We aimed to analyse the available scientific evidence on the effects of exercise programs on sleep quality in autism spectrum condition. Studies were searched in five electronic databases (MEDLINE/PubMed, Web of Science, EBSCOhost Environment Complete, Dialnet Plus and Scopus) until February 2024 (updated in August 2024). A total of ten randomized clinical trials were included. The pooled mean difference for subjective sleep duration (Child's Sleep Habits Questionnaire [CSHQ] sub-scale), total CSHQ score, objective sleep duration and objective efficiency were - 1.62 points (95 % confidence interval [CI] - 2.34 to - 0.91; p < 0.001), -9.43 points (95 % CI: -16.89 to -1.97, p < 0.001), 0.42 h (95 % CI: 0.05-0.80, p = 0.03) and 9.91 % (95 % CI: 5.04-14.78, p < 0.001), respectively. In conclusion, exercise can serve as an adjunct therapy for managing sleep-related problems among children on the autism spectrum.
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