The Effects of Aerobic Exercise on Sleep Quality in older adults with Sleep Problems: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Sleep problems among older adults have long been a major concern in the field of public health. For this population, aerobic exercise is considered a more appropriate non-pharmacological approach to improving sleep quality. Nonetheless, there is a scarcity of concrete evidence focusing on older adults who have clinically recognized sleep problems. As a result, the objective of this research is to assess the impact of aerobic exercise on the sleep quality of older adults experiencing sleep problems. A thorough investigation was performed across five primary databases: PubMed, Embase, Cochrane Library, Web of Science, and EBSCO, aimed at identifying all pertinent studies released up until September 30, 2025. The search method specifically targeted randomized controlled trials (RCTs) that explored the relationship between aerobic exercise interventions and sleep quality outcomes among older adults experiencing sleep problems. To guarantee comprehensiveness, the search included all accessible records from the beginning of each database's establishment. After systematic screening and comprehensive evaluation, a total of 12 studies were identified from 2,752 initial records that met the inclusion criteria for meta-analysis. All participants were older adults with sleep problems. Data analysis revealed that aerobic exercise had a significant positive effect on improving sleep quality in this population (SMD = -0.98, 95% CI: -1.36 to -0.60, p < 0.001). Subgroup analyses further indicated that various parameters of the exercise intervention—including weekly frequency, session duration, and total intervention period—had statistically significant positive effects on sleep quality. The results of this study indicate that exercise therapy can significantly improve sleep quality in older adults with sleep disorders. In terms of intervention frequency, programs conducted more than three times per week achieved the best outcomes. Moreover, the findings suggest that exercise sessions lasting 60 minutes or longer were more effective than shorter sessions, while a 12-week intervention period produced the most favorable clinical benefits. Overall, these results provide a solid scientific basis for developing precise exercise therapy programs and health management strategies aimed at optimizing sleep quality among older adults. When designing exercise prescriptions, it is essential to fully consider individual differences to ensure long-term adherence and safety.