Progressive Muscle Relaxation

Last reviewed October 2026 · Based on 17 studies

Bottom line

Progressive muscle relaxation (PMR) improves sleep quality and eases anxiety in pooled randomised trials, with a moderate level of evidence. The trials vary widely in results and size, and several compared PMR only with usual care. Few trials reported side effects, and one review called long-term safety uncertain.

What it helps with

Helps you sleep better — Benefit, evidence grade B (Moderate). Two meta-analyses of randomised trials; downgraded one level for very high heterogeneity (I² 86–92%).
Eases anxiety — Benefit, evidence grade B (Moderate). Meta-analysis of 31 RCTs; downgraded one level for very high heterogeneity (I² 85%).
Helps with cancer-related fatigue — Benefit, evidence grade C (Limited). Meta-analysis of 12 RCTs, but the review itself rates the certainty of evidence for fatigue as low.

What it is

Progressive muscle relaxation involves tensing and then relaxing muscle groups, which helps people notice and reduce physical tension [1]. Some versions include breathing techniques [2]. One trial in burn patients called it Jacobson's relaxation technique [3].

What the research says

Sleep quality. A 2026 meta-analysis of 31 randomised trials (2,277 people) found PMR improved sleep quality compared with controls, with a standardised effect of -1.74. On the Pittsburgh Sleep Quality Index, a common questionnaire, the average score fell 3.8 points more than in controls [4]. A second 2026 meta-analysis of 14 trials (957 people) found a similar benefit [5]. Single trials agree: in 69 people having chemotherapy, PMR done twice a day for eight weeks gave better sleep scores than routine care [6]. In 72 people with rheumatoid arthritis, six weeks of PMR improved sleep and fatigue, while the control group did not change [7].

Anxiety. The 2026 meta-analysis found anxiety scores fell more with PMR than in controls, with a standardised effect of -1.11 [4]. In 67 COVID-19 patients, sessions twice a day for five days reduced anxiety compared with controls [8]. In 57 children with ADHD, adding PMR to sleep hygiene training gave bigger anxiety improvements than sleep hygiene training alone [9].

Cancer-related fatigue. A 2024 meta-analysis of 12 trials (1,047 cancer patients) found PMR improved fatigue, anxiety, depression and sleep quality more than routine nursing care. The review rated the evidence for fatigue and sleep as low certainty [10].

Pain after surgery. In 60 people after open heart surgery, PMR done twice a day for three days lowered pain and improved sleep more than usual care [11].

Doses used in studies

Trials ranged from three days to eight weeks. One burn-patient trial used 20 to 30 minutes a day for three days [3]. A COVID-19 trial used sessions twice a day for five days, supervised by the researcher [8]. A chemotherapy trial used twice a day for eight weeks [6], and a postmenopausal trial used daily practice for eight weeks [2]. A 2026 meta-analysis found no clear link between the number of sessions and the sleep benefit [5].

Safety and interactions

Few trials reported harms. In one COVID-19 review, one study reported that a patient's condition worsened, and the authors said the safety and long-term effects of PMR are uncertain [12]. No data on pregnancy, breastfeeding or medicine interactions were found in the studies read for this page, so people who are pregnant, have a health condition or take medicines should check with a doctor first.

Caveats and open questions

The pooled results vary widely between trials, with heterogeneity (I²) between 85% and 92% [4]. In the 2026 meta-analysis of 14 trials, the sleep benefit was clear in adults under 55 but not in adults aged 55 and older [5]. A 2023 review of four COVID-19 trials (227 people) found anxiety improved, but the sleep result was not statistically significant [12]. Most trials compared PMR with usual care, so they do not show whether it works better than other sleep or anxiety treatments [6][3]. A 2025 network meta-analysis ranked PMR second, after foot reflexology, for sleep in postpartum women, but network comparisons are indirect [13]. In COPD, a 2026 review found PMR improved sleep in the two trials that tested it, too few to rank it [14].