Effects of mind-body therapies on sleep quality in perinatal women: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND

Sleep quality often worsens in perinatal women because of physiological, endocrine, and psychosocial changes. This may increase the risk of maternal and infant complications, making it a public health concern. Because pharmacological treatments may pose safety risks, mind-body therapies have gained attention as a safe non-pharmacological option. However, current evidence mainly focuses on single intervention types, and their overall effect on sleep quality in perinatal women remains unclear.

METHODS

We systematically searched seven databases-PubMed, Web of Science, Embase, the Cochrane Library, Scopus, EBSCO, and ScienceDirect-and other sources up to January 20, 2026, to identify randomized controlled trials examining the effects of mind-body therapies on sleep quality in perinatal women. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias using the Cochrane Risk of Bias 2 (ROB2) tool. Meta-analysis was performed in Stata 17 using a random-effects model. Subgroup, sensitivity, and publication bias analyses were also conducted. In addition, the certainty of evidence for the primary outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

A total of 13 randomized controlled trials involving 782 participants were included. The main interventions were mindfulness, Pilates, and yoga. Meta-analysis showed that, compared with controls, mind-body therapies significantly improved sleep quality in perinatal women (MD = -2.63, 95% CI -3.36 to -1.90). However, substantial heterogeneity was observed across studies (I2 = 89.0%, P < 0.001). Subgroup analyses showed significant between-group differences by country (P < 0.05), intervention duration (P < 0.01), and session length (P < 0.05), suggesting that these factors may partly explain heterogeneity. Sensitivity analysis and risk-of-bias assessment suggested that the results were statistically robust, and no significant publication bias was detected (P = 0.900). According to GRADE, the certainty of evidence for the primary outcome was rated as low.

CONCLUSIONS

Mind-body therapies effectively improve sleep quality in perinatal women and may serve as a useful adjunct in clinical sleep health management. However, the certainty of evidence was rated as low according to GRADE; therefore, these findings should be interpreted cautiously and further confirmed by high-quality studies.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261290532, identifier: CRD420261290532.