Can Pilates Help with Stress, Anxiety and Sleep?

By Katherine, Lead Instructor, Certified Pilates Instructor

Pilates may help you sleep better, but the evidence for stress and anxiety is much weaker. A 2020 meta-analysis of six trials found people doing Pilates reported better sleep quality than non-exercising groups (Chen et al., 2020). The largest recent review found effects on anxiety and depression limited or non-significant (Tsartsapakis et al., 2026), so think of Pilates as calming movement, not treatment.

Key takeaways

• Sleep is the strongest result: six trials (477 people) found lower, meaning better, Pittsburgh Sleep Quality Index scores with Pilates, though the trials varied widely (Chen et al., 2020).

• Anxiety and depression are the weak spot: a 2026 review of 32 trials found evidence for these outcomes "limited or non-significant" (Tsartsapakis et al., 2026).

• The same review did find benefits for quality of life and self-esteem, with a lot of variation between studies.

• Many people find Pilates calming, but the breath and focus explanation is plausible, not proven.

• Pilates is not a substitute for care if you have an anxiety disorder, depression or ongoing insomnia. Talk to your family doctor.

What does the research say about Pilates and sleep?

The best available evidence is a systematic review and meta-analysis of randomized controlled trials by Chen and colleagues. It pooled six trials with 477 participants and found that Pilates groups had significantly lower Pittsburgh Sleep Quality Index (PSQI) scores than groups that did not exercise (mean difference of -3.60 points, 95% confidence interval -5.41 to -1.78) (Chen et al., 2020). The PSQI is a questionnaire where a lower score means better self-reported sleep.

There are real limits. The results varied enormously from trial to trial (an I² of 97%, which means the studies disagreed far more than chance would explain), so the exact size of the benefit is uncertain. The trials relied on questionnaires, not sleep monitoring. Pilates did not significantly reduce the use of sleep medication. And in the subgroup analyses, there was no significant improvement in PSQI scores for healthy participants over 40 or for postmenopausal women (Chen et al., 2020).

The fair summary is this: a small set of fair-quality trials suggests Pilates improves how people rate their own sleep. It does not show that Pilates treats insomnia or any diagnosed sleep disorder, because the trials were not done in people with those diagnoses. For the wider picture, see our guide to what the research actually shows about the benefits of Pilates.

Can Pilates reduce anxiety and depression?

In 2026, Tsartsapakis and colleagues published the largest recent meta-analysis we could find: 32 trials with 1,264 participants. The overall effect of Pilates on mental health outcomes was statistically inconclusive when the data were pooled directly. A significant pooled effect (g = 0.393, p = 0.023) appeared only after a statistical adjustment for the type of outcome measured, and the studies differed substantially from each other (I² = 91.7%) (Tsartsapakis et al., 2026).

The authors' own conclusion is the most useful part. They found demonstrated benefits for positive outcomes, namely quality of life and self-esteem, while evidence for negative psychological indicators such as depression and anxiety "remains limited or non-significant" (Tsartsapakis et al., 2026).

So Pilates may help your quality of life and self-esteem. It has not been shown to reliably lower anxiety or depression scores.

What about stress?

We found no Pilates-specific review focused on everyday stress, so we will not pretend there is one. What we can say comes from exercise in general. Canada's 24-Hour Movement Guidelines recommend at least 150 minutes of moderate to vigorous aerobic activity a week, muscle-strengthening activities at least twice a week, and 7 to 9 hours of good-quality sleep with consistent bed and wake times for adults aged 18 to 64. The guidelines connect following these recommendations with better outcomes that include anxiety, depression and quality of life (CSEP, 24-Hour Movement Guidelines).

Pilates can be one part of that pattern if you enjoy it enough to keep going, but it does not replace aerobic activity.

Why do so many people find Pilates calming?

This section is explanation, not proof. Pilates asks you to coordinate your breath with movement and to concentrate on how you are moving.

Breathing is the best-studied piece. A systematic review of three small studies found that diaphragmatic (belly) breathing may reduce stress measured by both biological markers and self-report, though the studies were small and varied too much to pool (Hopper et al., 2019). Two cautions apply. That research was not about Pilates, and Pilates usually teaches lateral (ribcage) breathing, which is different. Our guide to how to breathe in Pilates explains the technique. We do not know whether breath is why people feel calmer after class.

A simple evening routine

This is a gentle sequence for the hour before bed, about 10 minutes, on a mat or a firm bed. No trial has tested this routine. The NHS advises relaxing for at least an hour before bed and avoiding exercise in the 4 hours before bed, so keep this as gentle breathing and stretching, not a workout (NHS, Insomnia).

1. Resting breath (2 minutes). Lie on your back with your knees bent. Breathe in through your nose, letting your ribs widen, and breathe out slowly through your mouth. Keep it comfortable and never force it.

2. Pelvic tilts (8 slow repetitions). Breathe out as your lower back gently presses toward the floor, and breathe in as it releases.

3. Knee sways (6 each side). With your knees bent, let both knees drift slowly to one side and back, keeping your shoulders heavy.

4. Cat-cow on hands and knees (6 slow repetitions). Round your spine as you breathe out, and lengthen it as you breathe in, staying in a comfortable range.

5. Rest position (1 to 2 minutes). Sit your hips back toward your heels, rest your forehead down on your arms or a cushion, and breathe slowly.

Keep the effort low; if it feels like work, you are doing too much for this time of day.

Exercise is only one piece of sleep. HealthLink BC advises going to bed and getting up at the same times each day, having no caffeine for at least six hours before bedtime, avoiding alcohol before bed, limiting devices in the hours before sleep, and keeping your bedroom quiet, dark and cool (HealthLink BC, Sleeping Better).

Is Pilates good if sleep problems came with menopause?

The Chen review found no significant improvement in sleep scores for postmenopausal women in its subgroup analysis, so we would not promise it. Our guide to Pilates for perimenopause and menopause covers what it can and cannot do.

Safety note: This article is general information, not medical advice, and Pilates is not a treatment for anxiety, depression or sleep disorders. See your family doctor if anxiety or low mood is getting in the way of daily life. The same goes if you have had trouble sleeping for months or often feel anxious at night or have frequent nightmares (NHS; HealthLink BC). If you are thinking about suicide, call or text 9-8-8 any time, day or night, anywhere in Canada (Government of Canada). Stop any movement that hurts, and stop exercising and seek medical advice if you feel dizzy, faint or have chest pain. If breathing exercises make you lightheaded or more anxious, stop and return to normal breathing. We adapt sessions around what you and your health care provider share with us, and we work alongside your care team, not in place of it.

Trying a calming class with us in Markham

If you would like to move in a small, focused setting, our Small Group Pilates Class (reformer, maximum 3 people, 55 minutes, drop-ins welcome) is a good place to start, and your instructor can adapt exercises to you. We are in Markham and welcome clients from across York Region. You can book a class online. If you have never tried Pilates, our guide to what to expect at your first class will help you feel ready.

Frequently asked questions

Is it better to do Pilates in the morning or evening for sleep?

There is no research we know of that picks a best time for Pilates and sleep. HealthLink BC suggests regular exercise and working out what time of day suits your own sleep patterns (HealthLink BC). If a class leaves you energized, try an earlier slot and keep the late evening for the gentle routine above.

Can Pilates replace therapy or medication for anxiety?

No. The best current evidence does not show that Pilates reliably reduces anxiety, and it should never replace treatment for a diagnosed anxiety or depressive disorder (Tsartsapakis et al., 2026). It can sit alongside care your doctor or therapist recommends, so tell them you are doing it.

How long before Pilates might improve my sleep?

We cannot give a reliable timeline. The sleep trials were fairly short, and results differed a lot between them (Chen et al., 2020). Attend regularly for several weeks and keep a simple note of how you sleep. Our guide to how long Pilates results take covers the wider picture.

Will I find Pilates relaxing as a beginner?

Possibly, though it may feel demanding at first. Early sessions involve learning new positions and breathing patterns, which can feel like effort before it feels calming. Our guide to Pilates for beginners explains how the first few sessions usually go.

Sources

1. Chen Z, Ye X, Shen Z, Chen G, Chen W, He T, Xu X (2020). Effect of Pilates on Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Neurology, 11:158. https://pubmed.ncbi.nlm.nih.gov/32265816/

2. Tsartsapakis I, Zafeiroudi A, Kouthouris C (2026). Effects of Pilates-Based Exercise on Mental Health, Psychological Well-Being, and Quality of Life: A Systematic Review and Meta-Analysis. Sports (Basel), 14(5):171. https://pubmed.ncbi.nlm.nih.gov/42188548/

3. Hopper SI, Murray SL, Ferrara LR, Singleton JK (2019). Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review. JBI Database of Systematic Reviews and Implementation Reports, 17(9):1855-1876. https://pubmed.ncbi.nlm.nih.gov/31436595/

4. Canadian Society for Exercise Physiology. Canadian 24-Hour Movement Guidelines for Adults (18 to 64 years). https://csepguidelines.ca/guidelines/adults-18-64/

5. HealthLink BC. Sleeping Better. https://www.healthlinkbc.ca/healthwise/sleeping-better

6. NHS. Insomnia. https://www.nhs.uk/conditions/insomnia/

7. Government of Canada. Mental health support: get help. https://www.canada.ca/en/public-health/services/mental-health-services/mental-health-get-help.html