ABC’s of OT: ZZZ’s (aka sleep hygiene)

Did you know that sleep is listed as an area of occupation? I personally am pretty happy about it; a good nap or a few extra hours during the night make me really happy!

When working with the dementia population, sleep hygiene can become completely discombobulated. People often sleep all day and are awake all night. But guess what, this is just another area that we as the OT can address therapeutically.

This is an area that I have tried to perfect through lots of trial and error. So for our final ABC’s of OT post of the year, I’m highlighting the techniques that I have found to be effective in improving sleep hygiene among older adults.

An active day usually leads to a restful night.

This is true as much for us as it is for our patients. Bodies are designed to move, even as they age. So a big part of prepping our patients for sleep is to make sure they are sufficiently moving throughout the day. This can be done through active one-on-one therapeutic sessions, exercise groups, walk-to-dine programs, and functional mobility programs.

Another concept to note: if patients are sleeping a lot during the day and are unable to sleep restfully at night, we can work to re-set their body clock by engaging them in meaningful leisure tasks during the day. This doesn’t mean eliminating naps, but stimulating the daytime environment enough to keep the patient engaged in a functional and meaningful routine.

Nobody likes wet jammies.

This is not the most exciting topic, but the truth is many of our patients with dementia also deal with incontinence. This means that a proper evening ADL routine should occur for all of our patients; empty the tank, clean the skin, and put on dry clothes. TMI? Maybe. But seriously, no one ever wants to sleep in wet pj’s, including our residents. They’re going to be restless and or crawling out of bed if they void frequently during the night. So proactive toileting tasks can really help.

Bonus: following a typical nighttime routine can help to stimulate long-term personal memories that can help with sleep prep.

Keep the nighttime environment calm.

Something I observed while working the evening shifts last week is how quickly and easily a little dimming of the lights and a change in background music can really bring about a calm and restful atmosphere.

Use sensory techniques to increase calm affect.

I’m going to talk a little bit more about this next week when we talk about my experience working during the second and third nursing shifts, but I found that deep pressure sensory techniques were incredibly useful in assisting in sleep onset in our patients. This included weighted blankets, joint compressions, muscle belly massage, and weighted dolls/stuffed animals. To ensure appropriate sleep prep, I performed these techniques after we transferred the patient into bed.

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