The report of a federal parliamentary inquiry into sleep health awareness was released in April 2019

It was drafted by eight Members of the House of Representatives Standing Committee on Health, Aged Care and Sport, following a reference from the Health Minister. Over several months it held interstate hearings, received 138 expert submissions and 30 exhibits, and considered key previous studies, including 318 NHMRC-supported research grants relating to sleep or sleep disorders from 2000-2018.

It seems fair to ask, given the exhaustive (and expensive) nature of the exercise, whether all this work tells us anything new. The temptation is to suggest not, as clinicians and the broader community seem well aware that, “Sleep is a fundamental human need and, along with nutrition and physical exercise, it is one of the three pillars of good health.”

As everyone agreed, “Sleep is a crucial element in the maintenance of health and wellbeing.”

However, we may not have adequately considered that one in every ten Australians is not getting enough quality sleep [7-9 hours per night for adults, more for young people] for our own good, nor how best we might remedy this situation.

“Society’s apathy towards sleep has, in part, been caused by the historic failure of science to explain why we need it - sleep has remained one of the last great biological mysteries.”

  • Professor Matthew Walker, Why We Sleep: The New Science of Sleep and Dreams (Penguin Books 2017), cited in the parliamentary report.

The Committee’s response to this apparent crisis includes a key recommendation to develop a national education and awareness campaign to help address the identified barriers to improved sleep health. As they explained:

“This campaign should emphasise the important role of sleep in a healthy lifestyle as well as the health and wellbeing risks that are associated with inadequate sleep. In addition, the awareness campaign should provide people with practical advice on how they can improve their sleep health.

“Some of the great leaps in public health have happened because of successful national campaigns — be it in fitness (for example the Life. Be In It campaign), smoking prevention or our efforts to halt the spread of HIV.”

They said such a campaign should draw on the proposed educational strategy developed by the Australasian Sleep Association and the Sleep Health Foundation as part of their 2019 federal budget submission.

The parliamentary inquiry, coyly titled “Bedtime Reading”, was introduced as “a report we hope will give you a good night’s sleep”, suggesting the contents to be so soporific that a bedside copy might solve the problems identified. 

In fact, this consideration of “the prevalence, causes, and symptoms of inadequate sleep and sleep disorders, as well as the treatment and support available for sleep disorders” is never dull, and certainly timely. 

Committee Chair Trent Zimmerman MP notes that getting inadequate sleep is linked to a range of serious physical and mental health conditions such as diabetes, heart disease, and dementia, and on behalf of his cross-party colleagues says the awareness campaign would highlight that regularly foregoing sleep due to the pressures of a busy lifestyle will have health consequences.

“It is estimated that 7.4 million Australians are regularly not gaining the recommended amount of sleep… In 2016-17, this cost the Australian economy $26.2 billion… If the impact of lost health and wellbeing is included the estimated cost rises to $66.3 billion

At a time when many people work longer hours and remain wedded to electronic devices this may be easier said than done. Further, the timing of the report’s release in the lead-up to a federal election may not have helped. There are no signs so far of major parties urging Australians to change their sleeping practices, and like many a worthy endeavour, the funding for the sleep project could well determine its success.

The report’s 11 recommendations include:

  • The Australian Government prioritising sleep health as a national priority and recognising the importance of sleep to health and wellbeing alongside fitness and nutrition
  • Developing a national approach to working hours and rest breaks for shift workers
  • Enabling GPs to more effectively refer patients to diagnostic sleep studies
  • Urging the Australian Government, in consultation with the RACGP and other key stakeholders, to assess the current knowledge levels of GPs, nurses and psychologists in relation to sleep health, and to develop effective training mechanisms to improve the knowledge of primary healthcare practitioners in diagnosing and managing sleep health problems
  • Ensuring that all Pensioner or Health Care Card holders with moderate to severe obstructive sleep apnoea, regardless of their location, can access a free trial of CPAP therapy and if successful receive free ongoing CPAP treatment; and assess the potential benefits of providing subsidised CPAP therapy across the broader community.
  • A review of sleep health services funded under the MBS
  • Providing practical information in relation to sleep hygiene and measures an individual can use to improve their sleep

A recommendation given close attention was the need to fund research into the effects of the use of digital devices on children’s sleep health. A submission from the Australian Council on Children and the Media noted concern that the use of smartphones and tablets in the evening is negatively affecting children’s sleeping patterns.

The ACCM cited a survey that found almost half of Australian children “regularly use screen-based devices at bedtime, with one in four children reporting associated sleep problems.”