SIGNIFICANCE: Current literature suggests that sleep has a direct influence on all aspects of life; however, it is underrecognized by many occupational therapists (OTs). With literature supporting the negative impact of poor sleep on a person’s occupational performance and overall recovery from injury, it is imperative that OTs are addressing sleep with their clients. In occupational therapy history, addressing sleep has long been a topic of controversy among occupational therapy professionals. The American Occupational Therapy Association (AOTA) officially took a stand on this issue in 2008 with the reclassification of sleep from an activity of daily living (ADL) to an area of occupation in the Occupational Therapy Practice Framework: Domain and Process. Given that this change has occurred within the last 10 yr, there has been limited evidence to support the status and qualities of OTs with regard to the occupation of sleep. In this research, we specifically aimed to contribute to the occupational therapy literature regarding (1) whether OTs were addressing sleep, (2) any specific qualities of OTs who are addressing sleep (i.e., an OT’s professional consideration of sleep and region of practice), (3) when OTs are addressing sleep during treatment, (4) which assessments OTs are using to evaluate sleep, and (5) which interventions are being utilized. This research also serves to bring awareness to increased prevalence of sleep-related problems and the need for OTs to address these problems with their clients.

INNOVATION: Given that treatment of sleep has been a controversial topic within the profession, it is important for professionals to have knowledge regarding how sleep is classified by AOTA and how it is addressed by occupational therapy practitioners across the country. In this research, we specifically targeted OTs who are members of AOTA in hopes of detecting any trends regarding the status and qualities of OTs who were addressing sleep. The results of this research challenge OTs to increase their awareness and knowledge with regard to sleep and the occupational performance challenges that it presents to clients. The results suggest that more education needs to occur among occupational therapy professionals to develop appropriate sleep assessments and evidence-based support for interventions that are successfully utilized by OTs. With the prevalence of sleep-related problems, addressing the occupation of sleep is certainly a potential area of growth for the profession of occupational therapy.

APPROACH: Research questions included the following: (1) What is the current status of OTs in addressing the occupation of sleep? (2) What are the qualities of OTs who are addressing the occupation of sleep? (3) What, if any, assessments are OTs using to assess the occupation of sleep? (4) What interventions are OTs implementing to address the occupation of sleep?

Sleep has been identified as an essential component to a person’s physical health and emotional well-being, which directly affects a person’s daily occupational performance. Research states that sleep is vital to one’s overall health and quality of life. The AOTA Scope of Practice and the Framework refer to sleep as an occupation that should be treated by OTs. Yet, there is limited and controversial research existing in the literature regarding whether, or how, they are addressing problems with sleep. In addition, there is minimal knowledge regarding the use of standardized and nonstandardized assessments and interventions that are being utilized to measure a client’s sleep performance. Therefore, the purpose of this study is to investigate the current status and qualities of occupational therapy professionals who are members of AOTA in addressing the occupation of sleep.

METHOD: In this research, we implemented a cross-sectional, nonexperimental, mixed-method research design in which we utilized a convenient nonprobability sample of OTs who are members of AOTA and who participate in AOTA-regulated Special Interest Section (SIS) forums. Researchers posted a 12-question, web-based survey link to selected AOTA-regulated SIS forums for a span of 25 days. Participants read over the posting and gave consent by voluntarily choosing to complete the survey.

A pilot test of the survey was conducted before dissemination to AOTA-regulated SIS forums. A link to the survey was then posted to SIS forums that were relevant to the occupation of sleep, had recent activity, and had high volumes of posts. The link was posted to these forums multiple times over the span of 25 days. We obtained qualitative and quantitative data from the participants, which were analyzed using SPSS Version 22.0 and Microsoft Excel. The targeted outcomes were to investigate the status and qualities of OTs who were members of AOTA in addressing the occupation of sleep with their clients, and which assessments and interventions were utilized.

A cross-sectional, nonexperimental, mixed-method research design was implemented. We utilized a web-based survey method to obtain information from occupational therapy practitioners who are members of AOTA regarding the occupation of sleep. This survey method allowed researchers to collect data from a large number of respondents with relatively minimal financial expenditure in a short time period.

To discern how many therapists in the population reported to be addressing sleep, we performed a frequency analysis. On the basis of the therapists, or participants, who reported to address sleep, chi-square analyses were then performed between addressing sleep and various therapist qualities, including years of practice, level of education, professional consideration of sleep, region of practice, age of population treated, and practice setting. On the basis of a significance level of p < .10 for the chi-square analyses, logistic regression was then performed to identify any qualities that may be predictor variables describing OTs who are addressing sleep. Assessments and interventions utilized were also assessed with frequency distribution.

RESULTS: In response to the status of OTs addressing sleep, the data indicate that most OTs are addressing sleep in multiple stages of the occupational therapy process, especially the early stages of evaluation, goal-setting, and intervention. From the sample drawn, OTs in the Northeast region are more likely to address sleep than OTs in other regions of the country. It was also found that most of the OTs surveyed are relying on nonstandardized assessments. Furthermore, it was discovered that the most prominent focus of OT intervention when addressing sleep involves implementing various routines for clients to complete prior to sleep and making sure the surrounding environment and sleep space are appropriate for sleep. Another notable finding was that the majority of OTs consider sleep to be an ADL rather than an area of occupation.

CONCLUSION: Many OTs still consider sleep to be an ADL, despite the AOTA’s classification of sleep as an area of occupation. OTs in the Northeast region are addressing sleep more than in any other region of the country. There is a need for further education and evidence-based practice regarding assessments and interventions that can be utilized as well as awareness on the AOTA’s reclassification of the occupation of sleep among occupational therapy professionals.