Progressive muscle relaxation technique improves sleep quality and mental health: A systematic review and meta-analysis of randomized controlled trials.

PURPOSE: To evaluate the effectiveness of Progressive Muscle Relaxation (PMR) in improving sleep quality and mental health in adults. METHODS: This systematic review and meta-analysis followed PRISMA 2020 guidelines. Randomized controlled trials assessing PMR's effect on sleep quality were included. Databases searched included PubMed, Embase, Cochrane and Web of Science. Outcomes included sleep quality, anxiety, and quality of life. Effect sizes were pooled using Standard Mean Difference (SMD) or Mean Difference (MD), and heterogeneity was assessed with the I2. Subgroup analysis was performed according to the duration of PMR intervention in weeks. Statistical analysis was conducted with Rstudio version 4.4.1. RESULTS: Thirty-one RCTs involving 2277 patients were included. PMR significantly improved sleep quality compared to the control group, with a SMD of -1.74 (95% CI -2.14 to -1.34; I2 = 92.1%). Pittsburgh Sleep Quality Index (PSQI) showed a mean difference of -3.79 (95% CI -4.78 to -2.79; I2 = 94.2%), also indicating statistical significance. Furthermore, PMR significantly reduced anxiety, with an SMD of -1.11 (95% CI -1.69 to -0.53; I2 = 85%), and improved quality of life, which had an SMD of 1.32 (95% CI 0.53 to 2.12; I2 = 83%). Subgroup analysis by PMR duration showed effectiveness across all intervention periods. Despite the high heterogeneity, sensitivity analyses confirmed consistent beneficial effects across all outcomes. CONCLUSION: PMR is a non-pharmacological intervention that improves sleep quality and mental health in adults, with effects that vary across populations and settings.