# The Impact of Physical Activity on Sleep in Alcohol Users: A Systematic Review

## TL;DR

Physical activity may improve sleep in people who use alcohol, but more research is needed to determine the best ways to use it for this purpose.

## Contribution

This paper systematically reviews the limited evidence on physical activity's impact on sleep in alcohol users.

## Key findings

- 81.8% of selected studies show physical activity's positive association with sleep in alcohol users.
- Physical activity reduces insomnia and sleep fragmentation while improving sleep quality and duration.
- There is a lack of studies on nonclinical alcohol users and patients with alcohol use disorder.

## Abstract

Alcohol misuse impairs sleep quality and circadian rhythms. Yet, sleep is essential, as a lack of sleep is a predictive factor for addiction and relapse risk in patients with alcohol use disorder (AUD). On the contrary, effective insomnia treatment after withdrawal increases abstinence. Meanwhile, physical activity (PA) has been shown to improve sleep quality and circadian rhythms in nonclinical population. Hence, it would be interesting to assess the impact of PA on sleep in alcohol users with and without dependence. Systematic search was conducted using Prisma guidelines for the screening and ROB‐1 for bias analysis of randomized controlled trial (RCT). Out of 4995 studies screened, none assess as main purpose the impact of PA on sleep in alcohol users. Still, 81.8% of the selected studies, in their secondary outcomes, highlight PA's positive association with sleep in alcohol users with or without dependence. Main positive sleep outcomes were insomnia and sleep fragmentation reduction as well as sleep quality and duration improvement. There is a lack of publication regarding the impact of PA on sleep in nonclinical alcohol users and AUD patients. Still, PA appears to enhance sleep in both populations. Further well‐designed RCTs are needed to produce robust data. In the first instance, feasibility study should be performed as adhesion can be an issue in the population. Finally, different PA programs (frequency, intensity, time, type and duration) should be compared to determine the optimal dose in different AUD status (intoxication, withdrawal and abstinence).

Alcohol misuse impairs sleep whereas physical activity enhances it in ordinary population. Furthermore, sleep disturbances increase consumptions and relapse risk in patients with alcohol dependence. Thus, exercise could be used as a nonpharmaceutic tool to improve sleep in alcohol users. Systematic search of the literature was performed to ensure exercise has been shown to enhance sleep in this population. 4995 articles arose, yet 11 were selected as others did not answer the problematic. None of the selected studies had as main purpose to assess exercise impact on sleep in alcohol users. Yet, in secondary outcomes, 81.8% highlight physical activity's positive association with sleep in alcohol users with or without dependence. More studies are needed to precise programs modalities according to patients’ alcohol use and sleep profile.