# Effects of Physical Exercise on Substance Use Disorder: A Comprehensive Review
## 3 Results
### Assessment and Effects of Physical Exercise on Sleep Quality
#### 3.2.1 Sleep Quality and Types of Physical Exercise in Individuals with SUD  
Among the extensive range of studies employing physical exercise programs to improve the quality of life in individuals with SUD, sleep quality remains one of the least studied variables. No analyses or reviews have been found examining the impact of physical exercise on sleep quality specifically in this population. A systematic review and network meta-analysis focusing on older adults found better sleep quality in groups combining moderate-intensity exercise (walking) with muscle endurance exercises [86]. Interventions employing mind-body disciplines are those that most frequently consider this variable, reporting significant reductions in sympathetic activity and sympatho-drenal reactivity, which in turn facilitate parasympathetic system activation and reduce sleep disturbances [87]. In individuals with SUD, studies employing mind-body disciplines report heterogeneous results regarding sleep quality. Some studies concluded that these interventions did not lead to improvements compared to standard treatments [57; 72]. Similarly, those studies that did find significant improvements in certain scores failed to show consistent effects across different components of the PSQI. Improvements were often limited to components such as daytime dysfunction and total PSQI scores [32; 35; 50]. This lack of consensus suggests that the effects of mind-body interventions on sleep quality may not be as pronounced and may not represent the optimal strategy for improving sleep. This variability could be attributed to the wide variety of programs encompassed under the term \"mind-body\". For example, programs involving Qigong and Tai Chi have shown significant reductions in PSQI scores, indicating improvements in sleep quality (\(p<0.01\); \(p<0.01\)) [35; 50]. However, these effects were not replicated in other interventions involving disciplines like Chan-Chuang [57] or Yoga [72]. The literature on the effects of aerobic exercise on sleep quality is limited. In the two studies identified, the analyses focused only on the effect of aerobic exercise programs on total PSQI scores. In both interventions, aerobic training programs led to significant improvements in sleep quality compared to standard therapy (\(p<0.01\)) [42; 43]. The number of studies comparing aerobic exercise interventions with mind-body programs is limited to one [35]. This study reported that, while aerobic exercise was effective in improving various sleep components, such as general sleep quality (\(p<0.01\)), latency (\(p<0.05\)), total sleep duration (\(p<0.01\)), efficiency (\(p<0.01\)), and total PSQI score (\(p<0.01\)), Qigong produced superior improvements in scores related to latency (\(p<0.01\)), sleep disturbances (\(p<0.01\)), and daytime dysfunction (\(p<0.01\)) compared to directed aerobic activities [35]. 2.2 Frequency, Duration, and Intensity of Physical Exercise in Individuals with SUD for Improving Sleep Quality  
Among the protocols designed to improve sleep quality, programs typically range from a minimum duration of three months to a maximum of eight months, with exercise frequencies of three to five sessions per week. Regarding the optimal exercise intensity for improving sleep quality, the available evidence remains limited. For moderate-intensity exercise, only one study has examined its effect on sleep quality in individuals with SUD. In this study, the experimental group followed a 12-week exercise program consisting of five weekly sessions of one hour each, including activities such as cycling, jogging, and calisthenics at intensities of 70-75% HRmax. The training program resulted in significant reductions (F = 12.88; \(p<0.01\); \(\eta^{2}\) = 0.31) in global PSQI scores compared to the group receiving standard therapy [43]. Similarly, the effects of high-intensity exercise programs on sleep quality in individuals with SUD are also limited. Only one study has investigated this aspect to date [42].