Effects of physical activity on sleep in children and adolescents: a systematic review and meta-analysis of randomised controlled trials.

Abstract

Sleep problems are common among children and adolescents; however, the potential role of exercise in mitigating these issues is often overlooked. To examine the relationship between exercise interventions and sleep parameters in children and adolescents. The review adhered to the PRISMA 2020 guidelines. A comprehensive literature search was conducted on 8 databases from inception to February 2025. Randomised controlled trials of children and adolescents aged 6-18 years who applied exercise interventions and reported at least one sleep parameter were included. Data include participant characteristics, intervention details, and sleep parameter. Evidence quality graded by GRADE. 27 studies were used for meta-analysis. The results of the studies showed that exercise had a significant effect on sleep quality (standardized mean difference [SMD] =-1.06; 95% CI=-1.76 to -0.36), sleep efficiency (SMD=-2.17; 95% CI=-3.69 to -0.65), sleep duration (SMD=-0.70; 95% CI=-1.27 to -0.13), wake after sleep onset (SMD=-0.53; 95% CI=-0.91 to -0.15), sleep anxiety (SMD=-0.54; 95% CI=-0.98 to -0.10), sleep resistance (SMD=-0.33; 95% CI=-0.75 to -0.10), sleep latency (SMD=-1.05; 95% CI=-3.29 to 1.19), parasomnias (SMD=-0.67; 95% CI=-1.74 to 0.40), sleep onset delay (SMD=-0.30; 95% CI=-0.60 to -0.00), sleep-disordered breathing (SMD=-0.19; 95% CI=-0.50 to 0.13), and daytime dysfunction (SMD=-0.30; 95% CI=- 0.72 to 0.11) had an effect, but not on total sleep time (SMD = 0.02; 95% CI=-0.23 to 0.27). The findings emphasize the role of exercise in sleep among children and adolescents. Exercise interventions balancing effectiveness and efficiency may serve as an additional approach to sleep issues beyond sleep hygiene education.