Tired of tossing and turning? Strength training could be your best bet for better sleep.
A review of studies found that older adults who engaged in muscle-strengthening exercises saw the biggest improvements in sleep quality. While aerobic and combination exercises helped, resistance training stood out as the most effective.
Strength Training May Be the Best Exercise for Insomnia
Strength training, whether using weights or body weight, may be the most effective type of exercise for improving sleep in older adults, according to a pooled analysis of existing research published today (March 4) in Family Medicine and Community Health.
The study also suggests that aerobic exercise, as well as a combination of strength, aerobic, balance, and flexibility exercises, can help improve sleep quality.
Sleep tends to worsen with age, and up to one in five older adults experience insomnia, researchers note. Poor sleep is linked to serious health risks, including cognitive decline, and can contribute to workplace underperformance and absenteeism.
What Type of Exercise Works Best for Sleep?
Previous studies indicate that exercise can help relieve insomnia symptoms, but the most effective type of exercise has remained unclear.
To investigate, researchers analyzed clinical trials published up to October 2022 that compared different forms of physical exercise with routine activities, standard care, other non-exercise interventions, or health education. All participants in the studies had been formally diagnosed with insomnia, and sleep quality was measured using the Global Pittsburgh Sleep Quality Index (GPSQI).
The Different Types of Exercises Analyzed
The types of exercise covered by the studies included: aerobic, such as cycling, dancing, swimming, brisk walking, and gardening; resistance, such as using weights, push-ups, and planks; balance, such as step-ups, heel to toe walking; flexibility, such as gymnastics, yoga, and Pilates; and combination exercise encompassing a mix.
Twenty-four studies, involving 2045 adults aged at least 60 (average 70), were included in the pooled data analysis. Most were carried out in Asia (56%), North America (16%), South America (16%), and Europe (12%). One in five were carried out in nursing homes.
Over half of the reported exercise intensity was mild to moderate and moderate, with average length of a session just over 50 minutes, and frequency around 2 to 3 times a week. On average, the exercise programmes lasted 14 weeks.
The pooled data analysis included only studies looking at combination exercise and aerobic exercise, because there weren’t enough studies covering the other exercise types.
Which Exercises Improved Sleep the Most?
This analysis showed that combined exercise significantly improved the GPSQI by 2.35 points while aerobic activity improved it by 4.35 points.
When the data were pooled using a network meta analysis—a statistical method that looks at several different ‘treatments’ and combines both direct and indirect effects—strength/resistance exercise was the most effective, improving the GPSQI by 5.75 points.
Aerobic exercise improved the GPQSI by 3.76 points, while combination exercise improved it by 2.54.
Sleep Education Helps, But Not as Much as Strength Training
Of the comparators, sleep education was the most effective, although what this entailed wasn’t clearly defined in the included studies, and it still wasn’t as good as muscle strengthening/resistance exercise, the analysis showed.
The researchers caution that the design and methodology of the included studies varied considerably, and only a few looked at particular types of exercise. Several didn’t include any information on exercise intensity either.
The Takeaway: Exercise Boosts Sleep Quality
Some exercises may prove challenging for older people because of restricted physical capabilities, suggest the researchers. But they nevertheless conclude that: “Exercise, particularly strengthening exercise and aerobic exercise, is beneficial for enhancing subjective sleep quality at a clinically significant level compared with normal activities.”
Reference: “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” by Pakwan Bahalayothin, Kittiphon Nagaviroj and Thunyarat Anothaisintawee, 4 March 2025, Family Medicine and Community Health.
DOI: 10.1136/fmch-2024-003056
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