Date Presented 04/21/2023
Interrogating the relationship between sensory processing and sleep in adults with mental health diagnoses is significant because few studies have examined this relationship in the adult population. This study aims to identify which sensory factors enable and impede sleep quality in adults with mental health diagnoses so that OTs can effectively support this population to improve their sleep, occupational engagement, and well-being.
Primary Author and Speaker: Megan C. Chang
Additional Authors and Speakers: Mckenzie Brown, Anna Dayley, Cean Arada, Matthew Kawakami, Jennifer Stevenson
INTRODUCTION: In the United States, roughly one in five adults has a mental health diagnosis (National Alliance on Mental Illness, 2021). Research has shown significant correlations between mental illness and sleep-related problems (Blackwelder et al., 2021; Khurshid, 2018). Research has shown sensory processing deficits to correlate with multiple mental health conditions, including PTSD, MDD, BP, and SSD, attention deficit hyperactivity disorder, and autism (Engel-Yeger & Dunn, 2011; Koshiyama et al., 2021; Rieke & Anderson, 2009). Yet, the majority of research into sensory processing dysfunction related to sleep has focused on children. While some studies on sensory processing deficits have considered the adult population, very few have examined the associated functional effects on sleep performance. Thus, this study examines the relationships between sensory processing, sleep, and mental health diagnoses in adults ages 18-64.
METHOD: The survey study employed an online, anonymous, quantitative survey design that consisted of three standardized assessments along with a short demographic survey on adults aged 18-64. The measures included the Adult Sensory Processing Scale (ASPS; Blanche, et al., 2014), Pittsburgh Sleep Quality Index (PSQI; Buysse, et al., 1989), Perceived Stress Scale (PSS; Cohen et al., 1994). Participants were recruited using convenience and snowball sampling via social media postings, outreach through the OT Mental Health Clinic and paper flyer distribution at the affiliated university the greater Bay Area.
RESULTS: A total of 146 survey responses were recorded, of which 88 respondents satisfied inclusion criteria and completed the survey. The majority of the participants were White, English-speaking adults from the United States. Notably, 30.6% of the participants identified with diverse gender identities, outside the cisgender man-woman binary. The most common diagnoses among the participants were anxiety (64.8% of participants), depression (46.6%), and ADHD (20.5%). Results show that 80% of subjects scored above five on the PSQI, indicating possible sleep dysfunction. Additionally, 75% of participants scored within the possible or definite ranges for sensory dysfunction on the ASPS. There were significant relationships between PSQI global and total ASPS scores (r = .236 ; p = .027), indicating that increased sleep problems were associated with heightened sensory processing dysfunction. Furthermore, specific PSQI and ASPS components displayed significant correlations, such as perception of sleep quality with over-responsiveness to three sensations: vestibular (r = .239, p = .025), auditory (r = .250, p = .019), and social touch (r = .398, p < .001).
DISCUSSION AND IMPLICATIONS: Results suggest that people with mental health conditions experience dysfunctions in sensory processing and sleep quality. Results were also consistent with the literature on different populations that reveals a higher amount of sensory processing difficulties to be associated with increased sleep problems. Further research is needed to examine the efficacy of sensory processing assessments during initial OT evaluation for clients with mental health diagnoses and sleep impairments. The findings provide evidence to support occupational therapy practitioners to consider including sensory-based approaches for related sleep problems in clients with mental health condition.
References
Blackwelder, A., Hoskins, M., & Huber, L. (2021). Effect of inadequate sleep on frequent mental distress. Preventing Chronic Disease, 18, E61–E61. https://doi.org/10.5888/pcd18.20057
Koshiyama, D., Thomas, M. L., Miyakoshi, M., Joshi, Y. B., Molina, J. L., Tanaka-Koshiyama, K., Sprock, J., Braff, D. L., Swerdlow, N. R., & Light, G. A. (2021). Hierarchical pathways from sensory processing to cognitive, clinical, and functional impairments in schizophrenia. Schizophrenia Bulletin, 47(2), 373–385. https://doi.org/10.1093/schbul/sbaa116
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4.
