Comparative effectiveness of single vs. combined exercise modalities on sleep disorders in Chinese adolescents: a systematic review and network meta-analysis
Abstract
Objective: To systematically compare the effectiveness of single vs. combined exercise modalities for sleep disorders in Chinese adolescents and explore optimal exercise prescription variables using network meta-analysis.
Methods: Eight databases were searched up to May 31, 2025. Stata 18.0 was used for analysis, with intervention rankings determined by SUCRA probabilities. The GRADE approach assessed evidence certainty.
Results: Fourteen randomized controlled trials involving 1,375 participants were included. The combination of aerobic and mind-body exercise (AE + ME) showed the highest probability of being most effective (SUCRA = 87.1%), followed by mind-body exercise alone (ME, SUCRA = 71.3%). Pairwise comparisons confirmed that ME, AE, AE + RE, and AE + ME all significantly improved sleep disorders compared to controls. The optimal regimen consisted of 40-60 min sessions, ≥5 times per week [MD = 4.05, 95% CI (2.09, 6.01)], for less than 8 weeks [MD = 2.34, 95% CI (0.32, 4.37)]. GRADE assessment indicated moderate certainty for ME, aerobic exercise, and these optimal parameters.
Conclusion: Mind-body exercise performed for 40-60 min per session [MD = 3.18, 95% CI (2.20, 4.15)], at least five times per week, for less than 8 weeks, may be the most effective approach for improving sleep disorders in Chinese adolescents, supported by moderate certainty evidence. Findings should be interpreted cautiously due to low or very low certainty for most combined modalities.
Systematic…
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: 1,375 participants or records.
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