Exercise for sleep - Part 1
Exercise is one of the most powerful tools for improving sleep. In this first of three posts, we’ll go over what the clinical trials show about exercise and sleep. Check back for Part 2 (biological mechanisms that link exercise to sleep) and Part 3 (for practical tips on when, how much, and what exercises can optimize your sleep) later this month!
Clinical trials about how exercise impacts sleep
We all know that exercise is good for our health, but most of us need some motivation. Let’s face it, it can take weeks, months, or years to get the cardiovascular and other health benefits of exercise. But exercise can improve sleep the very same night, so you can benefit right away! So what do the data show about the benefits of exercise on sleep?
There are a lot of clinical trials on exercise and sleep: as of today, there are 1748 clinical trials in Pubmed on this topic on human adults published in English. What scientists and physicians do in these situations is to look at meta-analyses, where data from multiple studies are methodically pooled together. So let’s look for meta-analyses that include studies that are
randomized: participants get randomly assigned to exercise or not
controlled: there is a comparison group that didn’t get exercise
exercise was clearly defined
for our purposes, enrolled middle-aged and older adults
validated sleep outcome measures.
published in the last few years
Regular exercise improves subjective sleep quality
In general, the studies are highly consistent — people feel like they sleep better after exercise. The most commonly used subjective sleep outcome measure is the Pittsburgh Sleep Quality Index (PSQI, which is pronounced “piss-key” according to Dr. Dan Buysse who co-developed it). You can try it out yourself at the link — it combines various measures of sleep duration, quality, and how you feel during the daytime, for a composite score of sleep quality.
Sleep quality improves with regular exercise in the general adult population: A meta-analysis of 22 trials of middle aged or older adults, that looked at >2 months of regular exercise, showed positive effects on sleep quality as rated by the PSQI, as well as the Insomnia Severity Index and the Epworth Sleepiness scale. (Xie 2021) There was no difference in the benefit on sleep whether the study included just women or both men and women (there was only 1 trial with just men so they couldn’t compare that one). There were similar effects whether the participants were elderly or middle-aged. Additionally, there were 6 studies that used actigraphy (activity monitor) to objectively measure sleep, and overall there was improved sleep efficiency (% of time in bed that someone is actually sleeping), reduced sleep onset latency (SOL - time to fall asleep), increased total sleep time, and reduced wake time after sleep onset (WASO - aggregate time awake in the middle of the night).
This is true even when only people with sleep disorders are studied: In a meta-analysis of studies including 1214 individuals, exercise improved sleep efficiency and WASO. (Wang 2025)
Or women: In a meta-analysis of 16 studies than enrolled women, exercise improved PSQI scores. Regular exercise for >12 weeks reduced sleep medication use. (Qiao 2025). Similar results were seen in a meta-analysis of peri and post-menopausal women (Zhou 2025).
Or older people: In a meta-analysis of 25 studies including 2170 people, PSQI improved with aerobic exercise, strength training, or a combination. (Bahalayothin 2025)
Or people with mild cognitive impairment: (Páez 2024): In a review of 20 studies and 13 of those included in a meta-analysis, exercise did improve sleep in individuals with mild cognitive impairment or early dementia.
The studies are overwhelmingly clear and consistent: exercise improves subjective sleep quality.
But what about objective measures of sleep? Do those change with exercise?
Exercise improves objective sleep measured by gold-standard polysomnography
Our perception of our sleep is not necessarily accurate, because… we are asleep when we are sleeping. The best quality, gold-standard objective information about sleep is measured through polysomnography, or a sleep study, done in a sleep lab. Clinical trials of exercise on sleep that use polysomnography are much less common, so we can review them individually.
To start off, in a study of 48 adults (mean age 44; 38 were women) with chronic insomnia, participants were randomized to moderate or high aerobic exercise, moderate resistance exercise, or control groups. They did polysomnography before and after ONE exercise session. The moderate aerobic exercise group fell asleep faster—SOL decreased from 37.6 to 16.8 minutes by polysomnography—whereas their subjective experience showed an even more dramatic change, decreasing from 80.8 to 49 minutes! Polysomnography also showed that sleep efficiency improved (71.8% to 80.9%), and total sleep time increased from 4.9 to 5.8 hours (their subjective recollection was also improved by around an hour, from 3.9 to 4.9 hours). (Passos 2010)
Another study very carefully examined the brain waves (EEG) during sleep with and without exercise. In this study, 14 participants (all men, age 20-40) were compared to themselves when they exercised for 40 minutes on an exercise bike daily for 5 days, versus 5 days without exercise (this was a crossover design study). They found that the nights after exercise, they had increased slow wave sleep. (Aritake-Okada 2019)
Of course, we need to sleep every night, so we need data on whether longer-term regular exercise is helpful for sleep. And it is: regular exercise over a year improves objective sleep. In a randomized clinical trial of middle-aged-to-older adults (age 55+, 66 people) with chronic sleep problems, participants were randomized to a moderate-intensity exercise program for a year or to a non-exercise educational program. Polysomnography showed a shift from lighter, stage N1, sleep, to deeper, more consolidated (stage N2) sleep. The exercise group also had improvements in subjective sleep quality based on the PSQI. (King 2008)
A subsequent further analysis of the same data showed that those who were more sedentary to start with, and had more sleep problems to start with, benefitted the most from exercise! (Buman 2011) So it’s never too late — the worse off someone is (in terms of exercise and sleep) to start, the more they stand to gain from exercise.
The takeaway:
Exercise improves sleep, including on the very first night. Regular, consistent exercise improves sleep quality. This improvement can be sustained over weeks, months, and years, based on numerous high-quality clinical trials, using both subjective and objective measures.
Longer-term studies of exercises interventions are hard, because well-designed studies use an intention-to-treat analysis. This means that people who were assigned to the exercise group, but didn’t stick with it, still get included in the exercise group for the final analysis. This makes it less likely that a difference will be seen between the exercise and non-exercise groups. So, it is even more remarkable that exercise studies on sleep are so consistent in showing a positive effect on sleep, whether using subjective or objective outcomes.
So we have no excuse! If you haven’t worked out today, please stand up and do a few squats or a couple yoga stretches! Do it for your sleep!
Next time, we’ll go over how exercise improves sleep, by doing a deep dive into the biological mechanisms that muscles use to talk to the brain..
References (alphabetical)
Aritake-Okada S, Tanabe K, Mochizuki Y, Ochiai R, Hibi M, Kozuma K, Katsuragi Y, Ganeko M, Takeda N, Uchida S. Diurnal repeated exercise promotes slow-wave activity and fast-sigma power during sleep with increase in body temperature: a human crossover trial. Journal of Applied Physiology 2019; 127:1168-177. Fulltext.
Bahalayothin P, Nagaviroj K, Anothaisintawee T. Impact of different types of physical exercise on sleep quality in older population with insomnia: a systematic review and network meta-analysis of randomised controlled trials. Fam Med Community Health. 2025;13(1):e003056. Fulltext.
Buman MP, Hekler EB, Bliwise DL, King AC. Moderators and mediators of exercise-induced objective sleep improvements in midlife and older adults with sleep complaints. Health Psychol. 2011;30(5):579-87. Fulltext.
King AC, Pruitt LA, Woo S, Castro CM, Ahn DK, Vitiello MV, Woodward SH, Bliwise DL. Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. J Gerontol A Biol Sci Med Sci. 2008;63(9):997-1004. Fulltext.
Páez A, Frimpong E, Mograss M, Dang-Vu TT. The effectiveness of exercise interventions targeting sleep in older adults with cognitive impairment or Alzheimer's disease and related dementias (AD/ADRD): A systematic review and meta-analysis. J Sleep Res. 2024;33(6):e14189. Fulltext.
Passos GS, Poyares D, Santana MG, Garbuio SA, Tufik S, Mello MT. Effect of acute physical exercise on patients with chronic primary insomnia. J Clin Sleep Med. 2010 15;6(3):270-5. Fulltext
Qiao Y, Wang C, Chen Q, Zhang P. Effects of exercise on sleep quality in women - A systematic review and meta-analysis. J Sci Med Sport. 2025;28(4):274-281. Pubmed.
Wang P, Chen Y, Zhang A, Xie C, Wang K. Comparative efficacy of exercise modalities on sleep architecture in adults with sleep disorders: a systematic review and network meta-analysis of randomized controlled trials. Sleep Med. 2025;134:106680. Pubmed.
Xie Y, Liu S, Chen XJ, Yu HH, Yang Y, Wang W. Effects of Exercise on Sleep Quality and Insomnia in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Psychiatry. 2021;12:664499. Fulltext.
Zhou K, Ren Y, Zang L, Zhou Z. Sleep quality in perimenopausal and postmenopausal women: which exercise therapy is the most effective? A systematic review and network meta-analysis of 31 RCTs. Climacteric. 2025;28(5):516-528. Pubmed.
