep and proactively supporting members who would benefit is another way we can help our members reach their cardiometabolic health goals.
