Exercise interventions for the treatment of inflammatory factors in adults with chronic insomnia: Systematic review and meta-analysis

Inflammatory factors play a crucial role in insomnia in adults, and the effect of exercise on improving these factors remains controversial. To explore this further a systematic review and meta-analysis were conducted on randomized controlled trials from 2000 to 2024 involving adults with insomnia who underwent aerobic, resistance, or combined exercise interventions lasting up to three months. Primary outcomes were changes in interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels. A total of 10 studies involving 718 participants were included in the analysis. The results indicated that exercise interventions significantly reduced IL-6 (SMD = -0.66, 95% CI: -1.08 to -0.24, P = 0.002) and TNF-α (SMD = -0.57, 95% CI: -0.97 to -0.16, P = 0.006). In subgroup analysis, moderate-intensity resistance exercise with a duration of 45 minutes per session, 3-4 times per week for 24 weeks, had the most significant effect on IL-6, while moderate-intensity aerobic exercise with a duration of 25-40 minutes per session, 3-4 times per week for 24 weeks, had the greatest effect on TNF-α. In conclusion, while the duration and type of exercise session varied (45 minutes of resistance exercise for IL-6 compared to 25-40 minutes aerobic exercise for TNF-α), exercising for 3-4 times per week for 24 weeks at a moderate intensity appears to be the most effective for improvements in IL-6 and TNF-α in adults with insomnia. • This study showed that exercise as a therapeutic approach to improve inflammation levels in insomnia patients can effectively improve inflammatory factor indicators (IL-6, TNF-α) in insomnia patients. • Inflammatory factor indicators such as IL-6 and TNF-α can also be used as mediators of exercise and insomnia. • Exercise improves their IL-6 and TNF-α levels, which depends on various factors including exercise type, duration, intensity, frequency of exercise and body composition, gender, age. • For the improvement of IL-6 levels, a moderate-intensity resistance exercise regimen—comprising sessions lasting longer than 45 minutes, performed 3–4 times per week for 24 weeks—is recommended. In order to improve TNF-α levels, a moderate-intensity aerobic exercise program—consisting of sessions lasting 25–40 minutes, performed 3–4 times per week for 24 weeks—is advised.