BackgroundThis meta-analysis aimed to systematically evaluate the effects of exercise interventions on sleep quality in patients with depression and to explore the dose–response relationships of key intervention parameters.MethodsA comprehensive search was conducted in PubMed, Web of Science, Embase, Scopus, and the Cochrane Library to identify randomized controlled trials (RCTs). Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup and sensitivity analyses were performed to examine potential dose–response relationships.ResultsA total of 17 publications, including 19 randomized controlled trial comparisons and 1,457 participants, were included in this systematic review and meta-analysis. Pooled estimates indicated that exercise interventions significantly improved sleep quality [SMD = −0.37, 95% CI: −0.48 to −0.27]. Dose–response modeling suggested that exercise doses around 312.75 MET·min/week may be associated with greater improvements [Hedges’ g = −0.51, 95% CI: −0.71 to −0.31]. Subgroup analyses suggested that mind–body exercise [SMD = −0.49, 95% CI: −0.63 to −0.35], durations of 9–12 weeks [SMD = −0.49, 95% CI: −0.74 to −0.24], fewer than two sessions per week [SMD = −0.47, 95% CI: −0.65 to −0.29], and sessions longer than 90 minutes [SMD = −0.42, 95% CI: −0.66 to −0.18] may be associated with favorable changes.ConclusionsExercise interventions may improve sleep quality in individuals with depression, with potential benefits at low doses. These findings support individualized exercise prescriptions, but larger multicenter RCTs with long-term follow-up are needed to confirm the dose–response pattern and subgroup findings.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251105568, identifier PROSPERO (CRD420251105568).
Radically different