Capital University of Physical Education and Sports, Haidian, Beijing, China.
School of Sport and Art, Shenzhen Technology University, Shenzhen, Guangdong province, China.
Medicine (Baltimore). 2023 Nov 3;102(44):e35767. doi: 10.1097/MD.0000000000035767.
The efficacy of traditional Chinese exercise (TCE)-based interventions in the improvement of sleep quality is controversial. In this systematic review, we aimed to summarize randomized controlled trials (RCTs) that outline the effects of TCE on sleep quality.
Five databases (Web of Science, Embase, PubMed, Medline, and China National Knowledge Infrastructure) were searched for literature published before July 2022. RCTs examining TCE interventions were included. The treatment effects were estimated using a random-effect meta-analysis model with mean differences (MDs). There were 2 outcome scales for sleep quality; however, because they were extremely contrastive to be analyzed by standard MD, the scales were analyzed separately to ensure the accuracy of the results. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023421314).
Twenty studies were included for analysis at last. The outcome was calculated using the Verran and Snyder-Halpern Sleep Scale (MD: 344.17, 95% confidence interval: 316.95 to 371.39, P < .00001) and Pittsburgh Sleep Quality Index to measure sleep quality (MD: -2.24, 95% confidence interval: -3.05 to -1.43, P < .00001), both showed improvement effect. In subgroup analysis, for patients with fibromyalgia, normal older adults, and non-Hodgkin lymphoma, chronic fatigue syndrome-like illness, knee osteoarthritis, nasopharyngeal carcinoma, pausimenia, insomnia, TCE could improve sleep quality. However, there was no significant improvement in stroke patients, breast cancer patients, normal college students, and episodic migraine patients. Tai Chi had greater effects in improving sleep quality than Qigong. In addition, the participants practice site, duration, and age did not influence the effects of TCE.
TCE can improve sleep quality in specific populations in specific populations clinical applications. Tai chi should be considered first to improve sleep quality. However, further extensive trials and rigorous study designs should be conducted to strengthen the findings of this study. In addition, considering the large heterogeneity, the findings of our study should be interpreted cautiously.
传统中医锻炼（TCE）干预改善睡眠质量的效果存在争议。在本次系统评价中，我们旨在总结概述 TCE 对睡眠质量影响的随机对照试验（RCT）。
检索了 Web of Science、Embase、PubMed、Medline 和中国知网（China National Knowledge Infrastructure）五个数据库，以获取截至 2022 年 7 月前发表的文献。纳入 TCE 干预的 RCT。使用随机效应荟萃分析模型，采用均数差值（MD）估计治疗效果。有 2 个睡眠质量的评估量表，但由于其对比标准 MD 时差异非常大，因此分别进行分析，以确保结果的准确性。本研究已在国际前瞻性系统评价登记处（标识符 CRD42023421314）注册。
最终纳入 20 项研究进行分析。采用 Verran 和 Snyder-Halpern 睡眠量表（MD：344.17，95%置信区间：316.95 至 371.39，P<.00001）和匹兹堡睡眠质量指数（PSQI）来衡量睡眠质量（MD：-2.24，95%置信区间：-3.05 至 -1.43，P<.00001），均显示出改善效果。亚组分析显示，对于纤维肌痛、正常老年人、非霍奇金淋巴瘤、慢性疲劳综合征样疾病、膝骨关节炎、绝经后、失眠患者，TCE 可改善睡眠质量。但对于脑卒中患者、乳腺癌患者、正常大学生和阵发性偏头痛患者，睡眠质量无显著改善。与气功相比，太极拳在改善睡眠质量方面的效果更大。此外，参与者的练习地点、持续时间和年龄均不影响 TCE 的效果。
TCE 可改善特定人群的睡眠质量，在临床应用中，应优先考虑太极拳。然而，为了加强本研究的结果，还需要进行更广泛和更严格的试验和设计研究。此外，考虑到存在较大的异质性，我们的研究结果应谨慎解释。
