Using Occupational Therapy Process Addressing Sleep‑Related Problems in Neurorehabilitation: A Cross‑sectional Modeling Study

Introduction: Sleep is one of the main occupations defined in the occupational therapy (OT) Practice Framework-4. Methods: A survey link was sent to registered OT practitioners in Florida (N = 14,978) in September 2019 through E-mail addresses obtained from the Florida Department of Health website. A convenience sample of 213 OT practitioners responded; the majority were female (87%), with 56% reporting over 10 years of experience treating patients with neurological disorders. The person-environment-occupation-performance (PEOP) OT process provided the guiding framework for the proposed model. Spearman’s rho correlation coefficients determined the correlations between the variables of interest. Regression coefficients attained through hierarchical ordinal logistic regression estimated the log odds between the variables. Results: Therapists who wrote more sleep-oriented goals were predicted to use a greater variety of sleep-related assessments (odds ratio [OR] = 1.256; 95% confidence interval [CI] = 1.171–1.347). Furthermore, a greater repertoire of sleep interventions was predicted when more types of sleep assessments were utilized (OR = 2.134 (95% CI = 1.750– 2.602); more clients expressed sleep-related concerns to the OT practitioners (OR = 1.207; 95% CI = 1.044–1.395); and when the OT practitioners worked in a greater number of clinical settings (OR = 1.308; 95% CI = 1.113–1.539). Conclusion: The findings confirmed that the PEOP model might guide the OT service process when addressing sleep-related problems in neurorehabilitation. However, variations between settings and environmental facilitators/barriers may also play a role in sleep-related interventions.