GP nurses could deliver effective sleep treatments

A new Flinders University study shows that nurses working in general practice could play a major role in improving access to sleep‑health treatment, but only if patients and general practice staff are involved in designing these services.

Published in BMC Primary Care, the study is the first to explain why effective nurse‑delivered sleep‑care models have not yet made it into everyday GP clinics, despite strong evidence that they work.

Researchers from FHMRI Sleep Health reviewed and combined the findings of 85 studies exploring nurse-delivered models of care after seeing growing delays for specialist sleep services and limited access to recommended treatments such as cognitive behavioural therapy for insomnia (CBTi) and CPAP machines for obstructive sleep apnoea (OSA).

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.

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."

Nicole Grivell, lead author, sleep researcher and registered nurse

The review found strong potential for GP nurses to deliver assessment and treatment for common sleep problems like chronic insomnia and OSA, conditions frequently raised in everyday GP appointments.

"We know nurses in general practice are well placed to deliver treatments like CBTi and to support patients to commence CPAP," says co-author and senior researcher, Associate Professor Ching Li Chai-Coetzer, a respiratory and sleep physician.

"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 study also revealed that if models of care are not designed to meet the needs of patients and general practice does not have sufficient funding, particularly for nurses to deliver the care, many new models of care will struggle to get off the ground.

The authors say that this leads to services that work well in trials but could fail in real‑world practice.

The researchers urge policymakers, clinicians and researchers to co‑design services with patients and GP clinic staff from the start to improve uptake, sustainability, and outcomes.

Key findings:

• Nurse‑delivered models of care could ease pressure across the health system, improving access to timely assessment, treatment and follow‑up for sleep disorders and other long‑term conditions
• Patients must be central to designing models of care, because people's abilities, daily routines and motivation differ widely
• Co‑designing services with patients and GP clinic staff would lead to more practical and sustainable models that better fit real‑life needs
• Better‑designed systems save time and resources, supporting smoother, more efficient care in general practice

"Despite strong evidence that nurse‑delivered models of care work, they haven't made it into everyday practice," says Ms Grivell.

"Our review shows that involving patients and GP clinic staff in the design of these services is critical for real‑world success.

"Done well, these models could reduce demand on specialist services and improve long‑term health outcomes for thousands of Australians."