But researchers warn new models will fail unless patients and clinic staff help design them from the outset.
General practice nurses could become a frontline solution to Australia’s growing sleep health crisis, with new research suggesting they are well placed to deliver evidence-based treatment for insomnia and obstructive sleep apnoea inside GP clinics.
The Flinders University review, published in BMC Primary Care, analysed 85 studies on nurse-delivered chronic disease care models and found strong support for expanding nurses’ involvement in sleep assessment, treatment and follow-up.
The researchers said the findings came amid mounting pressure on specialist sleep services and poor access to recommended treatments such as cognitive behavioural therapy for insomnia (CBTi) and CPAP therapy.
Lead author, sleep researcher and registered nurse Nicole Grivell said the evidence for nurse-led sleep care was already well established, but implementation in routine practice had stalled.
“General practice nurse‑delivered models of care for the management of sleep disorders have already been shown to be effective, but they still haven’t been adopted into routine care,” said Ms Grivell.
“Until now, no research had explored the real‑world barriers and enablers that affect whether GP clinics can successfully put these models into practice, especially in sleep health.”
The review identified chronic insomnia and obstructive sleep apnoea as common conditions that could potentially be managed more effectively within primary care, particularly through nurse-supported assessment and treatment pathways.
Co-author Associate Professor Ching Li Chai-Coetzer, a respiratory and sleep physician said practice nurses could play a larger role in delivering CBTi and supporting patients starting CPAP therapy.
“These approaches can improve sleep quality, daily functioning, and long‑term wellbeing.”
“With specialist wait times rising and limited access to CBTi, empowering GP nurses to deliver proven sleep care could change lives and ease pressure on the wider health system.”
The review also found multiple barriers to broader uptake, including inadequate funding, uncertainty around nursing scope of practice and the challenge of integrating new workflows into already stretched clinics.
The researchers warned that models developed in tightly controlled research settings risked failing in day-to-day practice if they were not built around patient needs and the realities of general practice operations.
Patient willingness, motivation and capacity to engage in chronic disease management also emerged as major influences on whether models succeeded, prompting researchers to modify existing implementation frameworks to better account for patient-centred factors.
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The researchers said that co-designing services with both patients and general practice teams would be critical to creating sustainable sleep care pathways that worked outside trial settings.
“Our review shows that involving patients and GP clinic staff in the design of these services is critical for real‑world success,” said Ms Grivell.
“Done well, these models could reduce demand on specialist services and improve long‑term health outcomes for thousands of Australians.”
The researchers reviewed barriers and facilitators across chronic disease models more broadly to inform future implementation of sleep disorder care in primary care settings.
“Greater consideration of patient need and motivations for engagement in chronic condition management, improved clarity about the scope of practice of general practice nurses, and co-design with general practice staff and consumers may offer greater opportunities for success when designing and delivering new models of care for chronic conditions, including chronic sleep disorders,” they concluded.
The study was funded through scholarships and grants linked to Flinders University and the National Health and Medical Research Council Centres of Research Excellence program.
