A systematic review of 23 studies examined the relationship between adherence to the Mediterranean diet and sleep features. Most studies, conducted in the Mediterranean region, found that higher adherence to the Mediterranean diet was associated with better sleep quality, reduced daytime sleepiness, and lower likelihood of insomnia. Studies outside the Mediterranean basin also showed similar associations, suggesting potential biological mechanisms. The Mediterranean diet, rich in plant-based foods, healthy fats, and antioxidants, may improve sleep through anti-inflammatory and neuroprotective effects. It also provides essential nutrients like magnesium and zinc, which support sleep regulation. The diet's impact on sleep is further supported by its association with better sleep efficiency and reduced sleep disturbances. While most studies were observational, findings align with randomized trials suggesting that the Mediterranean diet may improve sleep. However, the direction of the association and causality remain unclear. The review highlights the potential of the Mediterranean diet as a tool to enhance sleep quality, particularly in populations with chronic diseases. Further research is needed to confirm these findings and explore the bidirectional relationship between diet and sleep.A systematic review of 23 studies examined the relationship between adherence to the Mediterranean diet and sleep features. Most studies, conducted in the Mediterranean region, found that higher adherence to the Mediterranean diet was associated with better sleep quality, reduced daytime sleepiness, and lower likelihood of insomnia. Studies outside the Mediterranean basin also showed similar associations, suggesting potential biological mechanisms. The Mediterranean diet, rich in plant-based foods, healthy fats, and antioxidants, may improve sleep through anti-inflammatory and neuroprotective effects. It also provides essential nutrients like magnesium and zinc, which support sleep regulation. The diet's impact on sleep is further supported by its association with better sleep efficiency and reduced sleep disturbances. While most studies were observational, findings align with randomized trials suggesting that the Mediterranean diet may improve sleep. However, the direction of the association and causality remain unclear. The review highlights the potential of the Mediterranean diet as a tool to enhance sleep quality, particularly in populations with chronic diseases. Further research is needed to confirm these findings and explore the bidirectional relationship between diet and sleep.