Effect of mind–body therapies on anxiety, depression and sleep quality in college students: a network meta-analysis

TL;DR

This study compares mind-body therapies like Qigong and yoga to see which are most effective for reducing anxiety, depression, and improving sleep in college students.

Contribution

The study provides a network meta-analysis comparing the relative effectiveness of various mind-body therapies for mental health and sleep outcomes in college students.

Findings

Qigong was found most effective for depression and sleep quality, with yoga being most effective for anxiety.

Qigong outperformed yoga and Baduanjin in treating depression and sleep issues.

The SUCRA ranking identified Qigong as the top intervention for sleep and depression, and yoga for anxiety.

Abstract

Mind–body therapies (MBTs) have demonstrated beneficial effects on anxiety, depression, and sleep quality in college students. However, few studies have compared the efficacy of different types of MBTs. Therefore, we conducted this study to compare and rank the relative effects of various MBTs on these outcomes.

A systematic search was conducted across seven electronic databases (inception-July 8, 2025) for randomized controlled trials investigating the effects of MBTs on depression, anxiety and sleep quality among college students. Literature selection was performed in accordance with the PICOS framework, and data extraction was carried out independently by two reviewers. Risk of bias was assessed via the Cochrane risk of bias tool, version 2 (RoB 2.0) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Both pairwise and network meta-analyses were performed via Stata software, which generated forest, network, and funnel plots. Furthermore, we adopted the surface under the cumulative ranking curve (SUCRA) to evaluate and rank the intervention effects of different MBTs on depression, anxiety and sleep quality among college students.

Twenty-seven eligible studies with 2,664 participants were included. This network meta-analysis revealed significant differences in the impact of MBTs on sleep quality among college students compared with the control group. Baduanjin [SMD = −1.29, 95% CrI (−2.67, −0.02)] and Qigong [SMD = −2.24, 95% CrI (−3.85, −0.44)] demonstrated the most notable effects. Additionally, for anxiety, yoga [SMD = −3.72, 95% CrI (−6.26, −1.47)] was significantly more effective than the control. Furthermore, for depression, Qigong [SMD = −3.9, 95% CrI (−5.76, −1.37)] was significantly better than the control group. Furthermore, Qigong was significantly more effective than yoga [SMD = 3.78, 95% CrI (0.96, 5.99)] and Baduanjin [SMD = 3.35, 95% CrI (0.03, 5.27)]. The SUCRA ranking identified Qigong (SUCRA = 90.5%) as the best intervention for sleep quality, yoga (SUCRA = 89.0%) for anxiety, and Qigong (SUCRA = 95.0%) for depression.

The current evidence indicates that Qigong is the optimal intervention for alleviating depression and improving sleep quality, whereas yoga is the most effective intervention for alleviating anxiety. Nevertheless, due to the limited number of studies included, further research is needed to enhance the reliability of the findings.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251104941, identifier (CRD420251104941).

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