The effects of exergaming on sleep quality: a systematic review and meta-analysis of randomized controlled trials

Reduced sleep quality is a growing concern that can affect both mental and physical health in individuals of all ages. Exergames, which combine physical activity with gaming elements through digital technology, are an emergent popular intervention nowadays. This review aims to review the potential effects of exergames on sleep quality.

This review is registered in PROSPERO under the identifier CRD42024601725. A systematic search of the literature was performed on February 13, 2025, across MEDLINE, EMBASE, SCOPUS, Web of Science, CENTRAL, CBM, and CNKI. Randomized controlled trials comparing the effects of exergame interventions on sleep quality were included. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated to compare various sleep quality scales. Heterogeneity was assessed using the I² statistic and Cochran's Q test, and random effects models were applied in the meta-analysis where appropriate. Subgroup analyses were conducted based on participant age and the type of exergaming.

Our search identified a total of 800 studies, and 11 articles comprising 521 participants were included. Participants ranged in age from 9 to over 80 years old, with 41% being male. Among 9 studies comparing exergaming with no intervention, participants who received exergaming intervention showed better sleep quality [SMD [95% CI] of -0.31[-0.60, -0.01], k = 9]. Subgroup analysis indicated participants who had interventions lasting 8 weeks or longer [-0.35(-0.64, -0.06), k = 5], engaging in aerobic exercise-based exergaming experienced [-0.35 (-0.59, -0.11), k = 7], aged 60 and older [-1.38 (-2.75, -0.00), k = 2] showed significant improvements in sleep. Moreover, three studies comparing exergaming with traditional exercise showed no significant differences.

Exergame interventions positively influence sleep quality, particularly for older adults or those with health conditions. Given their accessibility and ease of use, exergames can serve as a self-driven, long-term intervention at home.

PROSPERO CRD42024601725.