Sleep becoming major health issue for Australians as insomnia and sleep apnoea on the rise

Four in every ten Australians aren't getting enough sleep, sparking fears that a lack of funding to treat the issue could see wider-ranging health problems become more prevalent.

From brain, heart and metabolic function, to our immune system and growth, sleep is fundamental for our health and wellbeing.

Director of Flinders University Adelaide Institute for Sleep Research, Professor Danny Eckert, said sleep issues were far more prevalent than is currently understood.

"Inadequate sleep is affecting so many Australians, four out of ten in total," Professor Eckert told 7.30.

"But in terms of clinical conditions: Insomnia, sleep apnoea, it's at least a couple of million people walking around with this condition right now, most of whom are undiagnosed and untreated."

Just like smoking, alcoholism or obesity, sleep issues, he says, can take years off your life.

"From your central nervous system to your immune, respiratory and cardiovascular systems, so your brain, your heart, they're all affected.

"You name the condition, dementia, heart disease, diabetes — if you are sleeping poorly, you're not getting enough sleep, you've got disruptive sleep due to a sleep disorder, it is associated with increased risk of all of those conditions."

The two most common clinical sleep disorders are insomnia and sleep apnoea, while for other people, things like shift work and lifestyle patterns are restricting their ability to get enough sleep.

Professor Eckert said there were more risk factors emerging for worsening sleep problems.

He said pressures on people's time and a busy 24-hour society were also chipping away at precious sleep time.

"As housing becomes more expensive and people have to live further away from where they work, that's cutting into and causing people to have greater commuting time," he said.

A 'vicious cycle'

Regardless of the reason, long-term inadequate sleep comes with serious health impacts and can have a debilitating impact on quality of life.

Brisbane father Hamish Sinclair-Ross had always been a good sleeper, even during his time doing shift work at central Queensland mines.

So when he suddenly found himself unable to sleep, it came as a "bolt out of the blue".

"At one point I just got into bed, and it didn't happen," he said.

"It impacts your mental health, impacts you physically, hampers your day-to-day ability to do much, it's hard to concentrate."

He now realises his sleep issues were due to stress, largely caused by the impacts of the COVID pandemic.

His GP determined he wasn't clinically depressed, but he didn't "fit into the bucket" of long-term insomnia.

She prescribed sleeping pills, which helped him get over his initial sleep issue.

For a year-and-a-half, Hamish was on and off sleeping medication, finding that when he tried to wean himself off, he'd hit a wall and need to start taking them again.

Necessity not luxury

Professor Eckert said public awareness of the importance of sleep, and how to treat inadequate sleep, was lacking.

"It's a major issue that people come to see their doctor with sleep problems. It's one of the most common reasons that they arrive at the doctor," Professor Eckert said.

"And yet, our workforce is not appropriately trained overall."

He said not only was there a lack of national awareness campaigns and guidelines around sleep, but there was a misconception that sleep was merely a luxury.

"There is that message out there that it's somewhat heroic if you can get by or not very much sleep, that you are somehow stronger or better than other folks around you.

"That's simply not true."

A 2017 Deloitte Access Economics report found a lack of sleep was estimated to result in more than 3,000 deaths in 2016-17, with 394 of those from falling asleep at the wheel of a vehicle or from an industrial accident.

A 2021 report commissioned by the Sleep Health Foundation found that almost 1,000 deaths were attributed to sleep disorders in 2019 due to increased risk of cardiovascular and metabolic conditions, mental health conditions and reduced mental health.

While searching for an alternative to sleeping medication, Hamish found there was "nothing really accessible, and often it was really expensive."

Then he stumbled across a program he could access online for cognitive behavioural therapy for insomnia, or CBTi.

CBTi teaches participants to identify thoughts and behaviours that cause sleep problems, and change them.

For Mr Sinclair-Ross, that meant limiting caffeine, creating a screen-free bedtime routine and, perhaps counterintuitively, limiting sleep time to make sure he was tired when he hit the pillow. 

"I felt like I was empowered to take control," he said.  

"I've just never looked back, haven't had a problem since."

CBTi is globally recognised as the first-line treatment for insomnia, but Dr Alexander Sweetman said only about one per cent of Australian adults with insomnia were currently accessing it.

"There's this huge gap between what's recommended in the evidence-based guidelines and what happens in practice," Dr Sweetman said.

Through his role with the Australasian Sleep Association, Dr Sweetman also trains clinicians including GPs and psychologists to recognise and assess insomnia and deliver CBTi.

And he's lobbying the government to expand access to digital CBTi programs.

In 2018, a federal parliamentary inquiry looked at sleep health awareness in Australia.

In 2023, the federal government supported, or supported in-principle, all but one recommendation including making sleep health a national priority, a national sleep health awareness campaign, further funding for research and upskilling of health workers like doctors, nurses and psychotherapists.

But peak bodies say they are yet to see significant action on any of the recommendations.

In a statement, a Department of Health spokesperson said the government was committed to progressing sleep health policy, and would soon update the Australian Physical Activity Guidelines for Adults and Older Australians to incorporate evidence on sleep.

The statement said the National Health and Medical Research Council provided more than $114 million towards sleep disorder research between 2015 and 2024, while the Medical Research Future Fund awarded $41 million towards 22 research projects relevant to sleep disorders.

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