Impact of postpartum physical activity on maternal sleep: a systematic review and meta-analysis

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.