Occupational Therapy for Sleep Difficulties
Introduction
If you are considering occupational therapy as a treatment for sleep difficulties, we want you to be as informed as possible—so we, as OTs, can truly partner to create the best course of treatment for YOU.
In occupational therapy, we tend to work from “menus” of evidence-based assessments and treatments. This gives us the flexibility to meet the specific needs of each patient. Below, you’ll find the assessment and treatment options your therapist may use, along with the evidence supporting them.
At the bottom of this page, you’ll find occupational therapists near you who can support you in addressing your sleep difficulties.
Please note that this page is for educational purposes and does not substitute advice from your medical provider.
Why pursue OT for sleep difficulties?
Occupational therapists view sleep as foundational to overall health and well-being.
Sleep is an area of health that has a direct impact on your ability to engage in all other occupations. Occupational therapists can play a vital role in helping individuals improve their sleep by addressing the factors that impact a person’s ability to fall asleep, stay asleep, and obtain restful sleep.
Unlike other, more invasive intervention options for sleep difficulties—such as prescription medications—occupational therapy focuses on healthy sleep habits and routines, environmental modifications, and stress reduction techniques that help promote more restful sleep.
Sleep difficulties impact a large percentage of the U.S. adult population, with 33% of Americans reporting their sleep as poor (Sleep Health, 2023). The estimated cost of insomnia in the U.S. is close to one billion dollars a year.
Therapy, on the other hand, costs around $100-$200 per session. Conservative treatments like occupational therapy—especially cognitive behavioral therapy for insomnia (CBT-I)—are considered the first-line intervention for insomnia, and they are highly effective in reducing sleep problems and improving sleep, health, and general well-being.
The benefits of quality sleep include improved:
cardiovascular health
energy and mood
mental health
cognition
memory consolidation
immunity
reproductive health
hormone regulation
Related Assessments
Assessments are powerful tools to help us partner in your care. They establish a clear baseline, direct our treatment efforts, and give us a reliable way to track your progress over time. Your team may select some specific measures that fit your unique situation. Here are some examples:
Occupation-focused
Occupation-Focused Assessments1, Sleep-Specific Assessments2
Possible Goal Areas
Therapy works best when there is buy-in from the patient. It is important that you work with your therapist to set treatment goals that truly reflect what’s important to you.
Sleep SMART Goal Bank
Intervention Focus | Example Short Term Goals |
|---|---|
Assistive aids for sleeping | Client will trial 2 different assistive devices during bedtime routine within the next week. |
Relaxation and mindfulness | Client will incorporate and engage in a relaxation activity prior to getting in bed 6 out of 7 nights within the next week. |
Sleep hygiene habits | Client will verbalize 2 sleep hygiene strategies to incorporate into their daily nighttime routine. |
Sleep diary | Client will complete their sleep diary daily 7/7 mornings for the next week. |
Wake up habits/routines | Client will maintain a consistent wake-up time 6/7 days in the next week. |
Sleep restriction | Client will limit napping to 1X/day for no more than 30 minutes for the next week. |
Sleep promoting activities | Client will engage in regular morning exercise 5/7 days this week to promote sleep. |
Wake up habits/routines | Client will utilize assistive aid to wake up at a consistent time 5/7 days within the next week. |
Intervention Focus | Example Long Term Goals |
|---|---|
Sleep Environment Modifications | Client will create a sleep friendly environment to promote sleep within 4 weeks. |
Daily Routine/Habits | By discharge, client will create and adhere to a healthy bedtime routine to promote sleep. |
Sleep Quality | Client will report an overall increase in their sleep quality as assessed by sleep diary ratings by the end of the 4 weeks. |
Sleep Performance | Client will demonstrate a clinically significant increase in their level of satisfaction with sleep performance on the COPM at time of discharge. |
Sleep Quality | Client will demonstrate an increase in their sleep quality as demonstrated by a decrease in their pre-post intervention PSQI score within 4 weeks. |
Treatment Interventions
Person:4,6
Sleep diary tracking7
Sleep physiology/circadian health education8
Health management behaviors
Positioning
Energy conservation9
Pain management
Relaxation/mindfulness, coping skills, stress management7
Sensory needs
CBT-I7
Environment:4,6
Environmental modifications
Education on sleep environment
Sleep hygiene
Sleep aids/adaptive equipment
Limiting screen time/device exposure
Sleep promotion education (including with caregivers/staff)
Occupation:4,6
Consistent sleep schedule
Healthy, consistent daily habits and routines
Wind-down/preparation for sleep
Wake-up habits and routines
Sleep-promoting occupations
Red Flags for Clinicians
Falling asleep while driving or other potentially dangerous situations
Repeated falling asleep without warning
Breathing interruptions or awakenings reported by a bed partner
Discharge Suggestions
Every person is unique, so your individual response to therapy will also be unique. We recommend that you:
Continue to use health management and empowerment strategies to control any remaining symptoms.
Follow recommendations/strategies for habit consistency, like using a habit tracker and adhering to routines post-discharge.
Utilize active coping strategies and proactive problem-solving if sleep becomes disrupted again (e.g., due to stress).
Education Resources for Clients
Education Resources for Clinicians
Choosing a Therapist
If you are looking for an occupational therapy professional near you to help address your sleep difficulties, you can use the OT Near Me Directory below. We’ve highlighted the professionals who have tagged “Insomnia & Sleep” as a focus area.
Note that cognitive behavioral therapy for insomnia is a specific evidence-based approach with its own certification. Therapists who have this certification typically use the CBT-I credential.
Khadijah Guy
OTD, OTR/L, CLT, DCS
Occupational Therapist
Full Circle Therapy & Wellness
Phoenix, Arizona
Health Promotion, Home Modifications, Insomnia & Sleep, Leadership, Lymphedema, Maternal Health, Pelvic Health, Population Health
Christine Urish
PhD, MS, OTR/L, BCMH, FAOTA, CCAP
Occupational Therapist
Drake University
Des Moines, Iowa
ADHD, Anxiety, Chronic Conditions, Coaching, Dementia, Health Promotion, Insomnia & Sleep, Lifestyle Medicine, Obsessive-Compulsive Disorder (OCD), Prevention, Population Health, Social Determinants of Health
Jamie Boldig
MOT, OTR/L
Appleton, Wisconsin
Aging in Place, ADHD, Amyotrophic Lateral Sclerosis (ALS), Anxiety, Aphasia & Communication Disorders, Assistive Technology, Autism, Burns, Cancer, Cerebral Palsy, Chronic Conditions, Chronic Pain, Coaching, Cognitive Rehabilitation, Dementia, Depression & Mood Disorders, Dystonia, Ergonomics, Fitness, Feeding and Eating, Functional Neurological Disorder (FND), Grant Writing, Hand Therapy, Health Data, Health Policy, Health Promotion, Hippotherapy, Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Knowledge Translation, Lifestyle Medicine, Leadership, Medication Management, Multiple Sclerosis, Nature-based, Neurodiversity, Obsessive-Compulsive Disorder (OCD), Orthopedics & Musculoskeletal, Osteogenesis Imperfecta, Parkinson’s, Pelvic Health, Prevention, Population Health, Postural Orthostatic Tachycardia Syndrome (POTS), Rare Diseases, Rheumatic Diseases, Seating and Mobility, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Tourette syndrome, Voice & Fluency
Alicia
OTR/L
MaineHealth Behavioral Health at Spring Harbor
Westbrook, Maine
ADHD, Anxiety, Autism, Coaching, Depression & Mood Disorders, Health Promotion, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Leadership, Neurodiversity, Obsessive-Compulsive Disorder (OCD), Trauma & PTSD
Ashley Halle
OTD, OTR/L, CAPS, LRC
Educator
University of Southern California
Los Angeles, California
Aging in Place, Chronic Conditions, Chronic Pain, Coaching, Dementia, Depression & Mood Disorders, Health Promotion, Insomnia & Sleep
Lauralee Gordon
OTR/L
Flow Therapeutics, LLC
Richmond, Virginia
ADHD, Anxiety, Autism, Cerebral Palsy, Chronic Conditions, Cognitive Rehabilitation, Dementia, Fitness, Hand Therapy, Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Maternal Health, Multiple Sclerosis, Neurodiversity, Neurorehabilitation, Obsessive-Compulsive Disorder (OCD), Orthopedics & Musculoskeletal, Parkinson’s, Pelvic Health, Prevention, Rare Diseases, Seating and Mobility, Sexuality/Intimacy, Spinal Cord Injury, Stroke, TBI, Tourette syndrome
Shubhangi Sharma
OTR, Registered OT (BC)
Shubhangi (Shubhi) Occupational Therapy, Coaching and Consulting
Vancouver, British Columbia
ADHD, Anxiety, Chronic Conditions, Chronic Pain, Coaching, Ehlers-Danlos Syndrome, Ergonomics, Functional Neurological Disorder (FND), Health Promotion, Insomnia & Sleep, Neurodiversity, Rheumatic Diseases, Sexuality/Intimacy, Trauma & PTSD
Samantha Valasek
OTD, OTR/L, ADHD-RSP, CTTS
Spectrum Psych LA
Los Angeles, California
ADHD, Anxiety, Autism, Chronic Conditions, Chronic Pain, Coaching, Ergonomics, Health Promotion, Insomnia & Sleep, Lifestyle Medicine, Leadership, Neurodiversity, Obsessive-Compulsive Disorder (OCD), Sexuality/Intimacy, Trauma & PTSD
Salmin Chacha
OTR/L
Occupational Therapist
AL NOOR TRAINING CENTRE
dubai
ADHD, Augmentative and Alternative Communication, Aquatic Therapy, Aphasia & Communication Disorders, Assistive Technology, Autism, Burns, Cerebral Palsy, Chronic Conditions, Chronic Pain, CIMT, Coaching, Cognitive Rehabilitation, Dementia, Depression & Mood Disorders, Developmental Delays, Dystonia, Ehlers-Danlos Syndrome, Ergonomics, Emergency Department, Feeding and Eating, Functional Neurological Disorder (FND), Grant Writing, Hand Therapy, Health Data, ICU/Critical Care, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Knowledge Translation, Lifestyle Medicine, Low Vision Rehabilitation, Maternal Health, Medication Management, Mitochondrial Disorders, Multiple Sclerosis, Nature-based, Neurodiversity, Neurorehabilitation, NICU, Pelvic Health, Postural Orthostatic Tachycardia Syndrome (POTS), Rare Diseases, Rheumatic Diseases, Seating and Mobility, Sexuality/Intimacy, Spinal Cord Injury, Stroke, Swallowing & Dysphagia, TBI, Trauma & PTSD, Vestibular & Balance Rehab
Marlene Handler
MS, OTR/L, TIPHP, CSOT
The Lifted Lotus, PLLC
Brooklyn, New York
Anxiety, Chronic Pain, Ehlers-Danlos Syndrome, Fitness, Health Promotion, Insomnia & Sleep, Maternal Health, Pelvic Health, Sexuality/Intimacy, Trauma & PTSD
Angela Robertson
OTR/L, ADHD-RSP
Occupational Therapy With Angela, LLC
Baltimore, Maryland
ADHD, Anxiety, Autism, Chronic Conditions, Coaching, Cognitive Rehabilitation, Depression & Mood Disorders, Health Promotion, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Lifestyle Medicine, Leadership, Maternal Health, Medication Management, Multi-tiered System of Supports, Neurodiversity, Obsessive-Compulsive Disorder (OCD), Prevention, Trauma & PTSD
Cynthia Kisik
COTA/L
Patriot at Home
Louisville, Ohio
Aging in Place, Amyotrophic Lateral Sclerosis (ALS), Aphasia & Communication Disorders, Assistive Technology, Burns, Cancer, Cerebral Palsy, Chronic Conditions, Chronic Pain, Dementia, Fitness, Grant Writing, Home Modifications, Insomnia & Sleep, Lifestyle Medicine, Medication Management, Multiple Sclerosis, Nature-based, Neurodiversity, Neurorehabilitation, Orthopedics & Musculoskeletal, Parkinson’s, Pelvic Health, Rare Diseases, Rheumatic Diseases, Seating and Mobility, Sexuality/Intimacy, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Vestibular & Balance Rehab
PJ Bhakta
OTR, OTD, PCES, CSOT
Consultant
TheraSolutions Consulting, LLC
Cedar Park, Texas
ADHD, Chronic Pain, Coaching, Depression & Mood Disorders, Ehlers-Danlos Syndrome, Ergonomics, Fitness, Hand Therapy, Health Data, Health Policy, Health Promotion, Industrial Rehabilitation, Insomnia & Sleep, Knowledge Translation, Lifestyle Medicine, Leadership, Maternal Health, Neurodiversity, NICU, Orthopedics & Musculoskeletal, Pelvic Health, Prevention, Population Health, Sexuality/Intimacy, Social Determinants of Health, Sports Medicine & Performance, Trauma & PTSD
Kimberly Eberly
OTR
Balanced Vision, LLC
Aurora, Nebraska
Aging in Place, ADHD, Autism, Drivers Rehabilitation, Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Low Vision Rehabilitation, Neurorehabilitation, Vestibular & Balance Rehab
Rebecca Villa
OTD, OTR/L, RYT-200
Student
San Diego, California
Aging in Place, Anxiety, Chronic Conditions, Coaching, Health Promotion, Home Modifications, Insomnia & Sleep, Lifestyle Medicine, Maternal Health, Pelvic Health, Prevention, Population Health, Sexuality/Intimacy, Trauma & PTSD
Stacy Simoneaux
OTR/L, MBA-HA, MOccThySt(Hons),
Occupational Therapist
Seattle, Washington
Aging in Place, ADHD, Anxiety, Autism, Cerebral Palsy, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Dementia, Health Data, Health Policy, Health Promotion, Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Leadership, Mitochondrial Disorders, Multiple Sclerosis, Neurodiversity, Obsessive-Compulsive Disorder (OCD), Prevention, Population Health, Social Determinants of Health, TBI, Trauma & PTSD, Tourette syndrome
Hurya Bin sultan
MSc, OTR/L, SIPT, ASI
Educator
King Saud University
Riyadh
Anxiety, Cognitive Rehabilitation, Depression & Mood Disorders, Home Modifications, Insomnia & Sleep, Knowledge Translation, Leadership, Medication Management, Neurodiversity, Obsessive-Compulsive Disorder (OCD), Trauma & PTSD
Monika Lukasiewicz
OTR/L
Occupational Therapist
MollyLu P-LLC
Mesa, Arizona
Aging in Place, Chronic Conditions, Chronic Pain, Coaching, Dementia, Fitness, Health Promotion, Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Lifestyle Medicine, Leadership, Low Vision Rehabilitation, Nature-based, Parkinson’s, Prevention, Population Health, Social Determinants of Health, Stroke
Marissa
OTR/L, OTD, AMPS, CEAS, LRC
Educator
True North Occupational Therapy
Nacka
ADHD, Anxiety, Assistive Technology, Autism, Chronic Conditions, Coaching, Ergonomics, Fitness, Health Promotion, Insomnia & Sleep, Lifestyle Medicine
Alana Woolley
OTD, OTR/L
Occupational Therapist
UnityPoint Meriter
Madison, Wisconsin
ADHD, Autism, Health Policy, Insomnia & Sleep, Knowledge Translation, Neurodiversity, Trauma & PTSD
Shaunna Kotka
OTD, OTR/L, CLT-LANA, CMT
Administrator
Open Grounds Inc.
Marina del Rey, California
ADHD, Anxiety, Cancer, Chronic Conditions, Chronic Pain, Cognitive Rehabilitation, Dementia, Depression & Mood Disorders, Dystonia, Ehlers-Danlos Syndrome, Fitness, Health Promotion, Home Modifications, Insomnia & Sleep, Knowledge Translation, Lymphedema, Medication Management, Neurodiversity, Neurorehabilitation, Obsessive-Compulsive Disorder (OCD), Orthopedics & Musculoskeletal, Parkinson’s, Prevention, Population Health, Postural Orthostatic Tachycardia Syndrome (POTS), Rare Diseases, Rheumatic Diseases, Social Determinants of Health, Sports Medicine & Performance, Stroke, TBI, Trauma & PTSD
Melina McSweeny
S/OT
Student
Xavier University
Columbus, Ohio
Dementia, Insomnia & Sleep, Maternal Health, NICU
Destiney Carmichael
OTS
Student
Xavier University
Cincinnati, Ohio
Aging in Place, ADHD, Amyotrophic Lateral Sclerosis (ALS), Anxiety, Assistive Technology, Autism, Burns, Cancer, Cerebral Palsy, Chronic Conditions, Chronic Pain, CIMT, Cognitive Rehabilitation, Dementia, Dystonia, Ehlers-Danlos Syndrome, Fitness, Feeding and Eating, Functional Neurological Disorder (FND), Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Lymphedema, Maternal Health, Multiple Sclerosis, Nature-based, Neurodiversity, Neurorehabilitation, NICU, Obsessive-Compulsive Disorder (OCD), Orthopedics & Musculoskeletal, Osteogenesis Imperfecta, Parkinson’s, Pelvic Health, Prevention, Postural Orthostatic Tachycardia Syndrome (POTS), Rare Diseases, Rheumatic Diseases, Seating and Mobility, Sexuality/Intimacy, Social Determinants of Health, Spinal Cord Injury, Stroke, TBI, Trauma & PTSD, Vestibular & Balance Rehab
Virginia Padgett
OTS
Student
Xavier University
Verona, Kentucky
ADHD, Anxiety, Autism, Cerebral Palsy, Chronic Conditions, Chronic Pain, Fitness, Feeding and Eating, Home Modifications, Insomnia & Sleep, Intellectual and Developmental Disabilities (IDD), Leadership, Nature-based, Neurodiversity, NICU, Prevention, Postural Orthostatic Tachycardia Syndrome (POTS), Seating and Mobility
Conclusion
Hopefully this article helped you understand what occupational therapy for sleep difficulties entails.
This article is updated once per month based on newly released research. If you have any research you would like us to consider, please contact us.
OT Potential does not endorse any treatments, procedures, products, or therapists referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking medical advice should consult their medical provider.
Contributors
Amanda Carroll
MS, PhD, OTR/L
Amanda L. Carroll, PhD, OTR/L, is an experienced occupational therapist, educator, and PhD trained occupational scientist dedicated to advancing the field of occupational therapy through teaching, research, and community engagement. She is currently an Assistant Professor at the University of Montana’s inaugural Occupational Therapy Doctorate Program.
She earned her Master of Science degree from The University of North Carolina at Chapel Hill in 2012, and her PhD in Occupational Science also from The University of North Carolina at Chapel Hill in 2021. She has practiced in both geriatrics, pediatrics, and mental health for over a decade in a variety of settings including travel therapy, skilled nursing, home health, and private practice. She is currently a member of AOTA and serves on the Research Committee for the Society for the Study of Occupation. She is also the co-owner and co-founder of Well-Rested Therapy, LLC a private community-based OT practice that provides occupational therapy services focused on helping people get a better night’s sleep so they feel well-rested and can participate in the activities they love.
Amanda’s research focuses on the intersection of occupation, mental health, and social determinants of health, with a particular interest in veteran populations, sleep interventions, and rural health disparities. Her work has explored topics such as resilience in older veterans, the role of sleep in shaping veterans’ mental well-being, and the impact of military service on long-term health outcomes. She has been awarded multiple research grants to investigate sleep interventions for veterans, contributing to the development of population-level occupational therapy solutions. Through her leadership, teaching, and research, Amanda is committed to shaping the future of occupational therapy by addressing real-world challenges and promoting occupational justice.
She is originally from North Carolina, and is a proud Tarheel. Growing up in North Carolina, she has always been surrounded by military culture and many of her family members are veterans. Her favorite occupations are spending time with her cats, trying out new recipes, reading historical and fantasy novels, cycling on her Peloton, and spending time in nature with her husband Philip, who is also and OT and professor.
Sarah Lyon
OTR/L
Sarah Lyon, OTR/L, is the CEO of OT Potential. Sarah earned her BA from St. Olaf College and her master’s degree in occupational therapy from New York University. Her diverse clinical background spans multiple settings, including critical access, acute trauma, and state inpatient psychiatric hospitals. In 2011, she founded OT Potential to fulfill the industry's need for reliable, high-quality occupational therapy resources and continuing education.
As a recognized content creator, Sarah has collaborated with top healthcare brands like VeryWell Health, WebPT, and MedBridge. She blends her clinical expertise with a talent for creating clear, action-oriented content that empowers practitioners to excel. Passionate about elevating the OT profession, she has been featured on numerous industry podcasts. Sarah ultimately returned to her roots, running OT Potential and raising her family in her hometown of Aurora, Nebraska.
References
Law M, Baptiste S, McColl M, Opzoomer A, Polatajko H, Pollock N. The Canadian Occupational Performance Measure: An Outcome Measure for Occupational Therapy. Can J Occup Ther. 1990.
Germain A, Hall M, Krakow B, Shear MK, Buysse DJ. A brief sleep scale for Posttraumatic Stress Disorder: Pittsburgh Sleep Quality Index Addendum for PTSD. J Anxiety Disord. 2005.
American Occupational Therapy Association. Occupational Therapy Practice Framework: Domain and Process—Fourth Edition. Am J Occup Ther. 2020.
Ho ECM, Siu AMH. Occupational Therapy Practice in Sleep Management: A Review of Conceptual Models and Research Evidence. Occup Ther Int. 2018.
Baum C, Bass J, Christiansen C. Person-Environment-Occupational Performance (PEOP) Model. In: Christiansen C, Baum C, Bass J, eds. Occupational Therapy: Performance, Participation, and Well-Being. 4th ed. Slack; 2015.
Green A, Brown C. An Occupational Therapist’s Guide to Sleep and Sleep Problems. Jessica Kingsley Publishers; 2015.
Eakman AM, Schmid AA, Rolle NR, Kinney AR, Henry KL. Follow-Up Analyses From a Wait-List Controlled Trial of Occupational Therapist–Delivered Cognitive–Behavioral Therapy for Insomnia Among Veterans With Chronic Insomnia. Am J Occup Ther. 2022.
Faulkner S. Sleep and occupational performance are inseparable: Why occupational therapy practice and research should consider sleep and circadian rhythm. Br J Occup Ther. 2022.
Akbarfahimi M, Nabavi SM, Kor B, Rezaie L, Paschall E. The Effectiveness of Occupational Therapy-Based Sleep Interventions on Quality of Life and Fatigue in Patients with Multiple Sclerosis: A Pilot Randomized Clinical Trial Study. Neuropsychiatr Dis Treat. 2020.
Additional Resources:
Faulkner S, Mairs H. An exploration of the role of the occupational therapist in relation to sleep problems in mental health settings. Br J Occup Ther. 2015.
Leland NE, Marcione N, Niemiec SLS, Kelkar K, Fogelberg D. What is occupational therapy’s role in addressing sleep problems among older adults?. OTJR (Occup Ther J Res). 2014.
Tester NJ, Foss JJ. Sleep as an occupational need. Am J Occup Ther. 2017.
