New research from Flinders University shows that nurses working in general practice could play a key role in improving access to sleep health treatments, but only if patients and general practice staff are involved in the design of these services.
Published in BMC Primary CareThis study is the first to explain why an effective nurse-delivered sleep care model has not been introduced into routine GP clinics, despite strong evidence that it is effective.
FHMRI Sleep Health researchers reviewed and synthesized the results of 85 studies examining nurse-led models of care after identifying increased delays in professional sleep services and limited access to recommended treatments, such as cognitive behavioral therapy (CBTi) for insomnia and CPAP machines for obstructive sleep apnea (OSA).
The care model for sleep disorder management by general practice nurses has already been shown to be effective, but has not yet been implemented into routine care.
To date, no study has investigated the real-world barriers and enablers that influence whether GPs are able to successfully implement these models, particularly in sleep health. ”
Nicole Gribel, first author, sleep researcher, registered nurse
This review found that GP nurses are likely to be able to provide assessment and treatment of common sleep problems such as chronic insomnia and OSA, which are symptoms frequently raised in routine GP consultations.
“We know that general practice nurses are well placed to provide treatments like CBTi and support patients to start CPAP,” says co-author and senior researcher Associate Professor Chin Lee Chai Coetzer, a respiratory and sleep physician.
“These approaches can improve sleep quality, daily functioning, and long-term health.”
“With specialist wait times increasing and access to CBTi limited, enabling GP nurses to provide proven sleep care could change lives and reduce pressure on the wider health system.”
The study also revealed that many new models of care struggle to take off if the models of care are not designed to meet patient needs and general practices, especially nurses, do not have sufficient funding to provide care.
The authors say this can cause services that work well in trials to fail in the real world.
The researchers are calling on policy makers, clinicians and researchers to co-design services with patients and GP staff from the outset to improve uptake, sustainability and outcomes.
Key findings:
- A nurse-delivered care model has the potential to reduce pressure across the health care system and improve 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 vary widely in their abilities, daily routines, and motivations.
- Co-designing services with patients and GP clinic staff will result in more practical and sustainable models that are better suited to real-world needs.
- A better designed system saves time and resources and supports smoother and more efficient care in general practice.
“Despite the strong evidence that nurses provide a model of care, it is not being incorporated into daily practice,” Ms. Gribel says.
“Our review found that involving patients and GP staff in the design of these services is critical to real-world success.
“If these models work well, they could reduce demand for specialist services and improve the long-term health outcomes of thousands of Australians.”
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Reference magazines:
Gribel, N. others. (2026). Factors influencing the implementation of chronic disease care models by general practice nurses: A mixed methods systematic review to inform chronic sleep disorders care models. BMC Primary Care. DOI: 10.1186/s12875-025-03078-4. https://link.springer.com/article/10.1186/s12875-025-03078-4
