Daily steps and sleep in adults: A systematic review and meta-analysis

Sleep problems constitute a global public health challenge, imposing adverse health consequences and substantial economic costs. Although physical activity improves sleep, the relationship between objectively measured daily steps-a widely adopted activity metric-and sleep in adults has not been quantified.

PubMed, Web of Science, Embase, Cochrane Library, and Scopus were searched from inception until February 18, 2025. Observational or interventional studies including adults aged ≥18 years with objectively measured daily steps and sleep outcomes were included. Data were synthesized using random-effects models for heterogeneous outcomes and common-effects models for homogeneous outcomes.

Thirty-six studies (8192 participants) were included. Observational data revealed that higher daily steps correlated with better sleep quality (correlation coefficient r = 0.15; 95 % confidence interval [CI], 0.02 to 0.27), decreased sleep duration (r = -0.20; 95 % CI, -0.35 to -0.04), and reduced daytime dysfunction (r = -0.15; 95 % CI, -0.28 to -0.01). No significant relationships emerged in sleep latency, efficiency, or disturbances. Step-increasing interventions improved sleep duration (standardized mean difference [SMD] = 0.27; 95 % CI, 0.15 to 0.38) and reduced sleep disturbances (SMD = -0.56; 95 % CI, -0.96 to -0.15) versus controls. Other sleep domains exhibited no statistical changes.

Higher daily steps are observationally associated with improved sleep quality, shorter sleep duration, and reduced daytime dysfunction. Interventions increasing steps enhance sleep duration and reduce sleep disturbances. Step-based strategies may improve targeted sleep outcomes, though heterogeneity warrants individualized approaches.