The Effect of Physical Activity on Sleep Quality and Sleep Disorder: A Systematic Review

“The CCB contains seven components: random sequence generation, allocation concealment, blinding of participants and people, blinding of result evaluation, completeness of outcome data, report selection, and additional biases [24].”

“This is a systematic review following the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [22] to identify pertinent articles published between 2013 and 2023 that address the effect of physical activity on sleep quality and sleep disorder.”

“Physical activities help improve sleep quality more effectively in children and older people than young adults and adolescents, leading to improved cognitive function and physical and psycho-social well-being [44,57,58].”

“Sleep promotes memory consolidation and learning while allowing the body to recover and restore itself [1].”

“Except for comparability, which allowed for two points, each NOS item could only receive one point, with a minimum score of zero [23].”

“[34] on sleep: a metaanalytic review review physical activity level, exercise type, timing, duration, and adherence influence these effects.”

“Over time, scientists have investigated several non-pharmacological methods to enhance sleep quality and address sleep disorders, and one among these approaches is engaging in physical activity [2,6,42].”

“Studies showed that insomnia prevalence rates range from 10% to 30%, and in some cases, even as high as 50-60% [6-8].”

“There is better sleep efficiency and higher overall sleep satisfaction among people who perform regular physical activities [54].”

“One strategy to enhance sleep quality and lower the risk of sleep disorders is through physical activity, which has a reciprocal relationship with sleep quality [2].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“Studies have found that aerobic exercises improve sleep quality and are effective in patients with insomnia [21,51].”

“The most prevalent sleep quality problem is insomnia, defined as chronic dissatisfaction with sleep quantity or quality, accompanied by difficulty falling asleep, numerous overnight awakenings with difficulty returning to sleep, and/or waking up earlier than desired [5].”

“[28] 2020 Effects of physical activity programs on sleep outcomes in older adults: a systematic review Systematic review Among older adults, moderate-intensity exercise three times a week for 12 weeks up to six months leads to the most substantial improvements in sleep quality.”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“In addition, moderate-intensity aerobic exercise improves sleep among patients with insomnia [21].”

“Similarly, a systematic review and meta-analysis has found that high-intensity physical exercises were more likely to disrupt sleep than moderate-intensity physical exercises, primarily when performed three hours before bedtime [47].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“Other studies have shown that physical activity can help to reduce sleep disorders, such as insomnia, daytime sleepiness, and sleep apnea [15,19,20].”

“Studies conducted to evaluate the effect of yoga, tai chi, and qigong on sleep quality found that they improve sleep outcomes and decrease insomnia [51-53].”

“Furthermore, exercise stimulates the release of neurotransmitters such as serotonin and norepinephrine, which are involved in mood regulation and relaxation, perhaps assisting in better sleep start and maintenance [46].”

“Poor sleep quality and sleep disorders impair attention and memory, negatively affecting physical, psychological, and social interaction [9,10].”

“First, it increases the production of melatonin, a hormone that regulates sleep-wake cycles [11].”

“Holfeld and Ruthig [36] 2014 A longitudinal examination of sleep quality and physical activity in older adults Longitudinal study Higher initial sleep quality was linked to increased subsequent physical activity, independent of prior physical activity.”

“Studies showed that insomnia prevalence rates range from 10% to 30%, and in some cases, even as high as 50-60% [6-8].”

“Third, physical activity improves mood, leading to increased enthusiasm for physical exercise and a positive feedback loop [12].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“[31] 2017 The relationship between sleep, time of physical activity, and time outdoors among adult women Crosssectional study A significant interaction (p = 0.”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“The association between physical activity and sleep quality can be attributed to several mechanisms, including the release of endorphins, which can lower stress and anxiety, resulting in improved relaxation and better sleep, regulation of circadian rhythms, and a rise in body temperature followed by a subsequent decre…”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“Studies have shown that regular physical activity can improve sleep quality and duration [15-18].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“Studies conducted to evaluate the effect of yoga, tai chi, and qigong on sleep quality found that they improve sleep outcomes and decrease insomnia [51-53].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“It was found that for endurance-trained runners, high-intensity exercise does not interrupt and may even benefit future nocturnal sleep when conducted in the early evening [50].”

“Physical exercise can act as a natural sleep aid, promoting relaxation, and reducing the hyperarousal associated with insomnia supporting the integration of physical exercise in the treatment modalities of insomnia [55,56].”

“The Agency for Healthcare Research and Quality Scale (AHRQ), with scores ranging from 0 to 11, was used to assess the quality of cross-sectional research, with higher ratings showing better research methodology [25].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“Studies have shown that regular physical activity can improve sleep quality and duration [15-18].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“Poor sleep quality and sleep disorders impair attention and memory, negatively affecting physical, psychological, and social interaction [9,10].”

“, in their study, found a positive correlation between physical activity and improved sleep quality, which, in turn, positively influenced cognitive function among middle-aged and older populations [39].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“The association between physical activities and sleep quality was exclusively reported in 18 articles [3,4,13,16,18,26-28,30-33,35-37,39,40], while five articles reported an association between physical activities and insomnia and other sleep disorders [15,20,29,38,41].”

“Some individuals explore herbal supplements, such as turmeric or ginger, for their potential anti-inflammatory properties [99].”

“Our findings reveal a significantly negative correlation with intense physical activity, which is consistent with some previous studies indicating a deterioration in sleep quality at higher levels of activity [82].”

“Additionally, PE can increase the production of melatonin, regulate the sleep-wake cycle, and help with faster sleep onset [41].”

“Exercising too close to bedtime can delay these physiological processes, leading to difficulty falling asleep and reduced sleep efficiency [60].”

“As a key factor in promoting health and enhancing quality of life, physical activity has been extensively evidenced to exert broad benefits on both physical and psychological well-being, serving as a potentially effective means to improve sleep [4–8].”

“Physical activity significantly negatively predicts insomnia, which is consistent with previous research findings [24, 25, 78–80].”

“Multiple studies support the idea that physical activity—particularly at higher intensities—enhances sleep quality and recovery, lowering the risk of sleep disorders [44–46].”

“For instance, Alnawwar et al. (62) have demonstrated that engaging in moderate -intensity physical exercise can result in improved sleep patterns, reducing the risk of sleep disturbances.”

“Alnawwar et al. suggest that physical activity promotes the release of serotonin and melatonin, both of which are crucial for initiating and maintaining restful sleep [64].”

“In both men and women, higher levels of daily PA associate with better sleep outcomes [35–41].”

“On the other hand, physical activity is a protective factor against bedtime delay and poor sleep [32,34–36].”

“…as nutrition plays a crucial role in cognitive health, and deficiencies in certain nutrients can contribute to its development and progression [8], such as a lack of vitamin B1 (thiamine) that can contribute to cognitive problems affecting confusion and coordination, vitamin B6 (pyridoxine)…”

“On the other hand, alternatives such as physical activity interventions have shown favorable results in improving sleep quality [24], where physical activity can prevent complications in sleep quality and can be used as a complementary technique to cognitive behavioral therapy, which is the…”

“Physical activity has been linked to increased production of neurotransmitters like serotonin and dopamine, which help regulate mood and improve sleep (Alnawwar et al. 2023).”

“This decision was based on previous literature, which has reported negative associations be-tween PA and psychological distress [82,83], as well as positive associations between PA and sleep indicators [84].”

“Stress-inducedsleep-onsetinsomniaisdetrimentaltothehealthof humanbeingsandadverselyaffectspubliclife,increasingtheriskofnegative outcomesincludingheartdisease,stroke,andall-causemortality 5 – 7 .”

“These findings are consistent with previous research suggesting that moderate physical exercise can reduce the frequency of nighttime awakenings and improve sleep efficiency [27,66].”

“…concentration, social cognition, attention, etc.) and technologically advanced diagnostic assessments that have progressed with technological advancements such as magnetic resonance imaging (MRI) and functional MRI (fMRI) imaging, demonstrated both structural and clinical changes in the CNS [20].”

“Moreover, systematic review fi ndings suggest that moderate-to-vigorous (but not high intensity) physical activity bene fi ts sleep quality indices (i.e., sleep onset latency, wake after sleep onset, sleep ef fi ciency) 39,45,46 .”

“35 Patient satisfaction is the state of contentment experienced by patients while receiving health care and has become a standardized measure to judge the efficiency and effectiveness of a treatment.”

“Some studies indicates that sleep could even be disturbed due to the heavy exercises performed in the evenings [37].”

“Selain itu, aktivitas fisik sedang turut berperan dalam menurunkan tingkat kecemasan dan stres, dua faktor yang sangat berpengaruh terhadap gangguan tidur, terutama di kalangan mahasiswa dan usia produktif [10].”

“For example, some studies have shown that emotional regulation mechanisms such as decreased anxiety and increased positive affect jointly contribute to better sleep outcomes among young adults engaging in regular physical exercise 104,105 .”

“Existing research indicates that engaging in regular physical activity enhances mood, promotes a positive out-look, and potentially offers a means of managing depression and sleep impairment symptoms [20,21].”

“Regular engagement in moderate activity has been shown to improve sleep architecture, to reduce sleep latency, and to enhance subjective sleep satisfaction [62].”

“…fitness [27], manage chronic diseases [28] and enhance physical functioning [29], but also brings psychological benefits, such as improving emotional health [30], enhancing positive self-perceptions [31], decreasing the risk of dementia [32], and alleviating depression [33] and insomnia [34].”

“Additionally, it triggers the release of endorphins, which can reduce stress and anxiety 58 .”

“A recent systematic review study also concluded that regular physical activity can improve sleep quality, reduce sleep latency, and enhance sleep efficiency [35].”

“Practicing physical activities regularly has been associated with an increase in sleep quality and duration [52,53].”

“27,28 Also, Wendt et al found that night PA seems to have an inverse effect on sleep variables.”

“…for optimal mental health, a combination of moderate-to-vigorous physical activity and adequate sleep is particularly effective [19], However, when the specific goal is to improve sleep quality, evidence indicates that moderate-intensity exercise may be more beneficial than vigorous activity [20].”

“…and moderate aerobic or resistance exercises can increase slow-wave sleep proportion, extend deep sleep duration, reduce nighttime awakenings, and shorten sleep latency while stabilizing nighttime rhythms by regulating body temperature reduction and balancing the autonomic nervous system (94).”

“There is empirical evidence that regular physical activity contributes to improvements in sleep quality and duration [91,92] and is an effective non-pharmacological intervention for sleep disorders such as insomnia [93].”

“46 Lower levels of PA have been linked to higher BMI through many different mechanisms including insulin resistance and type 2 diabetes, increased inflammation, and inflammatory cytokines as a result of visceral body fat.”

“31,32 33-35 Our study also found a decline in sleep quality and an increase in sleep disturbances during the exam period.”

“…(9, 10) Existing finding shows that adults who exercised for at least 30 min a day slept an average of 15 min longer than those who did not exercise (11) Conversely, poor sleep quality is associated with reduced motivation for physical activity, creating a bidirectional relationship that…”

“PA , especially when it is moderate and performed as a leisure activity rather than strenuous work-related PA, can improve SQ, and high levels of physical exertion at work can negatively affect sleep [73].”

“Furthermore, regular physical activity contributes to better sleep quality, which is critical for maintaining attention, energy levels, and overall performance during long clinical shifts [6,8,9,15,16].”

“These problems include diabetes, cardiovascular disease, obesity, depression, anxiety, myocardial infarction, and stroke [22,23].”

“18,19 Poor sleep quality among patients with hypertension is associated with an increased risk of stroke and cardiovascular disease due to increased sympathetic nervous system activity, elevated blood pressure and impaired endothelial function.”

“There is ample evidence in the literature that exercise has beneficial effects for all cause mortality [66–68], metabolic health, insulin resistance, glucose and lipid metabolism [69–72], mental health [73], sleep [74] and the gut microbiome [75, 76].”

“In populations with mental illness, PA has been shown to mitigate stress, anxiety, and depression (Schuch & Vancampfort, 2021; Wolff et al., 2011; Zschucke et al., 2013), while also improving sleep quality in non-clinical populations (Alnawwar et al., 2023; Kredlow et al., 2015).”

“5).”

“Additionally, regular physical activity is known to improve sleep efficiency and quality, leading to deeper and more restorative sleep that can offset the negative effects of occasional poor sleep [58].”

“These enhancements may be explained by the role of PA in promoting several sleep variables, including sleep-onset latency, sleep efficiency, and total sleep duration [69-71].”

“16,17 However, there are mixed findings in the current literature with some evidence supporting an association between walkability and sleep, but not all.”

“Although physical activity, generally speaking, improves sleep metrics including daytime sleepiness (Alnawwar et al., 2023), and professional boxers engage in plenty of physical activity, the interplay between head injury, sleep disruption, physical activity, and mental health outcomes is largely…”

“43 Taken together, the interplay of these biological, behavioural and social factors provides a plausible explanation for sleep disturbances in this cohort.”

“When these interventions combined with regular exercise [123], reduced eve - ning screen time [124, 125], and earlier meal timing [126, 127], they can significantly mitigate the risk of sleep disturbances com - monly associated with aging.”

“Poor sleep quality in older adults (short duration and frequent awakenings) impairs recovery, increases cortisol and anxiety levels, and perpetuates fatigue and reduced quality of life [34].”

“Positive [14] and bidirectional associations between PA and sleep have been suggested [15].”

“Good quality sleep is essential for cognitive function, emotional regulation, immune health, and metabolic processes [10,11].”

“…during long HIIT compared to shorter formats, as players may experience heightened fatigue, greater reliance on anaerobic energy systems, and increased metabolic stress (Valstad et al., 2018), which may increase the negative effects of sleep deprivation on enjoyment (Alnawwar et al., 2023).”

“Exercise alleviates harmful effects induced by SD Exercise is widely recognized for its positive effects on sleep [37,38] and its ability to mitigate metabolic and cognitive impairments associated with SD [54,63].”

“Old people who have limited social involvements and few social ties are likely to engage in less physical activity, which may have an impact on their sleep quality, too [34].”

“Moderate exercise can relieve physical and mental tension and promote the release of neurotransmitters such as dopamine, endorphins, and serotonin, which contribute to improved mood (66).”

“High-inten-sity physical activities tend to lead to poor sleep quality, especially when performed for more than 90 minutes and close to bedtime (Alnawwar et al., 2023).”

“It is possible that the physical exertion from compulsive exercise may promote better sleep continuity, reducing the likelihood of waking up during the night (i.e., Alnawwar et al., 2023).”

“The interconnection between PA and sleep quality has gained substantial empirical support, as PA appears to optimize sleep architecture and reduce sleep onset latency through mechanisms such as enhanced serotonin and adenosine activity [10, 11].”

“To maintain ecological validity within the academic semester, the intervention duration was shorter than protocols typically required to elicit robust sleep adaptations [80].”