A systematic review and meta-analysis observed no bidirectional association between sleep outcomes and physical activity among adults. These findings were published in Sleep Medicine Reviews.

Researchers searched publication databases through July 2019 for studies of physical activity and sleep among adults. A total of 33 articles met the inclusion criteria.

This review comprised 14,387 study participants. The studies had sample sizes between 7 and 10,086. Of the studies, 33% excluded men, 24% included individuals with sleep disturbances, 9% included patients with mental disorders, and 8% included adults with chronic medical conditions.

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In the meta-analysis, among the 10 within-Pearson analyses, the directional relationship of wake after sleep onset (effect size, -0.15; 95% CI, -0.31 to 0.00; P =.05) and sleep quality (effect size, 0.35; 95% CI, 0.00-0.70; P =.05) on physical activity were significantly associated. Neither of these relationships remained significant in the sensitivity analyses; however, the association between total wake time and physical activity became significant (effect size, -0.26; 95% CI, -0.38 to -0.15; P =.02).

Among the 12 between-Pearson analyses, the effect of sleep efficiency on physical activity (effect size, 0.09; 95% CI, 0.01-0.18; P =.03) and physical activity on total sleep time (effect size, -0.05; 95% CI, -0.09 to 0.00; P =.05) were significant. These relationships were not significant in the sensitivity analysis, but the relationship between sleep onset latency on physical activity became significant (effect size, -0.09; 95% CI, -0.18 to 0.00; P =.05).

This study may have been limited by the choice to pool all types of physical activities, such as aerobic activity or intense physical activity, as a single predictor. The underlying studies varied on their assessment of sleep between self-reported, objective measurements, or a mixture of the two, which may have added noise to these data.

This meta-analysis did not identify clear bidirectional relationships between sleep parameters and physical activity.


Atoui S, Chevance G, Romain AJ, Kingsbury C, Lachance JP, Bernard P. Daily associations between sleep and physical activity: a systematic review and meta-analysis. Sleep Med Rev. 2021;57:101426. doi:10.1016/j.smrv.2021.101426

This article originally appeared on Psychiatry Advisor