Biological mechanisms of different exercise modalities in improving sleep disorders: A review

Sleep disorders such as insomnia, sleep apnea, and circadian rhythm dysfunctions constitute a major public health challenge due to their high prevalence and associated risks for physical and mental health. In response to the limitations and potential side effects of pharmacological treatments, non-pharmacological interventions have become increasingly central to management strategies. Among these, structured physical exercise has emerged as a particularly prominent and evidence-supported approach, valued for its demonstrated efficacy and favorable safety profile. This narrative review aims to consolidate and examine the contemporary body of scientific evidence elucidating how distinct forms of exercise, primarily categorized as aerobic endurance training, resistance or strength training, and mindful mind-body practices, act to alleviate various sleep disturbances. The underlying biological pathways through which these exercise modalities exert their positive effects are complex and interconnected, encompassing thermoregulatory processes, neurochemical adaptations, endocrine signaling, and shifts in autonomic nervous system balance.