The effect of physical activity on sleep quality in people with diabetes: systematic review and meta-analysis

Background: To revise and critically summarize the available scientific evidence regarding the effect of exercise on sleep quality in people with diabetes.

Methods: Three electronic databases (MEDLINE/PubMed, PEDro Database and Scopus) were searched systematically from their inception until February 2024. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database and Quality Assessment Tool for Before-After Studies with No Control Group scales.

Results: A total of 7 randomized controlled trials and 3 single-arm studies were included. Most of the studies included patients with type 2 diabetes (n = 8). Self-reported sleep quality (n = 9) and objective sleep status (n = 1) were the main outcomes analysed. A variety of training programs were assessed over durations ranging from 4 to 16 weeks in the studies included. Data from eleven interventions demonstrated a significant improvement in self-reported sleep quality among patients with type 2 diabetes (Hedges' g -1.45; 95% CI -2.6; -0.29, p = 0.005). However, data synthesis indicated that participants who exercised did not obtain significant improvements on their self-reported sleep quality compared to those in the control groups (Hedges' g 1.40; 95% CI -1.36; 4.18, p = 0.111).

Conclusions: Preliminary evidence suggests that exercise can be prescribed to manage self-reported sleep quality in this population, although its effects may not surpass those of usual care.