BACKGROUND: The objective of this study was to compare the impact of traditional Chinese exercise (TCEs) and general aerobic exercise (GAEs) on the sleep quality of university students and to determine which exercise is more effective in improving sleep quality in this specific population. METHODS: We utilized Review Manager 5.3 to analyze data from 21 randomized controlled trials (RCTs), which included a total of 1252 participants. Effect sizes of TCEs and GAEs were compared using a random-effects model. Subgroup analyses were conducted on 3 modulating variables: times per session, frequency per week, and period. RESULTS: A meta-analysis of 14 RCTs showed that both TCEs (standard mean difference (SMD) -0.89, 95% CI -1.18 to -0.61; p < 0.00001) and GAEs (SMD -1.53, 95% CI -2.10 to -0.97; p < 0.00001) can significantly improve the sleep of university students, with a significant difference between TCEs and GAEs (p = 0.05). Both GAEs and TCEs had positive effects on various aspects of sleep quality, including subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction. A subgroup analysis of aerobic exercise showed that the effect size was larger in the 40 to 60 minutes group compared to the 60 to 90 minutes group (SMD -1.89; 95% CI -2.19 to -1.59; p < 0.00001). Furthermore, the effect size was larger in the 3 to 5 times per week group compared to the 2 times per week group (SMD -1.56; 95% CI -2.33 to -0.80; p < 0.0001). The effect size was also found to be larger in a period of 2 to 4 weeks compared to 6 to 18 weeks (SMD -1.85; 95% CI -2.17 to -1.54; p < 0.00001). CONCLUSION: GAEs is more effective than TCEs in improving the sleep quality of university students. An optimal aerobic exercise regimen for enhancing sleep quality among university students involves engaging in sessions lasting 40 to 60 minutes, 3 to 5 times per week, over a duration of 4 weeks.

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