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Exercise Interventions for Improving Sleep Quality in Patients With Cancer: A Systematic Review and Network
Liang Li1, Zhengxin Hui1, Yinping Zhang1
1School of Wushu, Shanghai University of Sport, Shanghai, China.
Objective:
To systematically evaluate the effects of different exercise interventions on sleep quality improvement in patients with cancer and compare the relative effectiveness of various exercise programs using a network meta-analysis, providing evidence-based guidance for developing personalized exercise intervention strategies in clinical practice.
Methods:
We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and other databases for randomized controlled trials on exercise interventions for sleep quality in patients with cancer, published from database inception to September 2025. Two researchers independently performed literature screening, data extraction, and Cochrane risk-of-bias assessment. Network meta-analysis was performed with Stata 18.0 software, and the relative effectiveness of exercise interventions was ranked using surface under the cumulative ranking curve values.
Results:
Forty-five randomized controlled trials covering nine exercise interventions were included. Network meta-analysis revealed statistically significant differences in sleep quality improvement among progressive muscle relaxation exercise, aerobic exercise, and walking (p < 0.05). Surface under the cumulative ranking curve rankings were as follows: progressive muscle relaxation exercise (98.6%) > aerobic exercise (70.7%) > walking (68%) > tai chi qigong (53%) > dance (51.2%) > yoga (48.7%) > combination exercise (41.1%) > resistance exercise (30.2%) > high-intensity interval training (25.3%) > control group (13.1%).
Conclusions:
Progressive muscle relaxation exercises are the preferred recommendation for sleep intervention in patients with cancer. Aerobic exercise and walking are alternative options. Individual patient conditions should be considered to tailor intervention plans in clinical practice.
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