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J Psychiatr Res. 2019 Feb;109:96-106. doi: 10.1016/j.jpsychires.2018.11.004. Epub 2018 Nov 3.

Does exercise improve sleep quality in individuals with mental illness? A systematic review and meta-analysis.

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Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia; School of Medical Science, UNSW Sydney, NSW, Australia. Electronic address:
School of Psychiatry, UNSW Sydney, NSW, Australia; Schizophrenia Research Unit, Liverpool Hospital and Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.
NICM Health Research Institute, University of Western Sydney, Sydney, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom.
School of Medical Science, UNSW Sydney, NSW, Australia.
Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, United Kingdom.
KU Leuven Department of Rehabilitation Sciences, Tervuursevest 101, 3001, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, 3070, Kortenberg, Belgium.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
School of Psychiatry, UNSW Sydney, NSW, Australia.
School of Psychiatry, UNSW Sydney, NSW, Australia; Black Dog Institute, Randwick, NSW, Australia.


People living with mental illness often experience poor sleep quality compared to the general population. Poor sleep quality exacerbates symptoms of mental illness and contributes to increased physical comorbidities. Exercise has been shown to be an effective non-pharmacological treatment for managing poor sleep in the general population. Little is known regarding the efficacy of targeted exercise interventions for improving sleep quality amongst individuals with a mental illness. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) examining the impact of exercise on sleep quality in people with mental illness. Major electronic databases were searched from inception until June 2018 for exercise-based RCTs that included either subjective and/or objective measures of sleep quality in people with severe mental illness (SMI). Eight RCT's were included in the meta-analysis, involving use of a range of exercise modalities in people with SMI diagnoses. Overall, exercise had a large statistically significant effect on sleep quality (hedges g = 0.73, 95% CI; (0.18, 1.28), p-value = 0.01; N = 8, n = 1,329, I2 = 91.15%). The beneficial effect of exercise on sleep quality outlined in this study highlights the important role exercise has in improving health outcomes for people living with mental illness. Further research is required to determine the efficacy of exercise on sleep in people experiencing a psychiatric illness and to explore the effects of exercise intervention elements such as modality, frequency, intensity and delivery settings.


Depression; Exercise; Mental illness; Physical activity; Sleep; Systematic review

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