A systematic review (10 RCT, 2 non-randomised CT, n=690) (2020) demonstrated improvement in sleep quality with higher intensity and better effect with multimodal activity compared with sleep hygiene advice . The intervention 2-3 times a week 20-60 minutes over 3-16 weeks using a range of activities: resistance training, body weight functional mobility exercises, QiGong, yoga, Brazilian samba, cardio, strengthening. Controls were either receiving regular rehabilitation or on waiting list and in one study had high quality sleep hygiene advice. Assessment was measured by questionnaire and in the 1 high quality RCT polysomnography was used – Sleep efficiency, wake after sleep onset, total sleep time and time in slow wave sleep was better than compared to control .
Chronic activity has better improvement in sleep architecture than acute .
Quality of Evidence
A – This is based on a high-quality systematic review and meta-analysis.
Strength of Recommendation
1 – Studies on sleep in Parkinson’s have shown subjective and objective improvement in sleep.
Moderate to maximal intensity activity appears to be more effective to improve sleep quality than milder intensities.
Multimodal activity programmes appear to have a larger effect on sleep quality than a single type of exercise.
Chronic high intensity activity in People with Parkinson’s has a positive effect on sleep architecture.
 Cristini et al. The effects of exercise on sleep quality in persons with Parkinson’s disease: A systematic review with meta-analysis. Sleep Medicine Reviews Volume 55, February 2021, 101384
 Amara AW et al. Randomised Controlled Trial of Exercise on Objective and Subjective Sleep in Parkinson’s Disease. Movement Disorders. 2020, 25(6).