17 sources: 11 meta-analyses, 6 systematic reviews
Physical · Practice
Move Regularly for Better Sleep
Regular physical activity: one way to carry out what the reviews of non-drug approaches to sleep studied; Riedel 2024 reports exercise improved objective and subjective sleep in insomnia with larger effects at higher intensity, and Sella 2022 reports physical activity the only intervention to improve objectively measured sleep in older adults.
4 of 17 sources behind this entry were read from the abstract only; they are marked in the sources list.
most days
Any levelHome
Before you start
Follow general readiness guidance before increasing activity.
When to seek a professional
- Loud snoring with witnessed gasping/choking or breathing pauses plus daytime sleepiness (possible obstructive sleep apnea), refer to a clinician
- Difficulty falling or staying asleep at least 3 nights/week for 3+ months with daytime impairment (possible chronic insomnia disorder), refer to a clinician
- Excessive daytime sleepiness despite adequate time in bed, or falling asleep involuntarily during activities, refer to a clinician
How to do it
Regular activity most days
For most adultsOlder adults
What the evidence says
What the sources say
This practice is one way to carry out what the sources on the concept entry (phys.sleep.concept.exercise-and-sleep) studied: exercise and other non-pharmacological approaches to sleep, with self-reported and objectively measured sleep quality as the outcomes. Riedel 2024 (meta-analysis, 19 randomised trials) reports that exercise interventions significantly improved objective (SMD 0.37) and subjective (SMD 0.90) sleep parameters in insomnia, with the effect increasing with intervention intensity, and calls for larger trials before precise recommendations. Sella 2022 (meta-analysis, 31 studies, 2224 participants) reports that only physical activity improved objectively measured sleep in older adults (d = 0.31), with findings to be interpreted with caution given methodological weaknesses. Hwang 2016 (meta-analysis, 37 studies) reports non-pharmacological interventions, especially exercise, effective for improving sleep quality in older adults. Hirohama 2024 (network meta-analysis, 24 randomised trials) reports that resistance training “was the most effective intervention for improving sleep quality in nonelderly individuals”. The full account, source by source, is on the concept entry this practice links to (phys.sleep.concept.exercise-and-sleep).
What we won't claim
- Do not claim to diagnose, treat, or cure insomnia, sleep apnea, or any sleep disorder
- Do not promise guaranteed, instant, or permanent improvements in sleep
- Do not present these general hygiene techniques as clinical therapy (e.g., CBT-I) or a substitute for medical care
17 sources: 11 meta-analyses, 6 systematic reviews
- Agreement
- Direction recorded for 0 of 17 sources; not yet recorded for the rest.
- The claim's outcome
- Outcome not yet recorded
- Certainty
- A source states a certainty rating for 2 outcomes.
- How the sources were read
- Some sources are based on abstracts, not full texts.
What each source measured and concluded (17)
systematic review · 2016
Knowlden et al. (2016) — Systematic Review of Dietary Interventions Targeting Sleep Behavior
- What it measured
- Sleep behavior in response to dietary/nutritional intervention
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Systematic review
- Studies and participants, as stated
- 21 studies (17 in vivo, 4 in natura)
meta-analysis · 2025
Chang et al. (2025) — A Systematic Review and Meta‐Analysis of Footbath Effects and Optimal Procedures to Improve Sleep in Older Adults
- What it measured
- Subjective sleep quality
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Systematic review and meta-analysis
- Studies and participants, as stated
- 18 studies, 950 older adults
meta-analysis · 2022
Sella et al. (2022) — Non-pharmacological interventions targeting sleep quality in older adults: a systematic review and meta-analysis
- What it measured
- Self-reported and objectively-measured sleep quality
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Systematic review and meta-analysis
- Studies and participants, as stated
- 31 studies, N=2224
meta-analysis · 2024
Hirohama et al. (2024) — The effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials
- What it measured
- Sleep quality.
- How it measured it
- Standardized mean differences (SMD) and standard errors.
- Its conclusion, in its own words
- “The present results showed that resistance training was the most effective intervention for improving sleep quality in nonelderly individuals.”
- How it was read
- read in full text
- What the review says it includes
- Systematic review and network meta-analysis of 24 RCTs
- Studies and participants, as stated
- N=2,649 participants across 24 studies
meta-analysis · 2023
Thondala et al. (2023) — The effect of non-pharmacological interventions on sleep quality in people with sleep disturbances: A systematic review and a meta-analysis
- What it measured
- Sleep quality measured by Pittsburgh Sleep Quality Index (PSQI)
- How it was read
- based on the abstract, not the full text
- What the review says it includes
- Systematic review and meta-analysis of RCTs and cohort studies
- Studies and participants, as stated
- N=1885 across 16 trials
meta-analysis · 2022
Hasan et al. (2022) — Comparative efficacy of exercise regimens on sleep quality in older adults: A systematic review and network meta-analysis.
- What it measured
- Sleep quality
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and network meta-analysis of RCTs
- Studies and participants, as stated
- 35 trials; 3519 older adults
meta-analysis · 2024
Riedel et al. (2024) — The effect of physical exercise interventions on insomnia: A systematic review and meta-analysis.
- What it measured
- Objective and subjective sleep parameters
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of RCTs
- Studies and participants, as stated
- 19 studies
systematic review · 2025
Iyer et al. (2025) — Exogenous Melatonin and Sleep Quality: A Scoping Review of Systematic Reviews
- What it measured
- Effects of exogenously administered melatonin on sleep quality
- How it was read
- screened only, not extracted
- What the review says it includes
- Scoping review of systematic reviews with meta-analyses
- Studies and participants, as stated
- 57 systematic reviews comprising 227 meta-analyses
- Heterogeneity, as stated
- The direction of evidence consistently favors melatonin for sleep quality despite heterogeneity; adverse events generally mild.
meta-analysis · 2022
Nys et al. (2022) — The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis.
- What it measured
- Cortisol levels and sleep (subjective/objective)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis (RCTs and non-RCTs with control)
- Studies and participants, as stated
- 10 studies
systematic review · 2024
Fallah et al. (2024) — Mediterranean diet adherence and sleep pattern: a systematic review of observational studies
- What it measured
- Association between Mediterranean diet adherence and sleep patterns
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review of observational studies
- Studies and participants, as stated
- 20 studies (2 cohort, 18 cross-sectional); 21,714 participants
systematic review · 2018
Kim et al. (2018) — Natural Products from Single Plants as Sleep Aids: A Systematic Review
- What it measured
- Effects of single plant-derived extracts on sleep-related outcomes
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review
- Studies and participants, as stated
- 79 articles (21 plants identified)
meta-analysis · 2026
Song et al. (2026) — Effects of non-pharmacological interventions on sleep quality in older adults: a systematic review and network meta-analysis of randomized controlled trials
- What it measured
- Sleep quality (standardized mean differences, P-scores)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and network meta-analysis of RCTs
- Studies and participants, as stated
- 34 RCTs, 3078 participants, 21 interventions
meta-analysis · 2023
Hu et al. (2023) — Efficacy of acupuncture or moxibustion in treating senile insomnia compared with a control group: A systematic review and meta-analysis
- What it measured
- Efficacy (response rate) and Pittsburgh Sleep Quality Index (PSQI) scores
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of RCTs
- Studies and participants, as stated
- 20 studies (2007-2022), 1677 patients
systematic review · 2009
Niet et al. (2009) — Review of systematic reviews about the efficacy of non-pharmacological interventions to improve sleep quality in insomnia.
- What it measured
- Sleep quality
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review of systematic reviews/meta-analyses
- Studies and participants, as stated
- 16 reviews (17 interventions); 6 of adequate quality
meta-analysis · 2016
Hwang et al. (2016) — Effectiveness of Non-Pharmacological Intervention for Insomnia: A Systematic Review and Meta- Analysis
- What it measured
- Sleep improvement (effect size)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis
- Studies and participants, as stated
- 37 studies (from 343 reviewed)
meta-analysis · 2024
Chang et al. (2024) — Comparative efficacy of non-pharmacological interventions on sleep quality in old adults: A systematic review and network meta-analysis.
- What it measured
- Sleep quality
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and network meta-analysis (PRISMA-NMA)
- Studies and participants, as stated
- 71 RCTs (9 non-pharmacological interventions)
systematic review · 2025
Yu et al. (2025) — Non-pharmacological interventions for sleep in older adults: an umbrella review and evidence map of randomized controlled trials
- What it measured
- Sleep improvement (effectiveness of non-pharmacological interventions)
- How it was read
- screened only, not extracted
- What the review says it includes
- Umbrella review of systematic reviews with meta-analyses of RCTs (with evidence map)
- Studies and participants, as stated
- 19 systematic reviews comprising 160 RCTs
Certainty ratings the sources state (2)
Hirohama et al. (2024), for its own outcome
- Rating, as the source states it
- low
- Framework
- not named by the source
- Applies to
- Limitations: Variations in study characteristics affecting internal validity, limited studies on certain interventions affecting statistical power, varied intervention durations, concerns about risk of bias, low quality of evidence.
- Stated by
- Hirohama et al. (2024)
Nys et al. (2022), for its own outcome
- Rating, as the source states it
- low
- Framework
- not named by the source
- Applies to
- Physical activity effectively lowered cortisol (SMD=-0.37, 95% CI -0.52 to -0.21, p<0.001) and improved sleep quality (SMD=-0.30, 95% CI -0.56 to -0.04, p=0.02), with moderate- and low-certainty evidence respectively
- Stated by
- Nys et al. (2022)
Key sources (17)
Every source below is shown with its study design and links to the original study. This is the audit trail.
systematic reviewSystematic Review of Dietary Interventions Targeting Sleep Behavior
meta-analysisA Systematic Review and Meta‐Analysis of Footbath Effects and Optimal Procedures to Improve Sleep in Older Adults
meta-analysisNon-pharmacological interventions targeting sleep quality in older adults: a systematic review and meta-analysis
meta-analysisThe effects of nonpharmacological sleep hygiene on sleep quality in nonelderly individuals: A systematic review and network meta-analysis of randomized controlled trials
meta-analysisThe effect of non-pharmacological interventions on sleep quality in people with sleep disturbances: A systematic review and a meta-analysis
meta-analysisComparative efficacy of exercise regimens on sleep quality in older adults: A systematic review and network meta-analysis.
meta-analysisThe effect of physical exercise interventions on insomnia: A systematic review and meta-analysis.
systematic reviewExogenous Melatonin and Sleep Quality: A Scoping Review of Systematic Reviews
meta-analysisThe effects of physical activity on cortisol and sleep: A systematic review and meta-analysis.
systematic reviewMediterranean diet adherence and sleep pattern: a systematic review of observational studies
systematic reviewNatural Products from Single Plants as Sleep Aids: A Systematic Review
meta-analysisEffects of non-pharmacological interventions on sleep quality in older adults: a systematic review and network meta-analysis of randomized controlled trials
meta-analysisEfficacy of acupuncture or moxibustion in treating senile insomnia compared with a control group: A systematic review and meta-analysis
systematic reviewReview of systematic reviews about the efficacy of non-pharmacological interventions to improve sleep quality in insomnia.
meta-analysisEffectiveness of Non-Pharmacological Intervention for Insomnia: A Systematic Review and Meta- Analysis
meta-analysisComparative efficacy of non-pharmacological interventions on sleep quality in old adults: A systematic review and network meta-analysis.
systematic reviewNon-pharmacological interventions for sleep in older adults: an umbrella review and evidence map of randomized controlled trials
“Abstract only” means the review read that paper’s abstract, not its full text; “screened only” means it was included at re-screening and not extracted. Both stay in the trail with their DOI, because how a source was read is part of the audit.
Explore all 891 studies in Sleep →
The full evidence base this focus area draws on, every study with its design and DOI.What it is for
Feel better day to dayHave more energy through the dayRecover better between effortsSleep better