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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: The effects of physical activity on cortisol and sleep: a systematic review and meta-analysis
Author(s): De Nys, Len
Anderson, Kerry
Ofosu, Esther F
Ryde, Gemma C
Connelly, Jenni
Whittaker, Anna C
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Keywords: Physical exercise
Endocrine health
Hypothalamic–Pituitary–Adrenal axis
Sleep hygiene
Sleep quality
Issue Date: Sep-2022
Date Deposited: 27-Jun-2022
Citation: De Nys L, Anderson K, Ofosu EF, Ryde GC, Connelly J & Whittaker AC (2022) The effects of physical activity on cortisol and sleep: a systematic review and meta-analysis. Psychoneuroendocrinology, 143, Art. No.: 105843.
Abstract: Background Managing stress and having good quality sleep are inter-related factors that are essential for health, and both factors seem to be affected by physical activity. Although there is an established bidirectional relationship between stress and sleep, remarkably few studies have been designed to examine the effects of physical activity on cortisol, a key biomarker for stress, and sleep. Research is particularly scarce in older people despite both sleep and cortisol changing with age. This systematic literature review addresses this gap. Methods A systematic review was conducted following the PRISMA guidelines. Original, peer-reviewed records of intervention studies such as randomized controlled trials (RCTs) and non-RCTs with relevant control groups were eligible for inclusion. The Participant, Intervention, Comparison, Outcome (PICO) characteristics were (1) adults or older adults (2) physical activity programmes of any duration, (3) controls receiving no intervention or controls included in a different programme, (4) cortisol measurement, and subjective or objective measures of sleep. Results Ten original studies with low-to-moderate risk of bias were included. Findings from this review indicated with moderate- and low-certainty evidence, respectively, that physical activity was an effective strategy for lowering cortisol levels (SMD [95% CI] = -0.37 [-0.52, -0.21] p < 0.001) and improving sleep quality (SMD [95% CI] = -0.30 [-0.56, -0.04], p = 0.02). Caution is needed to generalize these findings to the general population, as included trials were predominantly participants with breast cancer, included few males and no older adults. Conclusion Cortisol regulation and sleep quality are intertwined, and physical activity programmes could improve both in several ways. Further, physical activity may benefit adults with long term conditions or current poor (mental) health states the most, although more research is needed to support this claim fully. Few intervention studies have examined the inter-relationship between cortisol and sleep outcomes in males or older adults, indicating fruitful enquiry for future research.
DOI Link: 10.1016/j.psyneuen.2022.105843
Rights: This is an open access article distributed under the terms of the Creative Commons CC-BY license (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. You are not required to obtain permission to reuse this article.
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