What type of exercise is best to improve sleep quality? Original paper

Poor sleep is a common problem among older adults, with an estimated 43% of this population reporting difficulties with sleeping.^[1] Aside from sleep medications, lifestyle interventions such as regular exercise can help improve sleep quality.^[2] However, older adults vary widely in their ability to perform physical exercise, which raises the question of which exercise types are most effective in improving sleep quality in this population.

This systematic review and network meta-analysis of 35 randomized controlled trials examined the effects of different exercise types on sleep quality in 3,519 older adults with insomnia (average age of 71), compared to usual care. The studies mostly included community-dwelling older adults (77%) and also older adults living in nursing homes (14%), whereas some studies did not report on living conditions (9%). Sleep quality was assessed through self-reported questionnaires such as the Pittsburgh Sleep Quality Index.

The exercise types included traditional exercises such as walking, resistance training, and endurance training (as well as combinations of them) and traditional Chinese practices such as yoga, tai chi and Baduanjin. The exercise intensities used by the studies ranged from low (6 studies), low-to-moderate (5 studies), moderate (18 studies), and up to moderate-to-vigorous intensity (4 studies), although 2 studies did not report on the exercise intensity. The average study duration was 15 weeks with interventions ranging from 1 to 7 exercise sessions per week with 20–120 minutes of exercise per session.

Overall, any type of exercise improved sleep quality compared to no exercise. When comparing exercise types, the researchers found that endurance training combined with walking was the most effective type of exercise to improve sleep quality in the context of insomnia. For optimal outcomes, the researchers recommended exercising for 40–60 minutes, 2–7 times per week, over a period of at least 8 weeks.

Although this study compared many types of exercise, it did not include all types of exercise. For example, there were no studies examining the effects of Nordic walking (a type of exercise often performed by older adults). Hence, more high-quality studies are warranted to confirm these findings.