Introduction: Aging is directly related to sleep problems. Primary insomnia has a negative impact on the lives of elderly adults, altering cognitive and metabolic functions. Physical activity is positively related to improvement in sleep quality. The objective of this systematic review was to analyze the effects of physical activity programs in healthy elderly individuals aged 60 years or older, using the Pittsburgh Sleep Quality Index (PSQI) as a tool. Methods: The search was performed in the PubMed and Scielo databases, July 2021. Only randomized clinical trials that evaluated the role of physical exercise in the sleep quality of elderly patients were selected by two independent reviewers. Results: The result of the PSQI analysis showed that compared with the control condition, the exercise intervention was beneficial for the groups with insomnia (SMD: −0.57; 95% CI: −0.73 to −0.4; p < 0.00001; I2 = 53%) and without insomnia (SMD: −0.61; 95% CI: −0.75 to −0.47; p < 0.00001; I2 = 73%) and for the two groups combined (SMD: −0.59; 95% CI: −0.70 to −0.49; p < 0.0001, I2 = 68%). Conclusion: The systematic and continuous practice of physical exercise significantly improves perceived sleep quality in elderly individuals. Therefore, physical activities can be used as a tool to prevent sleep disorders and improve health in general. Future studies may clarify the comparison between aerobic and resistance exercises, evaluate the dose–response relationship and include more participants.
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