Sleep participation is vital for optimal occupational participation and performance including everyday tasks such as driving, participation in formal education, safety maintenance, self-care, work, and leisure (AOTA, 2015). 

 

Obtaining adequate amounts of sleep can decrease the risk for chronic diseases such as hypertension, diabetes, depression, obesity, and cancer. Sleep insufficiency can also result in early mortality, decreased quality of life, and poor productivity (CDC, 2015).

 

Populations that may benefit from occupational therapy to address sleep disorders include children with Autism Spectrum Disorder and older adults in long-term care (AOTA, 2020).  Additionally, evidence supports the use of occupational therapy for improved sleep among veterans and individuals with PTSD (Eakman et al., 2017) and shift workers (Jarnefelt et al., 2017).

 

Occupational therapists can help individuals across the lifespan with sleep insufficiency and sleep disorders through the use of evidence-based sleep promotion practices (AOTA, 2020).  

 

According to AOTA, 2020, occupational therapy interventions that can promote optimal sleep performance include:

• Client and caregiver education on sleep misconceptions and expectations

• Addressing secondary conditions that may result in poor sleep quality (i.e. pain, anxiety, depression)

• Promoting positive health behaviors such as smoking cessation, avoidance of caffeine, proper nutrition, and exercise

• Establishing routines for waking and sleeping

• Addressing deficits in bed mobility and toileting, which may disrupt sleep

• Promoting individualized sleep hygiene routines that facilitate restorative sleep

• Educating clients on cognitive-behavioral strategies that promote sleep

• Improving stress management and time management skills

• Addressing sensory processing disorders and providing environmental modifications (noise, light, temperature, bedding, technology) as needed

• Advocating for laws that protect workers from excessive work schedules​

​

Cognitive Behavioral Therapy for Insomnia (CBT-I) is an evidence-based, structured method for treating insomnia that does not require medication (SleepFoundation.org, 2020).  CBT-I “aims to improve sleep by identifying and changing the negative thoughts and behaviors related to it, such as cognitive traps and beliefs concerning sleep restriction” (Ho & Siu, 2018, p. 4-9).  Participants’ progress is often monitored with a sleep diary (Ho & Siu, 2018).  

 

In a study by Eakman et al. (2017), the effects of CBT-I on insomnia among post-9/11 veterans in college was explored.  Participants engaged in seven weeks of multi-component CBT-I which consisted of sleep restriction, stimulus control, psycho-education, sleep hygiene, and mindfulness.  Results revealed that participants in the treatment group had significant reductions in insomnia, depression, anxiety, stress, and dysfunctional sleep beliefs.  They also demonstrated significant improvements in social role satisfaction and meaningfulness in daily activities.

 

In a study by Jarnefelt et al. (2014), the effectiveness of CBT-I among daytime and shift workers was examined over a 24-month time frame.  Results demonstrated that CBT-I had positive effects on participants’ self-perceived severity of insomnia, sleep-related dysfunctional cognitions, and psychiatric symptoms.