Effectiveness of physical activity programs in enhancing sleep outcomes among adolescents: a systematic review

Background Adolescence is a developmental period characterised by rapid physical and psychological changes that heighten the risk for inadequate sleep. Fortunately, physical activity programs (PAPs) are an easy-to-do intervention that has been associated with improved sleep outcomes in different population groups. This systematic review aimed to provide evidence to support the effects of PAPs on sleep outcomes among apparently healthy adolescents. Methods A systematic literature search was performed in online databases of PubMed, Cochrane Library, and PEDro for all dates up to April 2022. All relevant clinical trials reporting on the effects of PAPs on sleep among adolescents were included using a pre-defined inclusion/exclusion criterion (PROSPERO: CRD42020171852). The methodological quality of the included studies was assessed using 'specific checklists per design' (RCTs) provided by the Dutch Cochrane Centre. Qualitative synthesis was used to report the results of the review. Results Two RCTs were included and analysed in the review. Both studies were of good methodological quality but lacked blinding. The PAPs in the reviewed studies included mainly aerobic exercises in the form of cross-country running in the mornings, SMS-delivered motivational messages to increase daily step counts, and use of a pedometer and step diaries. Sleep was measured both subjectively by means of sleep questionnaires and objectively using sleep electroencephalographic recordings. Nevertheless, qualitative synthesis is suggestive of an overall positive effect of PAPs on some sleep outcomes in adolescents, albeit with limited to moderate evidence. Conclusion PAPs appear to have a beneficial effect on some sleep outcomes among apparently healthy adolescents. Nevertheless, the body of evidence is currently scanty, thus warranting the need for more high-quality RCTs.