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In the same way the human body requires food, hydration, and oxygen, it also requires sleep. Even among healthy people, the amount and quality of sleep substantially influence health and quality of life because sleep helps regulate physiological functioning. Given the impact of sleep on participation, the American Occupational Therapy Association reclassified sleep from an activity of daily living to an occupational domain. Poor sleep is a frequent medical complaint, especially among populations with neurological impairment. Occupational therapy practitioners should consider routinely screening for factors affecting their clients' sleep. By addressing such factors, as well as related routines and habits, practitioners can enhance the effectiveness of rehabilitation, promote health and well-being, and increase engagement and life quality. Practitioners should acknowledge the importance of sleep in practice, and the study of sleep should be prioritized by researchers in the field to meet client needs and establish evidence for interventions.
Sleep influences mood, behaviors, and energy levels and is vital to participation. Sleep is a state of altered consciousness during which the body rests and restores itself. Because sleep is an occupational domain that plays a critical role in health and well-being, occupational therapy practitioners should consider sleep with clients throughout the lifespan. This article describes the importance of sleep as an occupation and proposes recommendations for increasing occupational therapy's role in addressing this domain, especially with populations with neurological impairment. Improving sleep offers a strategy to prevent physical and psychological comorbidities, reduce health care costs, and increase clients' life quality and satisfaction.
Evolution of Sleep as an Occupational Domain
Adolf Meyer was the first in the occupational therapy field to recognize the vital role of sleep. In "The Philosophy of Occupational Therapy," he proposed that rest and sleep were necessary and of equal importance towork and play inmaintaining health and well-being (Meyer, 1922). The American Occupational Therapy Association (AOTA) originally classified sleep as an activity of daily living. In 2008, rest and sleep were reclassified as an occupational domain in the Occupational Therapy Practice Framework: Domain and Process (2nd ed.; AOTA, 2008). This shiftin focus acknowledged the significant effect rest and sleep can have on participation (Gentry & Loveland, 2013).
Given the unclear, and sometimes controversial, delineation between the definitions of occupation and activity, agreement...