Effects of different types of exercise on sleep quality based on Pittsburgh Sleep Quality Index in middle-aged and older adults: a network meta-analysis

Study Objectives: A 2021 survey by the World Health Organization showed that 27% of the global population experiences sleep problems and that middle-aged and older adults are more likely to have sleep disorders. Sleep deprivation increases cardiovascular disease risk. This study aimed to assess the effects of aerobic exercise, resistance exercise, combined training, and yoga on the quality of sleep in middle-aged and older adults through their effects on the Pittsburgh Sleep Quality Index (PSQI) and its components. Direct and indirect comparisons were used to determine which exercise modality most effectively improves sleep quality in middle-aged and older adults. Methods: This study conducted a systematic review and frequency network meta-analysis of all randomized controlled trials comparing the effects of aerobic exercise, resistance exercise, combined training, and yoga with a control group on sleep quality in middle-aged and older adults. Results: We included 28 studies involving 3,460 participants. According to the surface under the cumulative ranking (SUCRA) curve results, aerobic exercise was the most effective in improving total PSQI score (SUCRA = 93.2%), sleep latency (SUCRA = 96.8%), and sleep medication use (SUCRA = 77.1%). In addition, yoga was the most effective in improving sleep disorders (SUCRA = 90.4%), sleep efficiency (SUCRA = 95.9%), sleep duration (SUCRA = 93.8%), and daytime dysfunction (SUCRA = 98.3%). Conclusions: Aerobic exercise is the most effective exercise modality for improving PSQI total score in middle-aged and older adults.