Effects of different intervention modalities combined with exercise in patients with insomnia: a systematic review and network meta-analysis
Abstract
Background: Exercise, as a non-pharmacological intervention, is a promising adjunct for improving sleep outcomes in insomnia. However, a comprehensive assessment of exercise-based combination interventions remains insufficient. This study aimed to systematically evaluate and rank the intervention effects of different modalities combined with exercise on sleep outcomes via network meta-analysis (NMA).
Methods: Following the population, intervention, comparator, outcome, and study design (PICOS) framework, literature was searched in PubMed, Web of Science, Cochrane Library, Embase, CNKI, and CQVIP for randomized controlled trials (RCTs) until March 20, 2026. Independent screening and data extraction were conducted. NMA utilized a frequentist framework, with risk of bias assessed by the Cochrane RoB 2 tool and evidence certainty assessed by CINeMA.
Results: A total of 31 RCTs involving 2,457 participants were included, evaluating five types of exercise-based combination interventions. Results based on the surface under the cumulative ranking curve (SUCRA) indicated: (1) Pittsburgh Sleep Quality Index (PSQI): exercise plus cognitive behavioral therapy (EX + CBT) > qigong plus CBT (QG + CBT) > exercise plus traditional Chinese medicine interventions (EX + TCM) > qigong plus TCM interventions (QG + TCM) > exercise (EX) > TCM > conventional control (CON) > qigong (QG); (2) sleep onset latency (SOL): EX + CBT > QG + TCM > QG plus active repetitive transcranial magnetic stimulation…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, 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: 2,457 participants or records.
Read the paper
Related studies
- A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Evaluating the Evidence Base of Melatonin, Light Exposure, Exercise, and Complementary and Alternative Medicine for Patients with Insomnia Disorder
- Use of Melatonin and/on Ramelteon for the Treatment of Insomnia in Older Adults: A Systematic Review and Meta-Analysis
- Influence of evening light exposure on polysomnographically assessed night-time sleep: A systematic review with meta-analysis
- Use of melatonin in children and adolescents with idiopathic chronic insomnia: a systematic review, meta-analysis, and clinical recommendation
- Significant potential of melatonin therapy in Parkinson’s disease – a meta-analysis of randomized controlled trials
- Meta-Analysis: Melatonin for the Treatment of Primary Sleep Disorders
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.