Evidence for your Practice: Sleep habits and routines

 

 Sleep Habits and Routines of Individuals Diagnosed with Mental and/or Substance-Use Disorder

Article:  Gardner, J., Swarbrick, M., Dennis, S., Franklin, M., Pricken, M., & Palmer, K. (2021). Sleep Habits and Routines of Individuals Diagnosed with Mental and/or Substance-Use Disorders. Occupational Therapy in Mental Health, 37(2), 158-177.

Rationale: Sleep challenges such as insomnia affect approximately 10% of the general population and the challenges are perhaps further problematic for those experiencing mental illness and substance use disorders. Sleep is one of the most frequently reported occupations that individuals with mental health challenges tend to have problems with, particularly sleep preparation and management.

Method: A sleep quality index was used with 52 participants who self-reported as having a mental illness and/or substance use disorder. 13 of the 52 participants completed individual interviews with a focus on exploring sleep routines and habits.

Results: 

• 78.6% of participants reported having poor sleep
• Nearly 50% of participants reported taking medications such as antidepressants, antipsychotics and mood stabilizers
• 52.4% reported sleeping 7 or more hours per night, while 19% of participants reported sleeping 5 or less hours per night; suggesting duration of sleep does not necessarily mean feeling rested the next day. 
• Habits and routines that participants identified as positively impacting their sleep included taking a bath/shower, turning off the lights, listening to music, praying, taking medication, and snacking. 
• Habits and routines that participants reported as negatively impacting their sleep included napping, smoking, consuming caffeine, texting and talking on the phone. 
• Noise was reported as both a facilitator (e.g., listening to relaxing music) and a barrier (e.g., loud cars, animals) to sleep. 
• Toileting during the night was reported to disrupt sleep quality. 

Implications for OT: 

• Occupational therapists are experts in analyzing occupational performance issues and the potential causes of the occupational disruption. Assessing the sleep habits and routines of individuals is an important part of identifying the facilitators and barriers to sleep for clients with mental illness and/or substance use disorder. 
• Sleep may be influenced by personal factors (e.g., health status) and environmental factors (e.g., temperature, noise level, ambient light) and therefore requires a thorough investigation to determine the most appropriate recommendations. 
• Encouraging positive behaviors such as decreased use of technology before bed, turning off the lights, listening to relaxing music, taking medications as prescribed and creating a consistent sleep routine are important. 

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