Objective: Sleep-wake disorders is a common disease in children and adolescents. In recent years, there has been an increasing number of studies on the intervention of exercise therapy in sleep-wake disorders. This study aims to systematically review the development status, research frontiers, research hotspots and development trends of exercise therapy in the through bibliometric methods. Methods: The data comes from the Web of Science Core Collection database. Select all the original data from the establishment of the database to 26 April 2024. Summarize the external characteristics of the literature through Web of Science, Use Excel 2021, Origin 2021, VOS viewers 1.6.20 and Cite Space 6.3.R1 to visually analyze countries/regions, institutions, journals, authors, co-cited references and co-occurrence keywords, use the bibliometric online analysis platform (https://bibliometric.com/) to analyze the changes of keywords and extended keywords over the years. Results: We received a total of 775 publications. The works were sourced from 1429 institutions in 75 countries/regions, published in 113 journals, and written by 4332 authors. The number of publications peaked in 2012, 2018, 2019 and 2021 respectively. In the United States, Harvard University and Children (Basel) have the highest number of publications in this field. The analysis of co-cited references shows that there are three main research frontiers in this field, including 24-hour exercise behavior guidelines for children and adolescents, COVID-19 lockdown and cardiometabolic risk. Screen time, mental health, validity, depression, guidelines, stress, and mediterranean diet are still the current research hotspots in the field, and may become potential research hotspots in the future. Conclusion: The development of research in the field of exercise therapy for children and adolescents with sleep-wake disorders is relatively slow, and there is still a lack of cross-regional scientific research collaborations between countries/regions, institutions and individuals. Our research suggests that it may be a worthwhile research direction to promote the establishment of healthy lifestyle behaviors in the gathering environment of children and adolescents, formulate targeted policies for disease prevention, diagnosis and management, strictly implement preventive measures, improve the level of diagnosis, and dig deep into the precise treatment plan of diseases.

1. Arroyo Buenestado, A., & Ribas-Pérez, D. (2023). Early Childhood Caries and Sleep Disorders. J Clin Med, 12(4), 1378. https://doi.org/10.3390/jcm12041378
2. Angelillo, S., Sansone, V., Paduano, G., et al. (2024). The quality of sleep: evaluation among university students. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1270426
3. Agbaje, A. O. (2024). Mediating effect of fat mass, lean mass, blood pressure and insulin resistance on the associations of accelerometer-based sedentary time and physical activity with arterial stiffness, carotid IMT and carotid elasticity in 1574 adolescents. Journal of Human Hypertension, 38(5), 393–403. https://doi.org/10.1038/s41371-024-00905-6
4. Alruwaily, A., Alruwaili, H., Garvey, J., et al. (2022). Can Weight Loss Improve the Cardiovascular Outcomes of Patients with Obesity and Obstructive Sleep Apnea? Hearts, 3(2), 54–65. https://doi.org/10.3390/hearts3020008
5. Breda, M., Belli, A., Esposito, D., et al. (2023). Sleep habits and sleep disorders in Italian children and adolescents: a cross-sectional survey. Journal of Clinical Sleep Medicine, 19(4), 659–672. https://doi.org/10.5664/jcsm.10400
6. Baddam, S. K. R., Canapari, C. A., Van de Grift, J., et al. (2024). Screening and Evaluation of Sleep Disturbances and Sleep Disorders in Children and Adolescents. Psychiatric Clinics of North America, 47(1), 65–86. https://doi.org/10.1016/j.psc.2023.06.005
7. Барладин, О.Р., Вакуленко, Л. О., Храбра С. З., et al. (2022). Dance Therapy in The Rehabilitation of Children with Hearing Impairments (Ukrainian). Naukovyy chasopys Ukrayinsʹkoho derzhavnoho universytetu imeni Mykhayla Drahomanova, 7(152), 24–29. https://doi.org/10.31392/NPU-nc.series15.2022.7(152).06.
8. Carroll, A. J., Appleton, J., & Harris, K. M. (2024). Child sleep problems, maternal sleep and self-efficacy: Sleep’s complicated role in maternal depression. J Sleep Res, 33(2), e14005. https://doi.org/10.1111/jsr.14005
9. Calcaterra, V., Rossi, V., Tagi, V. M., et al. (2023). Food Intake and Sleep Disorders in Children and Adolescents with Obesity. Nutrients, 15(22), 4736. https://doi.org/10.3390/nu15224736
10. Cha, E. J., Lee, Y. J., & Jeon, H. J. (2022). Mother-Adolescent Discrepancies in Reporting Sleep Disturbances: Effects of Diagnosis and Mother’s Occupation. J Korean Med Sci, 37(6), e46. https://doi.org/10.3346/jkms.2022.37.e46
11. Chaput, J. P., Willumsen, J., Bull, F., et al. (2020). 2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5–17 years: summary of the evidence. International Journal of Behavioral Nutrition and Physical Activity, 17(1). https://doi.org/10.1186/s12966-020-01037-z
12. Chen, S. J., Li, S. X., Zhang, J. H., et al. (2023). School-Based Sleep Education Program for Children: A Cluster Randomized Controlled Trial. Healthcare, 11(13), 1853. https://doi.org/10.3390/healthcare11131853
13. Comeras-Chueca, C., Villalba-Heredia, L., Perez-Lasierra, J. L., et al. (2022). Active Video Games Improve Muscular Fitness and Motor Skills in Children with Overweight or Obesity. International Journal of Environmental Research and Public Health, 19(5), 2642. https://doi.org/10.3390/ijerph19052642
14. de Toni, E., & Aicardi, G. (1976). Radioimmunological determination of growth hormone after stimulation with insulin and arginine in 168 subjects with growth disorders (Spanish). Minerva Pediatr, 28(17), 1027–1034.
15. den Harink, T., Blom, N. A., Gemke, R. J. B. J., et al. (2022). Preconception lifestyle intervention in women with obesity and echocardiographic indices of cardiovascular health in their children. International Journal of Obesity, 46(7), 1262–1270. https://doi.org/10.1038/s41366-022-01107-1
16. Donath, C., Atzmüller, L., Florack, J., et al. (2024). The Effect of Exercise Therapy on Adolescent Mental Health: A Systematic Review with Practical Example (German). Z Kinder Jugendpsychiatr Psychother, 52(2), 94–108. https://doi.org/10.1024/1422-4917/a000960
17. El-Sobkey, S. B. (2022). Resistance training is an effective exercise therapy in cardiac rehabilitation program for patients with coronary artery disease: a systematic review. Beni-Suef University Journal of Basic and Applied Sciences, 11(1), 22. https://doi.org/10.1186/s43088-022-00206-2
18. El-Medany, A. Y. M., Birch, L., Hunt, L. P., et al. (2020). What Change in Body Mass Index Is Required to Improve Cardiovascular Outcomes in Childhood and Adolescent Obesity through Lifestyle Interventions: A Meta-Regression. Childhood Obesity, 16(7), 449–478. https://doi.org/10.1089/chi.2019.0286
19. Fishbein, A. B., Cheng, B. T., Tilley, C. C., et al. (2021). Sleep Disturbance in School-Aged Children with Atopic Dermatitis: Prevalence and Severity in a Cross-Sectional Sample. The Journal of Allergy and Clinical Immunology: In Practice, 9(8), 3120–3129.e3. https://doi.org/10.1016/j.jaip.2021.04.064
20. Finkel, M. A., Duong, N., Hernandez, A., et al. (2024). Associations of Infant Sleep Characteristics with Childhood Cognitive Outcomes. Journal of Developmental & Behavioral Pediatrics. https://doi.org/10.1097/dbp.0000000000001311
21. Fulfs, T., Poulain, T., Vogel, M., et al. (2024). Associations between sleep problems and emotional/behavioural difficulties in healthy children and adolescents. BMC Pediatrics, 24(1), 15. https://doi.org/10.1186/s12887-023-04487-z
22. Fernandes, A. E. R., Roveda, J. R. C., Fernandes, C. R., et al. (2023). Relationship between nocturnal enuresis and sleep in children and adolescents. Pediatric Nephrology, 38(5), 1427–1438. https://doi.org/10.1007/s00467-022-05818-5
23. Fang, Y., van Grieken, A., Windhorst, D. A., et al. (2023). Longitudinal associations between parent, child, family factors and dyssomnias in children from birth to 8 years: The CIKEO study. Journal of Affective Disorders, 323, 496–505. https://doi.org/10.1016/j.jad.2022.12.012
24. Fernandez-Mendoza, J., Bourchtein, E., Calhoun, S., et al. (2021). Natural history of insomnia symptoms in the transition from childhood to adolescence: population rates, health disparities, and risk factors. Sleep, 44(3). https://doi.org/10.1093/sleep/zsaa187
25. Gopinath, B., Hardy, L. L., Baur, L. A., et al. (2012). Physical Activity and Sedentary Behaviors and Health-Related Quality of Life in Adolescents. Pediatrics, 130(1), e167–e174. https://doi.org/10.1542/peds.2011-3637
26. Godoy-Cumillaf, A., Fuentes-Merino, P., Farías-Valenzuela, C., et al. (2023). The Association between Sedentary Behavior, Physical Activity, and Physical Fitness with Body Mass Index and Sleep Time in Chilean Girls and Boys: A Cross-Sectional Study. Children, 10(6), 981. https://doi.org/10.3390/children10060981
27. Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F.C. (2020). Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1.6 million participants. Lancet Child Adolesc Health, 4(1), 23–35. https://doi.org/10.1016/S2352-4642(19)30323-2
28. Genoni, G., Menegon, V., Monzani, A., et al. (2021). Healthy Lifestyle Intervention and Weight Loss Improve Cardiovascular Dysfunction in Children with Obesity. Nutrients, 13(4), 1301. https://doi.org/10.3390/nu13041301
29. Hulst, R. Y., Pillen, S., Voorman, J. M., et al. (2020). Sleep health practices and sleep knowledge among healthcare professionals in Dutch paediatric rehabilitation. Child Care Health Dev, 46(6), 703–710. https://doi.org/10.1111/cch.12799
30. Hoyer, S., Dietz, M., Ambrosi-Schneider, A. S., et al. (2024). Memory Consolidation and Sleep in Children with Epilepsy: A Systematic Review. Pediatric Neurology, 158, 66–70. https://doi.org/10.1016/j.pediatrneurol.2024.05.020
31. Huang, S., Huang, Y., Gu, Y., et al. (2023). Adherence to 24-Hour Movement Guidelines in Relation to the Risk of Overweight and Obesity Among Children and Adolescents. Journal of Adolescent Health, 73(5), 887–895. https://doi.org/10.1016/j.jadohealth.2023.06.009
32. Kim, W. P., Kim, H. J., Pack, S. P., et al. (2023). Machine Learning—Based Prediction of Attention-Deficit/Hyperactivity Disorder and Sleep Problems with Wearable Data in Children. JAMA Network Open, 6(3), e233502. https://doi.org/10.1001/jamanetworkopen.2023.3502
33. Kalak, N., Gerber, M., Kirov, R., et al. (2012). Daily Morning Running for 3 Weeks Improved Sleep and Psychological Functioning in Healthy Adolescents Compared with Controls. Journal of Adolescent Health, 51(6), 615–622. https://doi.org/10.1016/j.jadohealth.2012.02.020
34. Katz, E. S., Moore, R. H., Rosen, C. L., et al. (2014). Growth After Adenotonsillectomy for Obstructive Sleep Apnea: An RCT. Pediatrics, 134(2), 282–289. https://doi.org/10.1542/peds.2014-0591
35. Lister, N. B., Baur, L. A., Felix, J. F., et al. (2023). Child and adolescent obesity. Nature Reviews Disease Primers, 9(1). https://doi.org/10.1038/s41572-023-00435-4
36. Li, X., Lau, F. L. F., Chiu, W. V., et al. (2024). An Open-Label Pilot Trial of a Brief, Parent-Based Sleep Intervention in Children With ADHD. Journal of Attention Disorders, 28(8), 1173–1185. https://doi.org/10.1177/10870547241233731
37. Liu, H., Ma, S., Feng, L., et al. (2023). Longitudinal association of nighttime sleep duration with emotional and behavioral problems among rural preschool children. European Child & Adolescent Psychiatry, 33(1), 267–277. https://doi.org/10.1007/s00787-023-02153-4
38. Liu, W., Du, Q., Zhang, H., et al. (2022). The gut microbiome and obstructive sleep apnea syndrome in children. Sleep Medicine, 100, 462–471. https://doi.org/10.1016/j.sleep.2022.09.022
39. Liebig, L., Bergmann, A., Voigt, K., et al. (2023). Screen time and sleep among medical students in Germany. Scientific Reports, 13(1), 15462. https://doi.org/10.1038/s41598-023-42039-8
40. Liu, Y. (2023). Ideological and political reform in physical education courses combined with recreational exercise therapy on depression among college students. CNS Spectrums, 28(S2), S75–S76. https://doi.org/10.1017/s1092852923004406
41. Li, J., & Chen, C. (2022). CiteSpace: Text Mining and Visualization in Scientific Literature. Beijing: Capital University of Economics and Business Press.
42. López-Gil, J. F., Tapia-Serrano, M. A., Sevil-Serrano, J., et al. (2023). Are 24-hour movement recommendations associated with obesity—related indicators in the young population? A meta‐analysis. Obesity, 31(11), 2727–2739. https://doi.org/10.1002/oby.23848
43. Liu, J., Zhu, L., Chen, Z., et al. (2022). Effects and dose-response relationship of exercise training on cardiometabolic risk factors in children with obesity. Journal of Pediatric Endocrinology and Metabolism, 35(10), 1278–1284. https://doi.org/10.1515/jpem-2022-0395
44. Lee, M. W., Yang, N. J., Mok, H. K., et al. (2024). Music and movement therapy improves quality of life and attention and associated electroencephalogram changes in patients with attention-deficit/hyperactivity disorder. Pediatrics & Neonatology. https://doi.org/10.1016/j.pedneo.2023.11.007
45. Leiter, L. A., Fitchett, D. H., Gilbert, R. E., et al. (2011). Cardiometabolic Risk in Canada: A Detailed Analysis and Position Paper by the Cardiometabolic Risk Working Group. Canadian Journal of Cardiology, 27(2), e1–e33. https://doi.org/10.1016/j.cjca.2010.12.054
46. López-Gil, J. F., García-Hermoso, A., Sotos-Prieto, M., et al. (2023). Mediterranean Diet-Based Interventions to Improve Anthropometric and Obesity Indicators in Children and Adolescents: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Advances in Nutrition, 14(4), 858–869. https://doi.org/10.1016/j.advnut.2023.04.011
47. Mi, J., Zhang, L., Sun, W., et al. (2023). Research hotspots and new trends in the impact of resistance training on aging, bibliometric and visual analysis based on Cite Space and VOS viewer. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1133972
48. McDonald, A., & Joseph, D. (2019). Paediatric neurodisability and sleep disorders: clinical pathways and management strategies. BMJ Paediatr Open, 3(1), e000290. https://doi.org/10.1136/bmjpo-2018-000290
49. Mingli, R. A. O. (2015). Neurology, 3rd ed. Beijing: People’s Medical Publishing House.
50. Masi, A., Mendoza Diaz, A., Tully, L., et al. (2021). Impact of the COVID-19 pandemic on the well-being of children with neurodevelopmental disabilities and their parents. Journal of Paediatrics and Child Health, 57(5), 631–636. https://doi.org/10.1111/jpc.15285
51. Marquez-Vazquez, J. F., Arellano-Saldaña, M. E., Rojas-Martinez, K. N., & Carrillo-Mora, P. (2022). Comparative Efficacy of Botulinum Toxin in Salivary Glands vs. Oromotor Therapy in the Management of Sialorrhea in Cerebral Palsy Impact on Sleep Quality. Front Rehabil Sci, 3, 875235. https://doi.org/10.3389/fresc.2022.875235
52. Melkani, G. C., & Panda, S. (2017). Time‐restricted feeding for prevention and treatment of cardiometabolic disorders. The Journal of Physiology, 595(12), 3691–3700. https://doi.org/10.1113/jp273094
53. Nagata, J. M., Yang, J. H., Singh, G., et al. (2023). Cyberbullying and Sleep Disturbance Among Early Adolescents in the U.S. Academic Pediatrics, 23(6), 1220–1225. https://doi.org/10.1016/j.acap.2022.12.007
54. Navarro Vergara, A., & González Rabelino, G. (2022). Sleep disorders and their impact on neurodevelopment (Spanish). Medicina (B Aires), 82(3), 30–34.
55. Nur Zati Iwani, A. K., Jalaludin, M. Y., Roslan, F. A., et al. (2023). Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1097675
56. Pease, E., Shekunov, J., Savitz, S. T., et al. (2023). Association between early childhood sleep difficulties and subsequent psychiatric illness. J Clin Sleep Med, 19(12), 2059–2063. https://doi.org/10.5664/jcsm.10756.
57. Pietrobelli, A., Pecoraro, L., Ferruzzi, A., et al. (2020). Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity, 28(8), 1382–1385. https://doi.org/10.1002/oby.22861
58. Park, H. J., Rhie, S. J., & Shim, I. (2023). The effects of physical exercise therapy on weight control: its regulation of adipocyte physiology and metabolic capacity. Journal of Exercise Rehabilitation, 19(3), 141–148. https://doi.org/10.12965/jer.2346232.116
59. Qu, G., Liu, H., Han, T., et al. (2024). Association between adverse childhood experiences and sleep quality, emotional and behavioral problems and academic achievement of children and adolescents. European Child & Adolescent Psychiatry, 33(2), 527–538. https://doi.org/10.1007/s00787-023-02185-w
60. Roliz, A. H., & Kothare, S. (2022). The Interaction Between Sleep and Epilepsy. Curr Neurol Neurosci Rep, 22, 551–563. https://doi.org/10.1007/s11910-022-01219-1
61. Richter, K., Baumgärtner, L., Niklewski, G., et al. (2020). Sleep disorders in migrants and refugees: a systematic review with implications for personalized medical approach. EPMA Journal, 11(2), 251–260. https://doi.org/10.1007/s13167-020-00205-2
62. Reis, L. N., Reuter, C. P., Okely, A., et al. (2024). Replacing screen time, with physical activity and sleep time: influence on cardiovascular indicators and inflammatory markers in Brazilian children. Jornal de Pediatria, 100(2), 149–155. https://doi.org/10.1016/j.jped.2023.10.007
63. Reinehr, T., Lass, N., Toschke, C., et al. (2016). Which Amount of BMI-SDS Reduction Is Necessary to Improve Cardiovascular Risk Factors in Overweight Children? The Journal of Clinical Endocrinology & Metabolism, 101(8), 3171–3179. https://doi.org/10.1210/jc.2016-1885
64. Schmickler, J. M., Blaschke, S., Robbins, R., et al. (2023). Determinants of Sleep Quality: A Cross-Sectional Study in University Students. International Journal of Environmental Research and Public Health, 20(3), 2019. https://doi.org/10.3390/ijerph20032019
65. Schmidt, S. C. E., Anedda, B., Burchartz, A., et al. (2020). Physical activity and screen time of children and adolescents before and during the COVID-19 lockdown in Germany: a natural experiment. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-78438-4
66. Tubbs, A. S., Taneja, K., Ghani, S. B., et al. (2023). Sleep continuity, timing, quality, and disorder are associated with suicidal ideation and suicide attempts among college students. Journal of American College Health, 1–9. https://doi.org/10.1080/07448481.2022.2155828
67. Thabet, F., & Tabarki, B. (2023). Common sleep disorders in children: assessment and treatment. Neurosciences, 28(2), 85–90. https://doi.org/10.17712/nsj.2023.2.20220111
68. Tang, J., Chen, L. L., Zhang, H., et al. (2024). Effects of exercise therapy on anxiety and depression in patients with COVID-19: a systematic review and meta-analysis. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1330521
69. e, A. C. Y., Lee, P. H., Sit, C. H. P., et al. (2023). Comparing the Effectiveness of Physical Exercise Intervention and Melatonin Supplement in Improving Sleep Quality in Children with ASD. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-023-06172-7
70. Taylor, A., Kong, C., Zhang, Z., et al. (2023). Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder. Child and Adolescent Psychiatry and Mental Health, 17(1). https://doi.org/10.1186/s13034-023-00588-w
71. Viner, R. M., Gireesh, A., Stiglic, N., et al. (2019). Roles of cyberbullying, sleep, and physical activity in mediating the effects of social media use on mental health and wellbeing among young people in England: a secondary analysis of longitudinal data. Lancet Child Adolesc Health, 3(10), 685–696. https://doi.org/10.1016/S2352-4642(19)30186-5
72. Walsh, J. J., Barnes, J. D., Cameron, J. D., et al. (2018). Associations between 24-hour movement behaviours and global cognition in US children: a cross-sectional observational study. Lancet Child Adolesc Health, 2(11), 783–791. https://doi.org/10.1016/S2352-4642(18)30278-5.
73. Welsh, J. S. (2016). Commentary: Are Children Like Werewolves? Full Moon and Its Association with Sleep and Activity Behaviors in an International Sample of Children. Frontiers in Pediatrics, 4. https://doi.org/10.3389/fped.2016.00094
74. Xu, G., Li, L., Yi, L., et al. (2023). A pooled analysis of temporal trends in the prevalence of anxiety-induced sleep loss among adolescents aged 12–15 years across 29 countries. Front Psychiatry, 14:1259442. https://doi.org/10.3389/fpsyt.2023.1259442
75. Yücel, G., Kadir Arslan, A., Özgör, B., et al. (2023). Sleep quality and depression in mothers of children with epilepsy and its relation to their children’s sleep. Epilepsy & Behavior, 149, 109493. https://doi.org/10.1016/j.yebeh.2023.109493
76. Zhang, Y., Yao, J., Li, W., et al. (2023). Global research trends and hotspots in pharmaceutical care: a bibliometric analysis and visualisation using Cite Space and VOS viewer. European Journal of Hospital Pharmacy, ejhpharm-2022-003617. https://doi.org/10.1136/ejhpharm-2022-003617
77. Zhang,X., Liu, J., Ni, Y., et al. (2024).Global Prevalence of Overweight and Obesity in Children and Adolescents: A Systematic Review and Meta-Analysis. JAMA Pediatr. 178(8):800-813. doi: 10.1001/jamapediatrics.2024.1576