Physical activity and sleep: An updated umbrella review of the 2018 Physical Activity Guidelines Advisory Committee report

Abstract

Physical activity (PA) is widely considered to improve sleep, but a comprehensive review of the research on this topic has not been performed. In this umbrella review, conducted initially for the 2018 Physical Activity Guidelines for Americans Advisory Committee and updated to reflect more recent research, we examined whether PA enhances sleep outcomes across the lifespan as well as among individuals with sleep disorders. Systematic reviews and meta-analyses were utilized to assess the evidence. We also examined dose-response considerations and whether the association between PA and sleep was moderated by various factors (e.g., timing, sociodemographic characteristics). We found strong evidence that both acute bouts of PA and regular PA improved sleep outcomes. Moderate evidence indicated that longer bouts of PA (both acute and regular) improved sleep, and that the effects of PA on sleep outcomes were generally preserved across adult age groups and sex. Finally, moderate evidence demonstrated that PA improved sleep in adults with insomnia symptoms or obstructive sleep apnea. Several important areas in need of future research were also identified. Overall, the review supported the claim that PA improves sleep, but highlighted gaps that need to be addressed to facilitate more widespread utilization of PA for improving sleep.

Keywords: Exercise; Insomnia; Obstructive sleep apnea; Physical activity; Sedentary behavior; Sleep.

Figure 1.. Flow diagram of literature search strategy and article selection.

The original literature search was conducted on July 24, 2017; the updated search was conducted on May 6, 2020. CINAHL: Cumulative Index of Nursing and Allied Health Literature.

Figure 2.. The effect of acute and regular exercise on sleep outcomes in adults.

CI: confidence interval; SE: sleep efficiency; SOL: sleep onset latency; TST: total sleep time. Effect sizes are presented so that positive values represent an improvement in the specific sleep variable. The effect size defines the strength of the relationship, with d = 0.20 indicating a small, d = 0.50 a medium, and d = 0.80 a large magnitude of effect. Data are adapted from Kredlow et al. [43], with permission from Springer Nature.