Dose-response relationship between physical activity and subjective sleep quality in patients with insomnia: a systematic review and Bayesian meta-analysis of randomized controlled trials
Abstract
BACKGROUND: Insomnia is a prevalent public health concern with significant consequences for well-being. While physical activity (PA) is recognized as a beneficial non-pharmacological intervention, its precise dose-response relationship with subjective sleep quality remains insufficiently quantified. This study aimed to systematically evaluate the efficacy of PA on subjective sleep quality in patients with insomnia and to quantitatively delineate the dose–response relationship using Bayesian meta-analysis. METHODS: A systematic search was conducted across Web of Science, PubMed, Embase, PsycINFO, and the Cochrane Library from inception to February 2026. Randomized controlled trials (RCTs) investigating the effects of PA on subjective sleep quality in participants diagnosed with insomnia were included. A Bayesian random-effects meta-analysis was performed to calculate pooled effect sizes (Hedges’g) with 95% Credible Intervals (CrI). Dose–response relationships were modelled using restricted cubic splines to identify minimum and optimal dosages. Dosage was expressed as the weekly volume in MET-minutes (Metabolic Equivalent of Task × minutes/week). The certainty of evidence was assessed using the GRADE approach. RESULTS: 24 RCTs involving 1,591 participants were included. Bayesian synthesis indicated low evidence that PA significantly improves subjective sleep quality compared with inactive controls (Hedges’g = -0.56, 95% CrI: -0.68, -0.45). Dose–response analysis revealed a…
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: 1,591 participants or records.
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