BACKGROUND

Poor sleep quality not only diminishes people's quality of life and work efficiency but is also closely associated with various diseases. A reasonable exercise regimen can improve sleep quality to some extent, but there is a lack of comparative studies on the effects of different types of exercise, especially varying exercise doses, on sleep quality.

OBJECTIVE

To systematically evaluate the effects of different exercise modalities and doses on sleep quality.

METHODS

A search was conducted in PubMed, Web of Science, EBSCO, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases for randomized controlled trials (RCTs) on the effects of different exercise modalities on sleep quality, from database inception to November 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Network meta-analysis and dose-response analysis were performed using Stata 16.0 and R software with a random-effects model.

RESULTS

A total of 86 RCTs involving 7,276 participants were included. Six types of interventions were assessed: Aerobic Exercise (AE), Resistance Training (RT), Combined Aerobic and Resistance training (AE + RT), Yoga, Pilates, and Traditional Chinese Sports (TCS). The network meta-analysis results showed that compared to the control group, AE (SMD = -1.21, 95% CI: -1.50, -0.91, P < 0.01), RT (SMD = -1.12, 95% CI: -1.80, -0.44, P < 0.01), AE + RT (SMD = -1.11, 95% CI: -1.56, -0.66, P < 0.01), YOGA (SMD = -0.82, 95% CI: -1.22, -0.42, P < 0.01), Pilates (SMD = -1.65, 95% CI: -2.42, -0.88, P < 0.01), and TCS (SMD = -0.94, 95% CI: -1.28, -0.60, P < 0.01) all significantly improved sleep quality. The cumulative ranking probability (SUCRA) ranking showed that Pilates (91.7%) was the most effective, followed by AE (69.7%), AE + RT (59.4%), RT (58.6%), TCS (40.5%), and YOGA (30.1%). Additionally, the relationship between exercise dose and sleep quality was nonlinear, following a U-shaped curve. The overall optimal exercise dose for improving sleep quality was 920 MET-min/week. The optimal doses varied across exercise types, ranging from 390 MET-min/week for Pilates to 1,100 MET-min/week for aerobic exercise.

CONCLUSION

This study provides strong support for non-pharmacological interventions to improve sleep quality. For individuals aiming to improve their sleep through exercise, Pilates and aerobic exercise are recommended as the preferred options. Additionally, controlling the exercise dose within the optimal range (e.g., 920 MET-min/week) can significantly enhance the intervention effect.

CLINICAL TRIAL NUMBER

Not applicable.