Dr Hannah Scott ( left ) Research fellow , Adelaide Institute for Sleep Health , College of Medicine and Public Health , Flinders University , Adelaide , South Australia .

Dr Alexander Sweetman ( right ) Program manager , Australasian Sleep Association .

First published online on 28 July 2023

BACKGROUND

SLEEP , alongside diet and exercise , is

central to good health . Sleep disturbance is highly prevalent in the community , and sleep problems are among the most common reasons for patients to present to general practice in Australia . 1 Many of these patients may have a clinically diagnosable sleep disorder . In addition , there are strong bi-directional relationships between sleep problems and chronic diseases , such as cardiometabolic and mental health disorders . 2

While the mainstay of sleep assessment and treatment may not occur only in the primary care setting , it is increasingly recognised that sleep health forms a routine part of patient care to improve overall health outcomes . To achieve this , digital health interventions can be used to track , monitor and assist in the management of sleep problems and sleep disorders .

This How To Treat aims to demystify the digital health ecosystem in Australia and provide evidence about the different types of digital sleep health technologies and how to use them in clinical practice .

INTRODUCTION

SLEEP health is a broad term that encompasses multiple , and often interrelated , dimensions of sleep , such as sleep duration and timing , regularity of the sleep-wake cycle , sleep quality , and daytime factors such as alertness and vigilance . 3

Epidemiological evidence indicates that the sleep health of the Australian population is poor , with an estimated four in 10 adults regularly experiencing sleep disturbance . 4 Clinically , this can vary from self-reports of inadequate sleep duration through to clinical sleep disorders , such as insomnia disorder and obstructive sleep apnoea .

In addition , sleep disturbance and sleep disorders are risk factors for a wider range of chronic diseases , such as heart disease , depression and obesity , and reduced quality of life . 2

Because of the high prevalence of sleep disorders and the associated burden of chronic conditions , sleep disorders have been recognised as a public health epidemic . 5

Much of the initial diagnostic suspicion and ongoing management of sleep disturbance will impact directly on primary care . As general practice faces a multitude of clinical presentations related to disordered sleep , there is a need to develop new ways to evaluate and treat sleep disorders . Digital sleep health interventions offer a scalable solution to this growing burden .

We will briefly review sleep disorders in primary care before examining digital sleep health tools and interventions .

PREVALENCE

SLEEP problems are among the most common reason for patients to present to general practice in Australia . 1 An estimated 1.9 million Australians were affected by a sleep disorder between 2019 and 2020 . 6 These estimates are even higher when considering symptoms alone , where up to 60 % of the Australian population report at least one sleep symptom occurring three or more times per week . 7

The effects of poor sleep extend into the day , where fatigue negatively affects productivity in the workplace , mood and overall quality of life , increasing the risk of workplace accidents , reducing overall employment participation , and collectively costing Australia approximately $ 13.4 billion annually . 6 Sleep disorders also contribute to significant direct healthcare costs for managing the sleep disorder itself and indirect costs resulting