Engage During the Day for Better Sleep - AOTA Everyday Evidence

We all know sleep is important, but more than a third of American adults are not getting enough sleep. Occupational therapist Donald Fogelberg, Ph.D., OTR/L, discusses the distinct value of occupational therapy services to help you get a better night’s sleep. Fogelberg is one of the coauthors of the recent AJOT article, Napping and Nighttime Sleep: Findings From an Occupation-Based Intervention. Find more information on occupational therapy’s role in rest and sleep, check out AOTA’s Tip Sheet.

Listen to the 5-minute AOTA Everyday Evidence Podcast on getting better sleep on the embedded player or listen to the podcast on Stitcher.

AOTA's Digital Editor Stephanie Yamkovenko is the podcast moderator.


Yamkovenko: How well did you sleep last night? Sleep is one of the most important things we do every day. But more than a third of American adults are not getting enough sleep. Occupational therapist Don Fogleberg has been researching sleep for the past 8 years.

Fogleberg: Sleep is one of those things that is incredibly easy to overlook in our daily lives and we kind of take it for granted when it's working well, but when it's not, the effects are so pervasive and detrimental that I'm really pleased that it's getting some attention.

Yamkovenko: What happens when we're not sleeping well?

Fogleberg: We tend not to feel very well physically, we’re often tired, we fatigue more easily. It affects how we think and our ability to focus on specific things. It impacts our ability to make decisions and judgments. And this is going to have pretty widespread impacts then on how we function in a whole variety of different occupations and things we do day-to-day, whether it's at work or school or out socializing with people.

Yamkovenko: If you’re worried about how a sleep problem is affecting your daily life and activities, Fogleberg recommends talking to an occupational therapist.

Fogleberg: I think initially what the occupational therapist would do would be to try to pinpoint what the difficulty is in causing sleep problems and get a better description of the type of problem that the person is having. Is it a problem with falling asleep? Is it a problem staying asleep once they get to sleep? Or is it a problem with the timing of their sleep. One of the reasons that I think OT is so well placed to look at sleep is that we're used to kind of breaking down that holistic, complex, multi-leveled phenomenon and seeing where the problems lie.

Yamkovenko: It’s easy to say you need more sleep. It’s harder to implement. Occupational therapy practitioners are experts in helping people create and adhere to new routines and habits.

Fogleberg: One of the other things that OTs can do to help people get better sleep would be to look at their daily routines and their habits because we know that there are some things that make it more likely to get good sleep, like timing of exercise, timing of meals, when you have your last caffeine, etc.

Yamkovenko: Fogleberg’s recent coauthored study in the American Journal of Occupational Therapy looked at the napping habits of older adults. Daytime naps are not always beneficial for adults.

Fogleberg: If people aren't getting enought sleep at night, then it's better to nap than not nap. But if the daytime sleep starts to replace sleep at night then it creates a problem, because then we're not getting as much good quality sleep at night.

Yamkovenko: Fogleberg’s study found a connection between engaging in meaningful activities during the day and getting better sleep at night. Fogleberg explains that connection.  

Fogleberg: Engaging in occupations and daily activities they can help us structure our time in a more beneficial way, and that type of regularity is definitely helpful in promoting healthy sleep habits. And also just by increasing our physical activity that helps to increase sleep drive, which is kind of the central nervous system’s need for sleep. So you're more likely to feel sleepy if you've had a physically active day. That puts your body in to a more receptive state to fall asleep.

Yamkovenko: What other evidence supports occupational therapy’s role in sleep?

Fogleberg: There's very good evidence supporting cognitive behavioral therapy for insomnia, which largely focuses on sleep scheduling and working with people to manage their sleep’s schedules to fit better with their sleep needs. And OTs would be ideally suited to work with people around this, because our focus on working with people in establishing routines. And there's also an increasing amount of evidence for mindfulness-based interventions to help improve sleep.

Yamkovenko: Want to talk to an OT about your sleep problems? Ask your physician for a referral.

Fogleberg: If you're seeing an OT already, mention the sleep problem to an OT so that they can decide whether they feel like it needs further assessment or not.

Yamkovenko: Learn more about occupational therapy at


Centers for Disease Control and Prevention, (2016, February, 18). 1 in 3 adults don’t get enough sleep. Retrieved from