Effects of physical exercise on sleep quality in patients with psychiatric disorders: a systematic review and...

As an evidence-based complementary modality, physical exercise showed significant potential in mitigating sleep disturbances across various populations.

The objective of this study was to determine how physical exercise interventions influence the sleep quality among clinical populations diagnosed with psychiatric disorders.

A systematic search was conducted across four electronic databases, MEDLINE, Embase, the Cochrane Library, and Web of Science, to identify randomized controlled trials (RCTs) available from inception to March 1, 2026. Studies were included if they focused on exercise interventions in patients with psychiatric disorders, using sleep quality as the outcome. Assessment of risk of bias for the enrolled RCTs was conducted using the revised Cochrane Risk of Bias Tool 2. Data synthesis employed random-effects models to estimate Hedges' g, with subsequent subgroup analyses conducted according to the FITT (Frequency, Intensity, Time, and Type) framework.

A total of 21 RCTs (24 comparisons) with 1628 participants were analyzed and results indicated a moderate overall effect size, indicating that physical exercise contributes to a significant improvement in sleep quality (g = -0.57, 95% confidence intervals [CI]: -0.75, -0.38, P < 0.001). Subgroup analyses revealed larger effect sizes for interventions characterized by a weekly frequency of ≥ 3 sessions (g = -0.60), aerobic modalities (g = -0.69), and low-to-moderate intensity (g = -0.70). Furthermore, Furthermore, larger effects were also observed for single sessions lasting ≥ 30 min (g = -0.58) and a total intervention duration under 12 weeks (g = -0.58) in patients with psychiatric disorders. Univariate meta-regression analyses revealed no significant linear moderating effects of intervention duration, frequency, volume, or total weekly exercise time on sleep quality (all P > 0.05).

Overall, physical exercise serves as a potent complementary treatment option for enhancing sleep quality among individuals with mental health conditions. Following the exploration of candidate FITT dimensions, our findings offer actionable clinical insights for incorporating tailored exercise programs as a synergistic component of holistic psychiatric rehabilitation.