Volume 53, Issue 6, June 2024

Guest Editorial: Sleep – A key concern for primary care

Garun S Hamilton   
doi: 10.31128/AJGP-03-24-7192   |    Download article
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Sleep is an essential human need and one of the three key pillars of good health, along with nutrition and physical activity. Sleep plays an important restorative function, critical for optimal physical and mental health. Furthermore, in early life, sleep is important for growth, learning and cognitive development,1 as well as for maintaining cognitive and physical health during the ageing process.2 Sleep disorders, along with insufficient sleep, have a negative effect on human health. They lead to impaired quality of life, increases in negative moods, poor concentration and productivity, and increased workplace and motor vehicle accidents.3 Sleep disorders are associated with a range of chronic diseases, such as cardiovascular disease, hypertension and dementia.3 The economic cost of sleep disorders is also substantial. An economic analysis by Deloitte in 2019–20 revealed that the direct financial and non-financial costs of sleep disorders in Australia were greater than $51 billion per year, with the total costs of inadequate sleep being $75 billion.4,5

Sleep disorders and symptoms of poor sleep are incredibly common in the Australian population. The prevalence of obstructive sleep apnoea (OSA) increases with age, and at least moderate OSA based on sleep study is present in 9–17% of the adult population.6 Many individuals with OSA remain undiagnosed. With respect to insomnia, chronic insomnia is reported to affect approximately 15–20% of the population.7 Furthermore, symptoms that suggest a possible sleep disorder are reported frequently.7 In a representative survey of Australian adults conducted in 2016 by the Sleep Health Foundation, at least one sleep problem was reported by 65.9% of the population.7 Sleep health inequity is also a significant factor, with sleep problems and difficulty accessing care more prominent in disadvantaged and Indigenous populations. Within this context, sleep complaints and sleep disorders are among the most frequent presentations seen in primary care. Although historically diagnosis and treatment of sleep disorders have been heavily specialist based, the burden of disease can only be addressed if general practice plays the central role in screening, diagnosis and management. The Australasian Sleep Association (the peak body representing clinicians and scientists in the field of sleep medicine) has been working with The Royal Australian College of General Practitioners to educate and upskill general practitioners (GPs) in the management of sleep disorders. In this edition of the Australian Journal of General Practice, six articles are presented that form part of this education program.8–13 Included is an article about an online sleep health primary care clinical resource, which provides primary healthcare professionals with evidence-based information to help them manage common sleep disorders.8 The aim is for this to form the basis of an ongoing and expanding resource for GPs and their patients to access for years to come.

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  1. Mason GM, Lokhandwala S, Riggins T, Spencer RMC. Sleep and human cognitive development. Sleep Med Rev 2021;57:101472. doi: 10.1016/j.smrv.2021.101472. Search PubMed
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  3. Gottlieb DJ, Punjabi NM. Diagnosis and management of obstructive sleep apnea: A review. JAMA 2020;323(14):1389–400. doi: 10.1001/jama.2020.3514. Search PubMed
  4. Deloitte Access Economics. Asleep on the job: Costs of inadequate sleep in Australia 2017. Sleep Health Foundation, 2017. Available at [Accessed 19 March 2024]. Search PubMed
  5. Deloitte Access Economics. Rise and try to shine: The social and economic cost of sleep disorders in Australia. Sleep Health Foundation, 2021. Available at [Accessed 19 March 2024]. Search PubMed
  6. Senaratna CV, Perret JL, Lodge CJ, et al. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev 2017;34:70–81. doi: 10.1016/j.smrv.2016.07.002. Search PubMed
  7. Adams RJ, Appleton SL, Taylor AW, et al. Sleep health of Australian adults in 2016: Results of the 2016 Sleep Health Foundation national survey. Sleep Health 2017;3(1):35–42. doi: 10.1016/j.sleh.2016.11.005. Search PubMed
  8. Soenen S, Sweetman A, Balzer M, et al. Sleep health primary care clinical resource. Aust J Gen Pract 2024;53(6):349–55. doi: 10.31128/AJGP-03-23-6779. Search PubMed
  9. Chai-Coetzer CL, Hancock K. Diagnosis of obstructive sleep apnoea in primary care. Aust J Gen Pract 2024;53(6);358–62. doi: 10.31128/AJGP-03-23-6740. Search PubMed
  10. Ellender CM, Vakulin A, Stocks N, Chai Coetzer CL. Management of obstructive sleep apnoea in primary care. Aust J Gen Pract 2024;53(6):363–69. doi: 10.31128/AJGP-08-23-6933. Search PubMed
  11. Wong M, Chaudry R, Kevat A et al. An approach to common sleep presentations in infants and toddlers. Aust J Gen Pract 2024;53(6):371–78. doi: 10.31128/AJGP-05-23-6825. Search PubMed
  12. Chawla J, Lovato N, Wong M et al. Optimising sleep in adolescents: The challenges. Aust J Gen Pract 2024;53(6):379–86. doi: 10.31128/AJGP-05-23-6841. Search PubMed
  13. Reynolds AC, Lovato N, Sletten TL et al. Assessment and management of sleep disorders in shift workers: Challenges and considerations for general practice. Aust J Gen Pract 2024;53(6):389–93. doi: 10.31128/AJGP-12-22-6647. Search PubMed

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