A major new study has found that certain types of exercise can significantly improve sleep quality in older adults with insomnia, and one stands out as the most effective.
That matters because many adults over 60 struggle with falling asleep, staying asleep, or waking up too early. Sleep medications might help for a little while, but they can cause side effects or stop working over time. This study points to a safer, proven way to improve sleep naturally.
The Exercise/Insomnia Study:
A 2025 comprehensive review analyzed 25 randomized controlled trials (RCTs) involving 2,170 participants, all aged 60 and older and experiencing insomnia (1). Researchers studied how various types of physical exercise impact sleep quality. They used the Pittsburgh Sleep Quality Index, a trusted and widely used tool in sleep research.
The meta-analysis compared aerobic, resistance (strength), and combination exercises to control conditions such as usual care or no physical activity. Results were compelling:
- Strength training had the most significant impact, with a USMD (Unstandardized Mean Difference) of -5.75, the strongest reduction in PSQI scores, meaning people reported sleeping better, longer, and more soundly.
- Aerobic exercise also improved sleep, with a USMD of -3.76, though not as effectively.
- Combined exercise (aerobic + strength) also yielded positive results but had a smaller effect (USMD of -2.54).
To rank the effectiveness of each exercise type, researchers used SUCRA (Surface Under the Cumulative Ranking Curve). It’s a statistical method that ranks treatments based on their likelihood of being the best. Strength training scored 94.6%, far above other methods.
This means older adults with insomnia benefit the most from muscle-strengthening exercises—such as resistance bands, weightlifting, or bodyweight routines—done regularly and with proper technique.
So, Which Type of Exercise Is Best for Insomnia?
The short answer is strength training. But here’s what that means and why it matters.
Unlike aerobic exercises (like walking or cycling) that primarily boost cardiovascular health, strength training targets muscle mass, stability, and neuromuscular coordination. These outcomes are especially critical in aging adults, who naturally lose muscle and mobility over time. But what does this have to do with sleep?
- Hormonal response: Strength training boosts growth hormone and testosterone, which play roles in tissue repair and sleep regulation.
- Reduced anxiety: Strength-focused exercises decrease cortisol, the stress hormone that often keeps people awake at night.
- Improved sleep architecture: Older adults doing resistance training show more time in slow-wave (deep) sleep, which is the most restorative phase.
In practical terms, two to three sessions per week, lasting about 30–45 minutes, have been shown to improve sleep outcomes within 8–12 weeks significantly. These exercises don’t require heavy weights. Bodyweight squats, light dumbbells, or resistance bands can be enough.
Still, aerobic exercise has its place:
- Walking for 30 minutes daily improves sleep onset latency (how fast you fall asleep).
- Moderate-intensity aerobic exercise (e.g., brisk walking, swimming) improves mood, reduces depressive symptoms, and supports circadian rhythm alignment, which is often disrupted in older age.
Combination training, a mix of strength and aerobic, can offer broader health benefits (cardiovascular + muscular), but for maximum improvement in sleep quality, strength training leads.
Are There Any Risks Associated with Exercise for Older Adults?
Yes, but they’re manageable and don’t outweigh the benefits. Still, it’s important to understand them.
- Injury risk: Older adults may have reduced joint mobility, balance issues, or existing conditions like osteoporosis or arthritis. Improper technique or overexertion during exercise can cause sprains, falls, or joint pain.
- Cardiovascular stress: Starting a high-intensity regimen without clearance from a healthcare provider may pose risks, especially for those with heart disease or hypertension.
- Overtraining: While rare, too much exercise can actually worsen sleep, elevate cortisol levels, and lead to muscle fatigue, especially if the exercise is done close to bedtime.
That said, these risks can be mitigated with proper planning:
- Medical clearance before starting a new routine
- Professional guidance from physical therapists or certified trainers
- Low-impact options like chair squats, wall push-ups, or water-based exercises
- Proper warm-up and cooldown routines to avoid sudden strain
- Avoiding exercise within 1–2 hours of bedtime to prevent overstimulation
Additionally, it’s important to consider comorbid conditions. For instance, a person with Parkinson’s disease may require specialized exercises for balance and fall prevention. Those with diabetes need to monitor blood glucose levels before and after exercise. Exercise plans should be customized, not one-size-fits-all.
How to Incorporate Exercise Into Your Routine
Starting to exercise later in life is one of the best things you can do for your health. The key is to go slow, stay consistent, and choose movements that feel good and support your needs.
Here’s how to get started:
- Begin with small steps. Just 10–15 minutes a day can make a real difference. Work up to 150 minutes of moderate activity per week, like the CDC recommends.
- Add strength training 2–3 times a week. Focus on legs, arms, back, and core. Use light weights, resistance bands, or even just your bodyweight. Chair exercises work too.
- Pick activities that are fun and easy on the joints. Walking, swimming, yoga, or tai chi helps with balance and reduces the risk of falling.
- Time workouts right. Avoid intense exercise two hours before bed. Mornings or late afternoons are better for sleep.
- Listen to your body. Soreness is okay, sharp pain is not. Stay hydrated, know your limits, and talk to your doctor before starting something new.
- Set goals you can stick to. Track your progress to stay motivated and celebrate small wins.
- Get expert help if needed. Trainers, physical therapists, or sleep specialists can help you create a safe, personalized plan.
- Move more during the day. Things like gardening, cleaning, or walking the dog all count. Sitting too much hurts sleep and overall health.
Consistency matters more than intensity. For older adults with insomnia, gentle movement done regularly can be just as powerful as medicine.
How Can the Insomnia and Sleep Institute of Arizona Help?
The Insomnia and Sleep Institute of Arizona is physician-owned and home to top-rated sleep experts who focus solely on helping people sleep better.
From chronic insomnia to complex sleep conditions, we care for both adults and children as young as one. With locations in Scottsdale, Gilbert, and Phoenix and access to the most advanced sleep testing and treatments, you’ll be in the hands of a team recognized nationwide. When sleep struggles take over, reach out to us!
References
- Pakwan Bahalayothin, Kittiphon Nagaviroj, & Thunyarat Anothaisintawee. (2025). Impact of different types of physical exercise on sleep quality in older population with insomnia: a systematic review and network meta-analysis of randomised controlled trials. Family Medicine and Community Health, 13(1), e003056–e003056. https://doi.org/10.1136/fmch-2024-003056
Disclaimer: The information provided in this blog post is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a licensed healthcare provider for recommendations specific to your individual health needs.
