Mind-Body Therapies for Sleep Disturbances, Depression, and Anxiety in Menopausal Women: A Systematic Review and Meta-Analysis of randomized controlled trials

Zhixin Fan¹Yifan Zhang¹Yankai Shu^2*Yongxu Zhou³Zhongzhi Zuo³

• ¹Graduate School of Physical Education, Myongji University, Yongin 17058, Republic of Korea, Yongin, Republic of Korea
• ²College of Physical Education, Hunan University of Science and Technology, Xiangtan, Hunan,, China
• ³Graduate School of Physical Education,Kookmin University, Seoul 02707, Republic of Korea, Seoul, Republic of Korea

Background: Menopause is frequently accompanied by sleep disturbances, depression, and anxiety, negatively affecting women's quality of life. While hormone therapy can be effective, safety concerns highlight the need for accessible non-pharmacological options. Mind–body therapies (MBTs) have emerged as promising interventions, yet their overall efficacy remains unclear. Methods: A systematic review and meta-analysis were conducted on randomized controlled trials evaluating the effects of MBTs—such as Yoga, Mindfulness, Qigong, Art therapy, Music therapy, Dance therapy and Reiki—on sleep, depression, and anxiety in perimenopausal and postmenopausal women. Comparator groups included usual care or no-intervention controls. Eighteen studies involving 1,572 participants were identified through PubMed, Embase, Cochrane Library, and Web of Science (through October 10, 2025). Random-effects models were applied, along with subgroup, sensitivity, and publication bias analyses. Results: MBTs significantly improved sleep quality (SMD = –0.86; 95% CI: –1.24 to –0.48), reduced depression (SMD = –0.79; 95% CI: –1.18 to –0.40), and alleviated anxiety (SMD = –1.13; 95% CI: –1.66 to –0.59), showing moderate-to-large effects. Subgroup analyses showed that mindfulness, music therapy, dance therapy, and Reiki yielded greater psychological benefits than yoga and Qigong. Longer interventions (≥12 weeks) and studies from Asia showed stronger effects, possibly due to differences in intervention type, cultural familiarity, or adherence. Sensitivity analyses confirmed robust results, and no publication bias was detected. Conclusion: MBTs offer moderate-to-large benefits and represent safe, low-risk strategies for managing menopausal symptoms. Expressive approaches, including Mindfulness, Music therapy, and Dance therapy, may provide added value for emotional regulation and psychological well-being. Yoga and Qigong provide stable benefits for sleep improvement. High-quality trials are needed to inform clinical guidelines.