Exercise and sleep health in college students: Efficacy, mechanisms, and implications for practice

Sleep disorders are highly prevalent among college students, adversely affecting their physical health, psychological well-being, and academic outcomes. While pharmacotherapy remains a common intervention, its potential for dependency and adverse effects underscores the need for safer alternatives. Physical activity, characterized by accessibility and a favorable cost-effectiveness profile, has gained attention as a non-pharmacological intervention. However, the evidence regarding its efficacy and underlying mechanisms remains inadequately synthesized. This review evaluates the role of exercise in managing sleep disorders, highlighting evidence that aerobic, resistance, and mind-body exercises improve sleep quality, particularly through moderate-to-high-intensity sessions (40-60 minutes, 3 times per week), while emphasizing avoidance of exercise within 90 minutes of bedtime to prevent disruption. Long-term regular exercise typically yields better results. Mechanistically, exercise modulates sleep through circadian rhythm synchronization, psychological adjustment, anti-inflammatory actions, thermoregulation and neuroendocrine regulation. Despite promising evidence, methodological limitations persist, including heterogeneous outcome measures, short intervention durations, and restricted sample diversity. Future research should prioritize large-scale longitudinal investigations in randomized controlled trials that utilize standardized exercise protocols and objective sleep measurements. Collectively, exercise constitutes a multifactorial intervention for sleep disorder mitigation, offering personalized regimens that enhance both sleep parameters and overall quality of life.