Individuals with neurological conditions like stroke, Parkinson's disease, and multiple sclerosis are at higher risk of developing sleep disorders due to issues like pain, breathing problems, and effects of medications. Some common sleep disorders in these patients include insomnia, sleep apnea, REM sleep behavior disorder, excessive daytime sleepiness, and restless legs syndrome. Occupational therapists play an important role in managing sleep disorders in neurological patients through assessments, sleep education, cognitive behavioral therapy, relaxation techniques, environmental modifications, and addressing physical limitations to improve sleep quality and quality of life.

1. Bangladesh Health Professions Institute
Department of Occupational Therapy
Masters of Science in Occupational Therapy
Occupational Therapy in Adult Neurology
COMMON SLEEP DISORDERS
Individuals experiencing neurological conditions like stroke, Parkinson's disease, Motor Neuron Disease
(MND), Multiple Sclerosis (MS), meningitis, encephalitis, Guillain-Barré Syndrome (GBS), and spinal cord
injury are at higher risk of developing various sleep disorders. Some common sleep disorders that may
occur in people with these neurological conditions include:
1. Insomnia: Difficulty falling asleep, staying asleep, or waking up too early is prevalent in many
neurological conditions due to pain, discomfort, anxiety, or medication side effects.
2. Sleep-Related Breathing Disorders: Conditions like Parkinson's disease, MS, and spinal cord injury can
lead to weakened respiratory muscles, increasing the risk of sleep-related breathing disorders like
obstructive sleep apnea.
3. REM Sleep Behavior Disorder (RBD): RBD is often seen in individuals with Parkinson's disease and other
neurodegenerative conditions. It involves acting out vivid dreams during REM sleep due to a lack of muscle
paralysis.
4. Excessive Daytime Sleepiness (EDS): Neurological conditions can cause fatigue and EDS due to disrupted
sleep patterns or neurochemical changes.
5. Circadian Rhythm Disorders: Damage to the brain regions controlling circadian rhythms can lead to
circadian rhythm sleep disorders, affecting the sleep-wake cycle.
6. Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD): RLS and PLMD can occur
in various neurological conditions, leading to involuntary limb movements and discomfort during sleep.
7. Sleep Disordered Breathing: Conditions such as MND, GBS, and spinal cord injury can cause respiratory
muscle weakness, leading to sleep disordered breathing issues.
8. Central Sleep Apnea: Central sleep apnea may occur in neurological conditions that affect the central
nervous system's control of breathing.
9. Narcolepsy: While narcolepsy is less common in the listed conditions, it can still occur due to
neurochemical imbalances.
10. Parasomnias: Neurological conditions may increase the likelihood of experiencing parasomnias such
as sleepwalking, sleep talking, and night terrors.
11. Fragmented Sleep: Various neurological conditions can disrupt the normal sleep architecture, leading
to fragmented sleep patterns.

2. MANAGEMENT OT SLEEP DISORDER
Managing sleep disorders in individuals with neurological conditions is essential to improve overall well-
being, daytime functioning, and rehabilitation outcomes. Proper evaluation, diagnosis, and treatment by
healthcare professionals, including neurologists, sleep specialists, and occupational therapists, can help
address these sleep issues effectively. Interventions may include medication adjustments, behavioral
therapies, adaptive equipment, and lifestyle modifications to promote better sleep hygiene and quality of
life.Sleep rehabilitation for neurological dysfunction is an essential aspect of occupational therapy (OT)
intervention. Neurological dysfunction can have a significant impact on sleep patterns, leading to
disturbances in sleep quality, quantity, and overall well-being. OTs play a crucial role in addressing sleep-
related issues in individuals with neurological conditions to improve their overall functional abilities and
quality of life.
Here are some key perspectives and strategies that occupational therapists may employ in sleep
rehabilitation for neurological dysfunction:
1. Sleep Assessment: OTs start by conducting a comprehensive assessment of the individual's sleep
patterns, habits, and any existing neurological deficits. This assessment helps identify specific sleep-
related issues and how they may be influenced by the underlying neurological condition.
2. Sleep Education: OTs provide education to the individual and their caregivers about the importance of
sleep and its impact on neurological functioning. They may also discuss sleep hygiene practices, such as
maintaining a consistent sleep schedule, creating a conducive sleep environment, limiting screen time
before bed, and managing caffeine and alcohol intake.
3. Cognitive Behavioral Therapy for Insomnia (CBT-I): CBT-I is a well-established therapeutic approach that
OTs may utilize to address insomnia and sleep-related anxiety in individuals with neurological dysfunction.
CBT-I focuses on changing negative thought patterns and behaviors associated with sleep disturbances,
ultimately improving sleep quality.
4. Energy Conservation Techniques: For individuals with neurological conditions, fatigue and sleep
disturbances often go hand in hand. OTs teach energy conservation strategies to manage daily activities
more efficiently, reducing fatigue and improving the ability to engage in restorative sleep.
5. Relaxation Techniques: OTs can introduce relaxation techniques such as progressive muscle relaxation,
deep breathing exercises, and mindfulness practices. These techniques can help reduce stress, anxiety,
and physical tension, promoting better sleep.
6. Sleep Environment Modifications: OTs may recommend adjustments to the sleep environment to
promote better sleep. This could include optimizing lighting, noise control, and enhancing comfort
through appropriate bedding and positioning.
7. Adaptive Equipment: Depending on the individual's needs and limitations, OTs may recommend and
provide adaptive equipment, such as specialized pillows or positioning aids, to support comfort during
sleep.
8. Sleep-Wake Schedule Management: OTs may work with individuals to develop a structured sleep-wake
schedule that aligns with their circadian rhythms and daily routines, enhancing the body's natural sleep-
wake cycle.

3. 9. Addressing Physical Limitations: Neurological conditions can lead to physical limitations that affect an
individual's ability to move in bed comfortably. Occupational therapists can address these challenges and
suggest strategies to improve positioning and mobility during sleep.
10. Collaborative Care: OTs work in collaboration with other healthcare professionals, such as
neurologists, sleep specialists, and psychologists, to ensure a holistic approach to sleep rehabilitation for
individuals with neurological dysfunction.
By focusing on sleep rehabilitation, occupational therapists aim to optimize the individual's sleep patterns,
reduce the impact of neurological dysfunction on daily activities, and enhance their overall well-being and
functional independence. It's important to remember that each individual's needs are unique, and
interventions should be tailored to their specific condition and circumstances.