TOPLINE:

Aerobic exercise was associated with significant improvements in sleep quality in adults with psychiatric disorders, with the strongest benefits observed in those with depression or anxiety disorders, a new meta-analysis showed. Effective regimens included long-term, high-frequency exercise with low-to-moderate intensity and at least three sessions per week.

METHODOLOGY:

• A systematic review and meta-analysis of 15 randomized controlled trials (RCTs) conducted up to June 2025 included data for 775 adults with psychiatric disorders. Among the RCTs, seven assessed depression, three assessed schizophrenia, three anxiety disorders, and two substance use disorders.
• Pooled treatment effects were assessed for aerobic exercise, which included walking, cycling, jogging, stair-stepping, rowing, swimming, and mind-body exercise. Control interventions included usual care, waitlist, low-intensity activity, or health education.
• The primary outcome was improvement in sleep quality assessed using subjective self-report measures, including the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and the Pittsburgh Sleep Diary; and objective tools including polysomnography.
• Subgroup analyses examined effects by diagnostic category, and the exercise parameters of frequency, intensity, time, type, volume, and progression (FITT-VP).

TAKEAWAY:

• Aerobic exercise was linked to significant sleep quality improvement in the full patient population, with a moderate effect size (Hedges’ g, -0.67; P < .0001). Subgroup analysis also showed significant benefit in both subjective (P < .0001) and objective (P = .0005) sleep quality.
• Analysis by diagnostic category showed significant benefits for patients with depression (P = .0008) or anxiety disorders (P = .04) but not for those with substance use disorder or schizophrenia.
• Greater improvements in sleep quality were observed for aerobic exercise of three or more sessions per week (P < .0001), low-to-moderate intensity (P < .0001), and duration of 10 or more weeks (P < .0001). Low-frequency exercise had no significant benefit (P = .05).
• Optimal outcomes were observed with ≥ 30 minutes per session of aerobic exercise (P = .0002) and > 90 minutes per week of total exercise time (P = .0007).

IN PRACTICE:

“Collectively, these findings offer new insights on the dose-response relationship of aerobic exercise training and [support] the applicability of FITT-VP exercise principles for improving sleep quality in individuals with psychiatric conditions,” the investigators wrote.

SOURCE:

The analysis was led by Yang Xiang, PhD, Hunan First Normal University, Changsha, China. It was published online on March 18 in the Journal of Psychiatric Research.

LIMITATIONS:

There was substantial heterogeneity across studies, and the number of studies within diagnostic subgroups was limited. The exploration of effect moderators such as age, comorbidities, illness duration, and medication use was restricted by missing or inconsistently reported data. Small sample sizes further limited subgroup analyses; and variability in the study design persisted, making it difficult to define standardized and personalized exercise prescriptions.

DISCLOSURES:

The analysis did not receive any funding, and the investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.