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Diagnosis-Specific Links Between Physical Activity and Sleep Duration in Youth with Disabilities: A Systematic Review with Quantitative Synthesis

Watkins JM, Block ME, Goss JM, Munn EM, Antczak DX

International journal of environmental research and public health, 2026

138,016 participants

Abstract

Children and adolescents with disabilities experience disproportionate challenges in achieving recommended levels of physical activity (PA) and adequate sleep, two core determinants of health and functional well-being. This systematic review examined associations between meeting PA guidelines and sleep duration among youth with disabilities. Following PRISMA guidelines, MEDLINE, PsycARTICLES, and SPORTDiscus were searched through Spring 2024 for studies assessing PA and sleep in children and adolescents (N = 138,016) and synthesized using qualitative methods and regression-based quantitative analyses to examine the effects of diagnosis category and PA guideline adherence on sleep duration. The diagnosis type was associated with sleep duration, with youth with autism spectrum disorder (ASD) exhibiting shorter sleep than those with physical disabilities. Meeting PA guidelines (≥60 min/day) was associated with longer sleep duration among youth with ASD, but not consistently across other diagnostic groups. Qualitative findings further indicated diagnosis-specific variability, with PA positively associated with sleep outcomes in ASD, attention deficit/hyperactivity disorder, and epilepsy, and mixed associations observed for cerebral palsy and intellectual disability. These findings suggest that PA may support sleep health in specific disability groups. Given persistently low PA participation among youth with disabilities, integrating accessible, diagnosis-specific PA…

How strong is the evidence?

Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 138,016 participants or records.

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