Wpływ różnych rodzajów ćwiczeń na sen w populacjach siedzących: przegląd systematyczny i analiza meta-sieciowa

BACKGROUND: The widespread prevalence of sleep disturbances poses substantial challenges to both public health and individual well-being. Exercise may serve as an effective non-pharmacological intervention. However, the comparative efficacy of different exercise modalities and the influence of participant or intervention characteristics on treatment response remain unclear. METHODS: We conducted a systematic review and network meta-analysis of randomized controlled trials (RCTs) identified from PubMed, Web of Science, MEDLINE, SPORTDiscus, EBSCO, and Scopus (inception to November 2024). A total of 31 RCTs (n = 1,420) evaluating aerobic exercise (AE), resistance training (RT), high-intensity interval training (HIIT), mind-body exercise (ME), prolonged time of exercise (PTE), and mixed modalities (MIX) on sleep outcomes in sedentary adults with insomnia were included. Study quality was assessed using the Jadad scale, and analyses were performed in Stata 17.0 using a random-effects model. RESULTS: This study aimed to explore the effects of different types of exercise on sleep outcomes (sleep questionnaire score (SCORE), sleep latency (SL), sleep efficiency (SE), total sleep time (TST), sleep quality (SQ), and wake time after sleep onset (WASO)). The meta-analysis showed that exercise significantly improved SCORE (Hedges' g = 1.00, 95% CI [0.59-1.41]). Subgroup analyses indicated that the largest improvements occurred in individuals aged 45-59 (Hedges' g = 1.97, 95% CI [0.10-3.84]), those classified as overweight (Hedges' g = 0.27, 95% CI [0.04-0.51], and in interventions lasting 0-8 weeks (Hedges' g = 7.18, 95% CI [5.87-8.48]) or 8-16 weeks (Hedges' g = 0.73, 95% CI [0.32-1.13]). A significant effect was also observed in female-only samples (Hedges' g = 0.95, 95% CI [0.04-1.87]). Network meta-analysis further suggested that: (1) PTE improved SCORE, SE, TST, WASO, and SQ; (2) AE enhanced SE, TST, and SQ; (3) both MIX and ME had positive effects on SE and TST. CONCLUSION: Different exercise modalities show distinct benefits for specific sleep outcomes in sedentary adults with insomnia: PTE improved multiple domains (SCORE, SE, TST, WASO, SQ), AE enhanced SE, TST, and SQ, and MIX and mind-ME benefited SE and TST. Programs lasting 8-16 weeks yielded the most consistent effects. These findings support tailored exercise selection, though results should be interpreted cautiously due to limited evidence for some modalities.