The effects of Qigong exercise on sleep quality in older adults: a systematic review and meta-analysis

Sleep disturbances are common among older adults. While pharmacological treatments may offer short-term relief, they are often associated with adverse effects. Non-pharmacological interventions are thus urgently needed. Qigong, a traditional Chinese practice known for its safety and adaptability, has gained attention as a potential intervention to improve sleep. This study aims to systematically review and meta-analyze the existing evidence regarding the effects of Qigong on sleep quality in older adults.

Seven databases (PubMed, Cochrane Library, Embase, Web of Science, CNKI, VIP, and Wanfang) were searched for randomized controlled trials (RCTs) published up to October 8th, 2025. The primary outcome was the total score of the Pittsburgh Sleep Quality Index (PSQI) and its subcomponents. The methodological quality was assessed using the Cochrane Risk of Bias tool. Statistical analyses were conducted using Review Manager 5.4 and R version 4.2.0.

We included 15 RCTs involving 1,074 participants. Low certainty of evidence showed that Qigong significantly improved sleep quality compared to control groups, as measured by PSQI total score (MD = -2.47, 95% CI [-3.09, -1.85], p < 0.001). Substantial heterogeneity was observed (I ² = 82.3%). Subgroup analyses showed that Baduanjin demonstrated significant improvement in sleep quality (MD = -2.89, 95% CI [-3.39, -2.39], p < 0.001), while Wuqinxi did not (MD = -0.64, 95% CI [-3.74, 2.46], p = 0.68). Positive effects were observed in participants with sleep disturbances (MD = -3.30, 95% CI [-4.62, -1.98], p < 0.001), depression (MD = -1.96, 95% CI [-3.01, -0.90], p = 0.0003), and hypertension (MD = -2.61, 95% CI [-3.02, -2.20], p < 0.001). Sensitivity analyses confirmed the robustness of the results. However, the overall certainty of the evidence was rated as moderate to low due to the high heterogeneity and risk of bias in some studies.

Qigong, particularly Baduanjin, may effectively improve sleep quality in older adults. Nevertheless, given the methodological limitations and heterogeneity of the included studies, further high-quality research is needed to validate these findings and inform clinical practice.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024621360, identifier: CRD42024621360.