Abstract

Background: Sleep disorders are one of the prevalent health-related issues among older adults, significantly impacting their quality of life. Poor sleep quality can have adverse effects on individuals' health and increase the risk of cardiovascular diseases, anxiety, stroke, cancer and mortality. Due to the side effects of sleep medications in older adults, exercise and physical activity have been highlighted as non-pharmacological strategies. This systematic review aimed to investigate the effects of endurance training components on sleep quality in older men.  Methods: Following PRISMA 2020 guidelines, four databases (PubMed, Scopus, Web of Science, and SID) were systematically searched for studies published between 2010 and 2024. Studies were included if they assessed the effects of endurance exercise on sleep quality in older men (≥60 years) using the Pittsburgh Sleep Quality Index (PSQI). Following screening of 761 records, eight studies met the inclusion criteria and were synthesized narratively. In total, these studies involved 300 older male participants. Risk of bias was evaluated using appropriate tools based on the study design. Results: Of the eight included studies, six reported statistically significant improvements in sleep quality following endurance training. Moderate-intensity interventions, especially those performed 3 times/week for a duration of 6 to 12 weeks, were the most frequently associated with statistically significant improvements in sleep quality. Moreover, training in structured environments such as elderly centers or gyms also appeared beneficial. One study provided subgroup data on exercise timing, indicating that participants who completed their exercise sessions more than 8 hours before bedtime experienced better sleep outcomes. Conclusion: Findings suggest that endurance exercise may be an effective non-pharmacological strategy to improve sleep quality in older men, particularly when programs are designed with moderate intensity, frequency, and duration. Future research should address sex-specific factors by including and comparing older women and systematically investigate the role of exercise timing to optimize interventions for improving sleep in diverse elderly populations.

Keywords: Endurance exercise; Sleep quality; Older men; Aging; Physical activity; Pittsburgh Sleep Quality Index (PSQI); Systematic review