New research suggests three exercise modalities may be particularly beneficial in reducing insomnia symptoms.
How you exercise matters. You take cycling classes to gain cardiovascular fitness. You lift heavy weights to build bone density and strength. You practice plyometrics to develop power.
But if you want to improve your sleep, how should you train?
Turn to yoga, Tai Chi, walking, or jogging. Those were the findings of a recent investigation into the effects of different exercise modalities in people with insomnia, published in BMJ Evidence-Based Medicine.
The Context
Sleep problems are prevalent. In the U.S., more than 15 percent of adults have trouble falling asleep most days or every day. Twelve percent say they’ve been diagnosed with chronic insomnia, a disorder involving difficulty falling asleep, staying asleep, or getting good quality sleep. The problem? These sleep troubles can contribute to high blood pressure, heart disease, and diabetes.
Medications and cognitive behavioral therapy are the most common treatment methods for insomnia. But one alternative seems to be a promising adjunct therapy: exercise.
Physical activity has been found to improve sleep quality and efficiency, curb sleep disturbances, and shorten sleep latency (the amount of time it takes to fall asleep) in people with insomnia. That’s because exercise can enhance neuroplasticity and strengthen communication between brain regions that are involved in sleep-wake regulation, early research suggests.
Still, there haven't been any analyses to determine which specific exercise methods are the most effective at treating insomnia.
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The Details
The researchers behind the BMJ Evidence-Based Medicine analysis set out to pinpoint the modalities with the most therapeutic potential. To do so, they conducted a network meta-analysis of 22 randomized controlled trials. They looked at the effects of 13 insomnia interventions, including seven exercise-based modalities and six non-exercise control conditions, with protocols spanning four to 26 weeks.
In total, the review included data from nearly 1,350 participants with insomnia. The studied outcomes were tracked and measured using sleep diary data and results from questionnaires like the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI).
The Key Findings
Some exercise modalities do rival traditional insomnia treatment methods. Three were clear standouts: yoga, Tai Chi, and walking or jogging.
Yoga was found to, on average, increase total sleep time by roughly two hours. It also shortened sleep onset latency by about 30 minutes and improved sleep efficiency by 15 percent. In other words, participants fell asleep faster, slept longer, and spent less time awake while lying in bed. Plus, the modality was shown to significantly improve sleep quality — an effect that may be attributed to yoga’s focus on body awareness and controlled breathing, the researchers note.
A slow, rhythmic practice with a mindfulness focus, Tai Chi can help regulate emotions, ease anxiety, and decrease sympathetic nervous system arousal — effects that could be responsible for enhancing sleep. In the meta-analysis, Tai Chi reduced PSQI scores by an average of 4.57 points, indicating better sleep quality. The movement method also increased total sleep time by 52 minutes and shortened the amount of time it took to fall asleep by about 25 minutes, on average.
Similar to Tai Chi, walking or jogging may improve emotional regulation. It’s linked to reduced cortisol levels and increased melatonin secretion, too. That may explain the link between the modality and lower insomnia severity scores found in this analysis.
The Impact
According to the researchers, these findings support the use of exercise as a primary treatment strategy for insomnia. “Given the advantages of exercise modalities such as yoga, Tai Chi, and walking or jogging — including low cost, minimal side effects, and high accessibility — these interventions are well-suited for integration into primary care and community health programs,” the researchers stated.
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The Expert Insight
In the analysis, the researchers state: "The findings of this study further underscore the therapeutic potential of exercise interventions in the treatment of insomnia, suggesting that their role may extend beyond adjunctive support to serve as viable primary treatment options.”
The Caveat
Like any research study, this meta-analysis has some limitations. The authors point out that the evidence for certain interventions was low-quality, some reporting was inconsistent, and there was a lack of “participant blinding” — meaning some study participants knew about the interventions (which increases bias potential). More large-scale, high-quality randomized controlled trials are needed before these findings are widely interpreted and applied, according to the authors.
These limitations don’t fully negate the results, though. The researchers note the findings can help inform clinical recommendations surrounding exercise for insomnia. Since these exercise modalities offer other physical and mental health benefits, a regular Tai Chi or yoga practice is still worthwhile. You just might sleep a little more soundly, too.