Mind-body therapies for sleep disturbances, depression, and anxiety in menopausal women: a systematic review and meta-analysis of randomized controlled trials.

Background: Menopause is frequently accompanied by sleep disturbances, depression, and anxiety, negatively affecting women's quality of life. While hormone therapy can be effective, safety concerns highlight the need for accessible non-pharmacological options. Mind-body therapies (MBTs) have emerged as promising interventions, yet their overall efficacy remains unclear. Methods: A systematic review and meta-analysis were conducted on randomized controlled trials evaluating the effects of MBTs-such as Yoga, Mindfulness, Qigong, Art therapy, Music therapy, Dance therapy and Reiki-on sleep, depression, and anxiety in perimenopausal and postmenopausal women. Comparator groups included usual care or no-intervention controls. Eighteen studies involving 1,572 participants were identified through PubMed, Embase, Cochrane Library, and Web of Science (through October 10, 2025). Random-effects models were applied, along with subgroup, sensitivity, and publication bias analyses. Results: MBTs significantly improved sleep quality (SMD = -0.86; 95% CI: -1.24 to -0.48), reduced depression (SMD = -0.79; 95% CI: -1.18 to -0.40), and alleviated anxiety (SMD = -1.13; 95% CI: -1.66 to -0.59), showing moderate-to-large effects. Subgroup analyses showed that mindfulness, music therapy, dance therapy, and Reiki yielded greater psychological benefits than yoga and Qigong. Longer interventions (≥12 weeks) and studies from Asia showed stronger effects, possibly due to differences in intervention type, cultural familiarity, or adherence. Sensitivity analyses confirmed robust results, and no publication bias was detected. Conclusion: MBTs offer moderate-to-large benefits and represent safe, low-risk strategies for managing menopausal symptoms. Expressive approaches, including Mindfulness, Music therapy, and Dance therapy, may provide added value for emotional regulation and psychological well-being. Yoga and Qigong provide stable benefits for sleep improvement. High-quality trials are needed to inform clinical guidelines. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251103844.