AIM: to analyze the quality of sleep and cardiac autonomic modulation of elderly diabetic women in the post-covid-19 syndrome. METHODOLOGY: 41 elderly women, aged 60-75 years, with a diagnosis of Type 2 Diabetes Mellitus and who had covid-19 were included, divided into three groups: 14 in the Diabetes without covid-19 group (DG), 15 in the Diabetes with covid-19 group (CG), 12 in the Diabetes with covid-19 group who had Pulmonary Compromise (IG). Sleep quality was assessed using the Pittsburgh questionnaire, anamnesis, capillary blood glucose, blood pressure collection, anthropometry, resting electrocardiogram for 10 min for heart rate variability (HRV) analysis. Data were analyzed by 1-way ANOVA followed by Tukey-Kramer Multiple Comparisons Test, significance for p </= 0.05. RESULTS: there was no significant difference in age, blood glucose, blood pressure, and body composition between the groups. In the analysis of sleep quality, there was significance in the following indices: sleep duration, sleep efficiency, sleep disturbances, and daytime sleepiness. Further, there was a reduction in autonomic indices between CG vs. DG: VarRR (ms(2)), SDNN (ms), SD1 (ms), TINN (ms), HF-log (ms(2)), LF-log (ms(2)); and between IG vs. DG: VarRR (ms(2)), SDNN (ms), RMSSD (ms), SD1 (ms), SD2 (ms), and HF-log (ms(2)). CONCLUSION: it is suggestive that diabetic elderly women who had covid-19, with and without pulmonary impairment, have impaired sleep quality and interference on HRV with decreased parasympathetic autonomic modulation.