Comparative effects of exercise modalities on sleep quality in middle-aged and older adults with sleep disorders: A systematic review with pairwise, network, and dose-responsemeta-analyses.
- 1School of Competitive Sports, Beijing Sport University, Beijing, China.
- 2School of Sports Training, Tianjin University of Sport, Tianjin, China.
- 3School of Physical Education and Health, East China Normal University, Shanghai, China.
Abstract
Background
Exercise may improve sleep quality in middle-aged and older adults with sleep disorders, but the comparative effects of different exercise modalities and the dose-response relationship remain unclear.Methods
We systematically searched PubMed, Web of Science, Embase, and the Cochrane Library from inception to May 2026. Eligible studies were randomized controlled trials examining the effects of exercise interventions on sleep quality in middle-aged and older adults with sleep disorders. Two independent reviewers assessed study quality, and random-effects pairwise, network, and dose-response meta-analyses were performed to evaluate the effects of different exercise interventions and doses on sleep quality.Results
The analysis included 23 randomized controlled trials involving 1,478 middle-aged and older adults with sleep disorders. Pairwise meta-analysis showed that exercise reduced Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) scores but had no significant effect on Epworth Sleepiness Scale (ESS) scores. Bayesian network meta-analysis showed that, compared with the control group, aerobic exercise (SMD = 1.34, 95% CrI: 0.86∼1.82), mind-body exercise (SMD = 0.64, 95% CrI: 0.30∼0.97), and combined exercise (SMD = 0.60, 95% CrI: 0.13∼1.07) may improve PSQI scores. The dose-response analysis suggested an inverted U-shaped association, with the largest predicted effect occurring near 539 MET-min/week within the observed dose range.Conclusions
Low-to moderate-certainty evidence suggests that aerobic, mind-body, and combined exercise may reduce PSQI scores, with a nonlinear dose-response relationship.
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BibTeX
@article{wang2026comparative,
title = {{Comparative effects of exercise modalities on sleep quality in middle-aged and older adults with sleep disorders: A systematic review with pairwise, network, and dose-responsemeta-analyses.}},
author = {Ting Wang and Zhuang Ma and Boao Zhu and Yaqiong Tang},
journal = {Journal of exercise science and fitness},
year = {2026},
month = oct,
doi = {10.1016/j.jesf.2026.200526},
url = {https://europepmc.org/article/MED/42898167},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Comparative effects of exercise modalities on sleep quality in middle-aged and older adults with sleep disorders: A systematic review with pairwise, network, and dose-responsemeta-analyses.
AU - Ting Wang
AU - Zhuang Ma
AU - Boao Zhu
AU - Yaqiong Tang
PY - 2026
DA - 2026/10/01
JO - Journal of exercise science and fitness
DO - 10.1016/j.jesf.2026.200526
UR - https://europepmc.org/article/MED/42898167
AB - Background Exercise may improve sleep quality in middle-aged and older adults with sleep disorders, but the comparative effects of different exercise modalities and the dose-response relationship remain unclear.Methods We systematically searched PubMed, Web of Science, Embase, and the Cochrane Library from inception to May 2026. Eligible studies were randomized controlled trials examining the effects of exercise interventions on sleep quality in middle-aged and older adults with sleep disorders. Two independent reviewers assessed study quality, and random-effects pairwise, network, and dose-response meta-analyses were performed to evaluate the effects of different exercise interventions and doses on sleep quality.Results The analysis included 23 randomized controlled trials involving 1,478 middle-aged and older adults with sleep disorders. Pairwise meta-analysis showed that exercise reduced Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) scores but had no significant effect on Epworth Sleepiness Scale (ESS) scores. Bayesian network meta-analysis showed that, compared with the control group, aerobic exercise (SMD = 1.34, 95% CrI: 0.86∼1.82), mind-body exercise (SMD = 0.64, 95% CrI: 0.30∼0.97), and combined exercise (SMD = 0.60, 95% CrI: 0.13∼1.07) may improve PSQI scores. The dose-response analysis suggested an inverted U-shaped association, with the largest predicted effect occurring near 539 MET-min/week within the observed dose range.Conclusions Low-to moderate-certainty evidence suggests that aerobic, mind-body, and combined exercise may reduce PSQI scores, with a nonlinear dose-response relationship.
SN - 1728-869X
SN - 2226-5104
ER -