Importance of Sleep

Occupations are various kinds of life activities in which individuals, groups, or populations engage in. Occupational therapists work towards assisting individuals to be independent and functional within these occupations. There are 8 categories of occupations:

1.     Activities of daily living (ADLs)

2.     Instrumental activities of daily living (IADLs)

3.    Rest and Sleep

4.     Education

5.     Work

6.     Play

7.     Leisure

8.     Social participation

This blog is aimed at looking into the occupation of rest and sleep.

The American Occupational Therapy Association (AOTA) breaks the occupation of rest and sleep into three categories:

1. Rest

   1. The ability to engage in actions that place you in a relaxed state.

2. Sleep preparation

   1. The ability to engage in routines that prepare you for a comfortable rest (establishing a night time routine) such as grooming, undressing, reading, prayers, listening to music, saying goodnight to others, etc.

3. Sleep participation

   1. Looks at the ability to participate in sleep without disruption

We have five different brain wave patterns that determine which state of arousal we may be in and are directly related to sleep.

1. Beta State

   1. In this state your body and brain are active

2. Alpha State

   1. In this state your body is calm but brain is active

   2. This is the state for learning, thinking and processing information

3. Theta State

   1. In this state your body is calm and brain is calming down

   2. Examples may be:

      1. Mediation

      2. The state you are in prior to falling asleep and when you first wake up

4. Delta State

   1. This is where deep sleep occurs

   2. REM sleep

   3. This is the state you need to get to for a restful sleep to occur

5. High Beta

   1. State of anxiety and agitation

If a child is in a beta state and you ask them to lay down and go to bed, that is too big of a jump for them to fall asleep. Children need to progress from beta → alpha → theta → delta. Delta state is where recovery sleep occurs and the brain is able to turn off and relax.

Sleep latency vs. duration

1. Sleep latency

   1. This is looking at how long it takes your child to fall asleep

2. Sleep duration

   1. This is looking at how your child is sleeping throughout the night. Are they waking up, coming to your room, going to the bathroom, tossing and turning?

   2. Does your child’s bed look very messy in the morning?

      1. This is a sign your child was tossing and turning throughout the night and often means they did not make it into that delta state and they were stuck in theta state. Often these children are hitting delta state right before waking up. It is often difficult to wake these children up in the morning.

If a child isn’t getting a good night’s sleep you will most likely see functional difficulties throughout the day; such as:

1.     Difficulty participating in school

2.     Potential for increased tantrums/ behaviors

3.     Reduced focus/ concentration

4.     May appear drowsy or disinterested throughout the day

5.     May present with high activity levels (trying to wake themselves up through movement)

Occupational Therapists work on addressing sleep through implementation of child specific sensory diets

 Written by Kelsey Conlon MS, OTR/L

 References

American Occupational Therapy Association. Occupational Therapy Practice Framework. 3rd ed., American Occupational Therapy, 2014