Effects of exercise timing and intensity on physiological circadian rhythm and sleep quality: a systematic review

Humans show near-24-h physiological and behavioral rhythms, which encompass the daily cycle of sleep and wakefulness. Exercise stimulates circadian rhythms, including those of cortisol, melatonin, and core body temperature, and affects sleep quality. We systematically reviewed studies that examined the effects of exercise intensity and timing on physiological circadian rhythms and sleep quality.

In this systematic review, we used the online databases PubMed, Science Direct, Web of Science, and Embase. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent and experienced systematic reviewers performed the search and selected relevant studies. The participant, intervention, comparison, and outcome characteristics were: (1) adults; (2) exercise treatment; (3) no exercise treatment or different types of exercise (pre-exercise baseline); (4) cortisol, melatonin, or core body temperature measurement, and subjective or objective sleep quality assessments.

We identified 9 relevant articles involving 201 participants (77.1% of whom were male). Our review revealed that short-term evening exercise delayed melatonin rhythm and increased nocturnal core body temperature; however, no negative effects on non-rapid eye movement sleep and sleep efficiency were observed. Moreover, no differences in sleep quality were observed between acute high-intensity and moderate-intensity exercises. With long exercise durations, the core body temperature tended to increase and return to baseline levels at 30-120 min.

Our review showed that short-term evening exercise and high-intensity exercise did not have a significant negative effect on sleep quality but physiological circadian rhythm tended to alter. Longterm morning exercise tended to decrease cortisol concentrations after awakening and improve sleep quality. Future studies should examine the effects of long-term exercise timing and intensity on circadian rhythm and sleep.