We spend a third of our life sleeping, and we know from research and from everyday experience that how we sleep impacts on how we think and feel, and how we perform in our daily occupations. It is debated whether sleep itself is an occupation, or a meaningful activity (as we are unconscious during sleep), but going to bed, getting to sleep, and waking up and getting up, certainly are meaningful and important activities. Although for some it is easy to have good sleep and to have an adaptive sleep routine, for many it is not easy, and requires attention to the impact of environments and routines, and the use of a range of skills. This is where occupational therapists can help.
A person’s sleep is totally intertwined with their social and physical environment and their daytime routine. Occupational therapists are ideally placed to help people adjust their environment or routine in a client centred way, to improve their wellbeing.
Sleep is also affected by some skills, such as self-awareness, and self-control. For example it is a skill to learn and practice the ability to stop playing computer games and go to bed, or to resist having coffee too late in the day. Many higher level skills such as the ability to self-sooth are also very helpful for maintaining sleep during stressful times. Occupational therapists are ideally placed to help people develop skills, in a graded way, and to build confidence and self-efficacy around these skills.
People’s skills are also affected by their sleep; if the client is performing significantly less well than expected – have they slept? (for example, was there a lot of disturbance on the ward last night?) Poor sleep in particular can have quite an effect on attention and concentration, risk taking behaviour, and emotional regulation. So its useful to be aware of the impact of poor sleep as an occupational therapist assessing skills, and sometimes improving sleep can improve people’s occupational performance.