The effects of progressive muscle relaxation on sleep quality in adults: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: With the increasing number of people suffering from insomnia, sleep has evolved into a global public health issue. Compared to the side effects and instability of drug treatments, people are constantly seeking non-pharmacological treatments to improve sleep quality. Progressive muscle relaxation (PMR) has gradually come into focus. Because existing evidence remains inconsistent, this study conducted a systematic review and meta-analysis. METHODS: As of May 2026, studies related to progressive muscle relaxation and sleep quality were identified through searches of five databases, including CINAHL, Embase, PubMed, Scopus, and Web of Science. Sleep quality outcomes were synthesized using a random-effects meta-analysis. analyses were conducted according to participant type (cancer patients and non-cancer patients) and age group (Age < 55 years and Age ≥55 years). Meta-regression was used to examine whether the number of progressive muscle relaxation sessions was associated with sleep quality. Sensitivity analysis and publication bias assessment were performed. RESULTS: Fourteen studies involving 957 participants were included in the final analysis. The pooled findings indicated that progressive muscle relaxation improved sleep quality (Hedges g = -1.24, 95% CI -1.71--0.77, p < 0.001, I 2 = 85.5%). Improvements were observed in both cancer patients (Hedges g = -1.17, 95% CI -2.24--0.09, I 2 = 86.8%) and non-cancer patients (Hedges g = -1.29, 95% CI -1.94--0.65, I 2 = 86.5%), with a larger effect observed among non-cancer patients. When participants were grouped by age, a significant benefit was found in adults younger than 55 years (Hedges g = -1.40, 95% CI -2.12--0.69, I 2 = 89.4%), whereas no significant improvement was detected among adults aged 55 years and older (Hedges g = -1.17, 95% CI -2.67-0.32, I 2 = 77.5%). Meta-regression did not identify a significant association between the number of progressive muscle relaxation sessions and sleep quality (p = 0.2106). CONCLUSIONS: The available evidence suggests that progressive muscle relaxation improves subjective sleep quality in adults. Beneficial effects were observed in both cancer and non-cancer populations, whereas the effects among older adults remain uncertain. Sleep quality improvements also do not appear to be related to the number of progressive muscle relaxation sessions. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251267826, Identifier: CRD420251267826.