Exploring the Benefit of an OT-Led Modified CBT-I Sleep Intervention for Montana Veterans: A Pilot Study

ImportanceSleep disturbances are highly prevalent among veterans and negatively impact mental health and occupational performance. Occupational therapy (OT) practitioners are well equipped to address sleep as a core occupation through interventions that target habits, routines, and environmental contexts.ObjectiveTo examine the feasibility and acceptability of a community-based, OT-led modified cognitive behavioral therapy for insomnia (CBT-I) program for veterans with self-reported sleep disturbances and to explore associated changes in sleep, occupational performance, and mental health outcomes.DesignSingle-arm, pre-post pilot feasibility study with exploratory quantitative analysis.SettingCommunity-based veteran organization in Montana.ParticipantsNine veterans enrolled; seven completed the 5-week program.InterventionA 5-week OT-led modified CBT-I program consisting of weekly group education and individual OT sessions.Outcomes and MeasuresSleep quality and disturbance (PROMIS-SD, PSQI), occupational performance and satisfaction (COPM), depression (PHQ-9), anxiety (GAD-7), and quality of life (SF-12). Feasibility outcomes included recruitment, attendance, retention, and acceptability as assessed via postintervention feedback survey.ResultsParticipants demonstrated improvements in sleep, occupational performance, and mental health, with no changes in health-related quality of life. Attendance and retention were high, and all participants who completed the intervention reported positive acceptability and willingness to recommend the program.Conclusions and RelevanceOT-delivered, modified CBT-I appears feasible and acceptable in community-based settings and may be associated with improvements in sleep, occupational performance, and mental health among veterans. These findings highlight the potential role of OT in expanding access to sleep interventions, particularly in rural contexts where specialized sleep services are limited.