Improving treatment of sleep disorders in primary care

Poor sleep is linked with negative physical and mental health outcomes, as well as reduced productivity which is costing Australia $66 billion in lost economic activity every year, with insomnia and obstructive sleep apnoea (OSA) affecting more than 4 million Australians.

Flinders University sleep researchers are aiming to tackle sleep disorders with a four year NHMRC Partnership Grant of $1,439,099.70 (200579) to develop and trial packages which upskill GP’s and nurses in managing sleep disorders, as part of broader interventions assessing the uptake and effectiveness of sleep services in primary health care settings such as GP clinics.

Chief Investigator and Medical Director of the Adelaide Institute for Sleep Health, Professor Robert Adams, says the research is a major step towards ensuring Australians struggling with sleep disorders have access to facilities designed to recognise sleep disorders early and offer effective therapy as the first line of defence.

“A lack of sleep-specific training for GPs contributes to widespread under recognition of sleep disorders, and an over-reliance on specialist care leading to long waiting periods and a rising reliance on pharmacy and corporate treatment suppliers, without adequate medical input to manage these disorders.”

“Our research group and others, have demonstrated in randomised trials that GPs and practice nurses can manage obstructive sleep apnoea (OSA), producing equivalent patient outcomes to specialist centres at significantly lower cost.”

“Similarly, for insomnia, despite guidelines recommending cognitive behavioural therapy (CBTi) as the first line treatment, the overwhelming majority of patients receive drugs with potentially dangerous side effects, and rarely gain access to CBTi, so we’re also aiming to address that.”

The trial will also look at the best care for sleep disorders in rural and remote regions, and includes an economic evaluation to establish cost savings associated with treatments in GP clinics, and developing effective policy advice for future funding which supports sleep management.

Associate Professor Andrew Vakulin, NHMRC Career Development Fellow at the Adelaide Institute for Sleep Health, says there is an urgent need for new, simple and cost-effective tools to help screen, diagnose and manage sleep disorders in primary health care settings.

“We’re looking forward to the trial of a new, more collaborative and evidence-based, model of care for insomnia and OSA, designed specifically for GP clinics, utilising nurses and specialist centre support as well as a suite of support tools, co-designed in close collaboration with our partners.”

“Australians should have access to care that is best practice anywhere in the world with cognitive behavioural therapy (CBTi) programs targeting the eradication of unhelpful behaviours that maintain insomnia. Reducing these behaviours and thoughts will lead to reductions in symptoms.”

Existing partnerships with SA Health, Local Health Networks, industry and GP organisations will facilitate the study to improve management of sleep disorders in primary care by:

  • Developing and testing primary care education packages designed to up skill the GPs and primary care nurses in managing sleep disorder as part of the broader sleep intervention
  • Testing the uptake, effectiveness and scalability of sleep disorder management education on health services delivered in primary care settings
  • Undertaking a formal health economic evaluation to establish the cost of sleep health service delivery
  • Promoting and disseminate sleep disorder management education, guidelines and care pathways to rural and remote regions of South Australia
  • Driving policy change and development of funding models for sleep disorder management in rural and remote care
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College of Medicine and Public Health Research