Background <p>Diabetic kidney disease (DKD) is a significant microvascular complication of diabetes that substantially contributes to the global burden of end-stage kidney disease (ESKD). Sleep duration, which is modifiable through behavioral changes, has been implicated in the risk of developing diabetes and its complications. This study aimed to investigate the relationship between sleep duration and the risk of DKD using a large, nationally representative dataset from the National Health and Nutrition Examination Survey between 2005 and 2020.</p> Methods <p>We included 6,804 participants with diabetes aged 20 years with complete sleep duration. Sleep duration was categorized into quartiles, and the risk of DKD was assessed using logistic regression analysis after adjusting for potential confounders including age, sex, race, education, marital status, body mass index, waist circumference, smoking, drinking, hypertension, and coronary artery disease.</p> Results <p>The mean age of the participants was 61.1 years, and 47.8% were women. The prevalence of DKD was 26.0%. Univariate regression analysis revealed that age, ethnicity, education level, marital status, waist circumference, smoking, drinking, hypertension, and coronary heart disease were significantly associated with DKD. Multivariate regression analysis revealed a U-shaped relationship between sleep duration and DKD risk, with the lowest risk observed in participants sleeping 6.0–7.9&#xa0;h per day.</p> Conclusions <p>Our findings indicate that sleep duration within the 6.0–7.9-hour range is associated with the lowest risk of diabetic kidney disease (DKD). Although causality cannot be established due to the cross-sectional nature of the study, these results highlight the potential significance of sleep duration as a modifiable factor in diabetes management. Further longitudinal studies are warranted to validate these associations.</p>