1. In this systematic review and network meta-analysis, mind-body exercise, moderate aerobic exercise combined with light strength exercise, and moderate aerobic exercise alone were more effective than passive controls in improving sleep quality in those with sleep disorders.
2. However, the most effective treatment for improving sleep quality was mind-body exercise combined with treatment as usual.
Evidence Rating Level: 1 (Excellent)
Sleep disorders are highly prevalent and can be associated with impaired health and lower quality of life. Exercise has been investigated as a potential low-cost and easily accessible treatment to aid those with sleep disorders. Although prior studies have suggested a benefit of exercise in improving the symptoms of sleep disorders, there is still much to be discovered regarding the benefits of different exercise modalities on sleep quality in these patients. Thus, this study aimed to assess the current literature on the impact of various exercise types on sleep quality in patients with sleep disorders.
This systematic review and meta-analysis included 17 randomized controlled trials (n=1,090 participants) from database inception to April 8, 2023. Studies were included if they investigated patients with sleep disorders, including insomnia, sleep apnea, hypersomnia, circadian rhythm disturbances, and parasomnias, had an intervention group that received aerobic, strength, or mind-body exercise, a control group that received treatment as usual, placebo, wait-list, or other non-pharmacological interventions, and reported on sleep quality. Studies were excluded if the interventions involved pharmacologic treatment or if participants engaged in night-shift work. The risk of bias was assessed using the Cochrane Risk of Bias tool, and the review was carried out in accordance with PRISMA guidelines. The primary outcome was the association between sleep quality and various exercise modalities.
The results demonstrated that there was moderate-to-low certainty evidence to suggest that mind-body exercise, moderate aerobic exercise combined with light strength exercise, and moderate aerobic exercise alone were more effective than passive controls in improving sleep quality in patients with sleep disorders. However, the most effective treatment for improving sleep quality was mind-body exercise combined with treatment as usual. These results remained consistent after accounting for potential modifiers, such as region, age, and type of sleep disorder. However, the review was limited by the fact that most of the study participants were female, which may have affected the generalizability of the study findings. Nonetheless, the present study demonstrated that a wide range of exercise modalities can be effective in improving sleep quality in patients with sleep disorders.
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