Adequate sleep tailored to children's age is important for their well-being. This study aimed to examine the association between adequate sleep and children's participation in occupational areas. This study was a retrospective cross-sectional analysis of secondary data obtained from the 2020 National Survey of Children's Health in the United States. This study included 6,818 children aged 6 to 11 years. The mean age was 8.48 years (standard deviation = 1.72). Multivariate regression models revealed that adequate sleep was significantly associated with increased participation in occupational areas (17% more in leisure, 95% confidence interval [CI]: 1.11-1.23
15% more in play, 95% CI: 1.07-1.22
11% more in education, 95% CI: 1.01-1.22) in school-age children, but not with participation in work and social participation. Adequate sleep is associated with increased participation of school-age children in occupational areas.