Effects of Physical Activity and Massage Therapy on Sleep Disorders Among Children with Autism Spectrum Disorder: A Systematic Review

Background Sleep disturbances are common for children with autism spectrum disorder (ASD) and can have detrimental effects. Sleep disturbances may negatively impact the general well-being and quality of life of children. Objectives The purpose of this systematic review was to examine the effect of physical activity (PA) interventions and massage therapy (MT) on sleep disturbances in children with ASD. Methods We reviewed empirical research focusing on the effect of PA and MT on sleep-related variables published from inception to January 2023. Five electronic databases (PubMed, MEDLINE, Google Scholar, PsycInfo, and Web of Science) were included in the search. Outcomes included sleep efficiency, sleep-onset latency, sleep duration, sleep behavior, and sleep quality. PEDro and McMaster's scales were used to assess the quality of included studies. Results The search yielded a total of 20 studies meeting all inclusion criteria. Fifteen studies related to the effects of PA and five studies related to the effects of MT on sleep disorders in children with ASD. The total number of participants was 511. Conclusion PA and MT have beneficial effects on sleep efficiency, sleep-onset latency, wake after sleep onset, and sleep quality. In addition, aquatic exercise and swimming were found to be particularly effective in improving sleep in children with ASD.