Why Occupational Therapists Ask About Sleep: A 24-Hour Perspective

"Sleep is not just what happens at night—it is influenced by everything we do throughout the day."

At Haven OT, we know that quality sleep is fundamental to health, wellbeing and participation in everyday life. Whether it's managing emotions, concentrating at work or school, engaging in meaningful activities, or maintaining physical health, sleep plays an essential role in how we function each day.

Recently, our team had the privilege of learning from Dr Sue McCabe, founder of SleepLinks, during a professional development day focused on sleep assessment and intervention from an occupational therapy perspective. One of the biggest takeaways? Sleep is a 24-hour occupation.

Looking at Sleep Through the ICF Framework

Occupational therapists often use the International Classification of Functioning, Disability and Health (ICF) to understand the many factors that influence a person's everyday life.

Rather than asking only "How are you sleeping?", we explore the bigger picture:

• Health conditions that may influence sleep.

• Body structures and functions, such as the nervous system, hormones, pain, breathing, digestion and sensory processing.

• Activities and daily routines.

• Participation in work, education, leisure and social life.

• Environmental factors, including light, noise, temperature and the sleep environment.

• Personal factors, such as stress, habits, routines and individual preferences.

By understanding these interacting factors, occupational therapists can identify practical strategies that support healthier sleep and improved daily functioning.

Sleep Doesn't Start at Bedtime

One of the key messages from the workshop was that sleep begins long before we get into bed.

Our bodies rely on internal biological clocks—known as circadian rhythms—that help regulate when we feel awake and when we feel sleepy. While genetics influence these rhythms, they are also guided by environmental "timekeepers" such as:

• Natural daylight

• Darkness

• Temperature

• Physical activity

• Daily routines

• Meal timing

This means that what we do during the day has a significant impact on how well we sleep at night.

The Power of Daylight
One of the simplest yet most effective ways to support healthy sleep is by increasing exposure to natural outdoor light, particularly in the morning.

Morning light helps strengthen the body's circadian rhythm, making it easier to feel alert during the day and naturally sleepy at night.

Rather than focusing only on reducing screen time before bed which may be difficult for some, building strong daytime routines can be easier—including spending time outdoors—may have an even greater impact on sleep quality.

Your Wake-Up Time Is Your Anchor
While bedtime often receives the most attention, maintaining a consistent wake-up time can be even more important.

Waking at the same time each day helps regulate the body's internal clock and provides a reliable anchor for healthy sleep patterns.

Establishing a regular morning routine with natural light, movement and meaningful activities can set the foundation for better sleep each night.

Stress and Sleep Go Hand in Hand
Stress doesn't just affect how quickly we fall asleep—it can also influence how often we wake during the night and how restorative our sleep feels.

Finding ways to regulate stress throughout the day can support healthier sleep. This may include:

• Relaxation strategies

• Mindfulness or breathing exercises

• Self-talk techniques

• Meaningful daily activities

• Consistent routines

Rather than trying to "force" sleep, creating opportunities for the body and mind to relax often leads to better outcomes.

Sleep Looks Different for Everyone

There is no universal sleep routine that works for everyone.

Occupational therapists recognise that each person's sleep is influenced by their individual health, environment, sensory preferences, routines and daily occupations.

Sometimes small changes—such as warming your feet before bed, creating a calming environment, or using comforting sensory supports—can make a meaningful difference.

The goal isn't to chase sleep, but to create the right conditions for sleep to happen naturally.

When Sleep May Be Telling Us Something More

Persistent sleep difficulties may sometimes indicate an underlying sleep disorder or medical condition.

Some signs that may warrant further investigation include:

• Waking feeling unrefreshed despite sleeping through the night.

• Loud snoring or disrupted breathing.

• Excessive daytime fatigue.

• Restless legs or an urge to move the legs at night.

• Frequent waking due to pain or discomfort.

People who are neurodivergent may also experience higher rates of certain sleep disorders, making it especially important that sleep is discussed as part of a holistic assessment.

Why Occupational Therapists Ask About Sleep

Sleep affects almost every aspect of daily life—from concentration and memory to emotional regulation, physical health and participation in meaningful occupations.

That's why, at Haven OT, we don't just ask what happens overnight—we look at the entire 24-hour picture.

By understanding routines, environments, sensory preferences and everyday activities, occupational therapists can work collaboratively with individuals and families to identify practical strategies that support both better sleep and better participation in daily life.

Supporting Better Sleep

Improving sleep doesn't always require dramatic changes. Sometimes the biggest improvements come from small, consistent adjustments to daily routines, environments and habits.

If sleep challenges are impacting you or someone you support, our occupational therapists can help explore the factors contributing to poor sleep and develop personalised, evidence-informed strategies that fit your everyday life.

Because better days often begin with better nights.