Exercise, as a complementary and alternative therapy, is defined as any planned, structed and repetitive physical movement produced by skeletal muscles that results in energy expenditure, and correlates strongly with physical fitness and considered as a minimal risk, low-cost, and easily accessible to the patients [11,12]. Usually, exercise can be categorized into three main types: aerobic exercises, which is continuous movement of large muscles in the body over time to improve cardiorespiratory fitness; [13] resistance exercises, which increase skeletal muscle strength, power, endurance, and mass; [13] and mind-body exercises, which aim to relieve physical tension and emotional anxiety through techniques such as breathing, body relaxation, and self-awareness [14]. Existing systematic reviews (SRs) and/or meta-analyses suggested that various exercise modalities are effective in improving sleep quality for people with sleep disorders. For example, Banno et al. [15] found that aerobic exercise can relieve insomnia and improve sleep quality in people with insomnia. Kovacevic et al. [16] conducted a SR of 13 studies and concluded that resistance exercise can improve all aspects of sleep, with the greatest benefit for sleep quality in population with sleep disorders. Additionally, an umbrella review investigating the effects of Pilates on physical health showed that Pilates had a positive effect on improving sleep disorders compared to passive interventions [17].
While I agree with the conclusions that all modalities were helpful, I do not believe there is sufficient strength of evidence based on these study methods to conclude that one (i.e., mind-body exercise) was superior to the others. Still, the conclusion that sleep disorders can be addressed by behavior interventions (and especially exercise) is valid.
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