The impact of physical activity on insomnia, compared to pharmacological interventions: a narrative review

Background: Insomnia is a significant public health concern associated with reduced quality of life and persistent symptoms in many individuals. While cognitive behavioral therapy is the first-line treatment, its high cost limits accessibility, and there is growing interest in non-pharmacological approaches such as physical activity.Material and methods: A comprehensive search was conducted in PubMed, Google Scholar, and the Cochrane Library using predefined keywords to identify observational studies, clinical trials, reviews, systematic reviews, and meta-analyses on physical activity and pharmacotherapy for insomnia. Of the 384 records initially identified, 38 studies meeting the inclusion criteria were included in the final analysis.Results: Physical activity emerges as a promising adjunctive treatment for chronic insomnia, offering moderate improvements in subjective sleep quality without the adverse effects and dependency risks associated with pharmacotherapy.Conclusions: While pharmacological treatments provide rapid symptom relief and improve objective sleep parameters, physical activity offers broader health benefits and may serve as a complementary strategy for long-term insomnia management. Future research directly comparing these approaches should clarify their roles in optimizing treatment strategies for insomnia.