Objective: To examine the relationship between postpartum physical activity and maternal sleep.
Design: Systematic review with random-effects meta-analysis. Online databases were searched through 20 January 2025.
Study eligibility criteria: Studies of all designs (except case studies and reviews) in all languages were eligible if they contained information on the population (individuals up to 1 year post partum); interventions/exposures (including subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone ('exercise only') or in combination with other intervention components (eg, dietary; 'exercise+co-intervention')); comparator (low volume or no physical activity) and outcomes: sleep duration, quality, latency, efficiency, disturbance and fatigue.
Results: 12 unique studies (n=3096) from nine countries were included. Moderate certainty of evidence showed that exercise-only interventions were associated with a greater improvement in sleep quality (five randomised controlled trials (RCTs), n=375, standardised mean difference (SMD) -0.44, 95% CI -0.79 to -0.09) compared with no exercise. High certainty of evidence showed that exercise interventions were associated with a greater improvement in daytime/general fatigue (six RCTs, n=535, SMD -0.56, 95% CI -1.06 to -0.05) compared with no exercise. No effect was found for sleep duration, latency, efficiency, or disturbance.
Conclusion: Postpartum physical activity improves maternal sleep quality and daytime/general fatigue.
Keywords: Exercise; Fatigue; Meta-analysis; Sleep.
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