An Exploration of Pediatric Sleep Health in a Special Population

Insufficient sleep is a pervasive problem for children and can impact growth and development. Emerging research suggests that a child’s sensory processing abilities, specifically sensory sensitivities, may influence their sleep health (Foitzik & Brown, 2018; Mazurek & Petroski, 2015). Within populations who seek out occupational therapy services, many children have sensory processing patterns that impact participation in daily life, however sleep is often overlooked. In this dissertation, we characterize sleep health for children with sensory sensitivities and examine pediatric occupational therapists’ perspectives regarding assessing and intervening in sleep concerns within their daily practice. We use parent and child-reported subjective measures, daily sleep diaries, and movement-based actigraphy measures to thoroughly characterize multidimensional sleep health for children with and without sensory sensitivities. Our findings suggest a significant difference in subjective sleep health, by both parent and child report, and significant sleep onset delay for children with sensory sensitivities compared to peers. Measures of rest-activity rhythms and sleep variables using actigraphy were similar between groups, indicating that once a child with sensory sensitivities falls asleep, their sleep may not be different than children without sensory sensitivities. In our qualitative descriptive study, we examined perspectives of 20 pediatric occupational therapists regarding addressing sleep concerns within routine care. Therapists said that sleep health was within their scope of practice, but often personal, family, setting specific, or external barriers impacted their abilities to address sleep in their practice. Therapists said they were not confident in their knowledge surrounding sleep concerns and highlighted several areas of supports and barriers they regularly experience. This body of work lays a foundation for two lines of future research. First, we present novel characterization of multidimensional sleep health for children with sensory sensitivities compared to peers without sensory sensitivities. These findings can drive future studies examining neurological differences between these groups that may contribute to sleep and sensory processing within the brain. Second, we identified supports and barriers that impact a pediatric occupational therapists’ ability to intervene on sleep concerns. Future research can move forward to address barriers and expand upon supports to better equip occupational therapists to become sleep professionals