Jiaqi Liang,1 Xuanzhen Pan,1 Li Zhao,1,2 Yan Li1,2 

1Department of Exercise Physiology, School of Sport Science, Beijing Sport University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing, People’s Republic of China

Correspondence: Yan Li, Department of Exercise Physiology, School of Sport Science, Beijing Sport University, No. 48 Xinxi Road, Haidian District, Beijing, 100084, People’s Republic of China, Email bsuliyan@bsu.edu.cn

Purpose: Depression patients frequently report sleep disorder. Aerobic exercise is believed to improve sleep quality, but its effect on the overall sleep of depressed patients remains uncertain. This study systematically evaluates the effects of aerobic exercises at different intensities on subjective and objective sleep quality in participants diagnosed with depression or at high risk of depression, from studies covering various depression subtypes (including but not limited to geriatric depression, prenatal depression, and poststroke depression), and examines changes in depression, anxiety, and quality of life following aerobic exercise.
Methods: Systematic searches for randomized controlled trials on aerobic exercise, depression, and sleep quality were conducted using PubMed, Web of Science, Embase, and the Cochrane Library up to December 31, 2024. Meta-analysis was performed using Review Manager 5.4.1 and stata 17.0.
Results: In total, 13 trials (n = 994) were included. Aerobic exercise significantly improved subjective sleep quality [SMD = − 0.52, 95% CI = (− 0.66, − 0.38)] but had no significant effect on objectively measured sleep efficiency [SMD = − 0.14, 95% CI = (− 0.46, 0.75)], total sleep time [SMD = 0.30, 95% CI = (− 0.03, 0.62)], or sleep latency [SMD = − 0.11, 95% CI = (− 0.76, 0.54)]. Additionally, aerobic exercise significantly alleviated depression [SMD = − 0.70, 95% CI = (− 0.93, − 0.47)] and anxiety [SMD = − 0.47, 95% CI = (− 0.74, − 0.19)], and enhanced quality of life [SMD = 0.64, 95% CI = (0.36, 0.92)]. Subgroup analyses revealed no significant differences among the different intensities.
Conclusion: Aerobic exercise significantly improves subjective sleep quality, alleviates depressive and anxiety symptoms, and enhances quality of life in depression patients. Light-, moderate-, and vigorous-intensities aerobic exercises have equal positive effects on these indicators. Given the bidirectional relationship between sleep disturbances and depression progression, this study highlights the potential of exercise therapy to disrupt the vicious cycle.
Systematic Review Registration: www.crd.york.ac.uk/PROSPERO/, identifier, CRD42023455212.

Keywords: aerobic exercise, depression, sleep quality, meta-analysis