Effectiveness of Exercise in Improving Sleep Outcomes among Perinatal Women: A Systematic Review and Meta-analysis of randomised Controlled Trials

ABSTRACT

Background

Sleep problems are prevalent among perinatal women, contributing to the poor overall well-being of mother and child. Exercise is an inexpensive and sustainable intervention to improve sleep outcomes and can be personalized accordingly to individuals. This systematic review and meta-analysis aim to consolidate available evidence to evaluate the effectiveness of exercise on improving sleep outcomes among perinatal women.

Methods

Eight databases (CINAHL, Cochrane, EMBASE, PsycINFO, PubMed, Scopus, Web of Science and ProQuest) were used to perform a systematic search for studies in the English language from the inception of each database to 7 December 2019. The quality of studies was assessed using the risk of bias and GRADE. Review Manager was used for meta-analyses. Heterogeneity was determined by Cochran’s Q (chi-square) and I² values. The overall effect was evaluated using effect size and Z-statistics.

Results

A total of 2,139 records were identified. Ten randomized controlled trials were included, with seven in the meta-analysis, involving 998 pregnant and postpartum women across eight countries. With medium to very large effect sizes, the results favored exercise interventions on sleep quality, sleep efficiency, sleep duration, sleep latency, insomnia, diurnal tiredness and daytime dysfunction.

Conclusion

Exercise interventions produced significant effects on improving sleep among perinatal women. This can increase advocacy for exercise among perinatal women to improve sleep and general health. Future randomized controlled trial designs should adhere to the Consolidated Standards of Reporting Trials and Template to ensure reliability when conducting and reporting such studies.

Acknowledgments

We would like to acknowledge all the study author in this review for contributing their knowledge.

Disclosure statement

No potential conflict of interest was reported by the author(s).

PROSPERO database at the centre of reviews and dissemination in the United Kingdom

CRD42020152229

Authors’ contributions

SC was involved in generating search strategies and performing the literature search, screening articles, extracting and analysing data, and writing the manuscript. YL was involved in developing the research question, planning the search, guiding the article screening and selection process, providing help in the interpretation of data and revising the manuscript. JT was involved in the article screening and selection process. LJC was involved in the data management, reference editing and revising and formatting of the manuscript. All authors approved of the last version of manuscript.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not- for-profit sectors.