Chair's Foreword

Bedtime Reading is a report that we hope will give you a good night’s sleep.
Sleep is a fundamental human need and, along with nutrition and physical exercise, it is one of the three pillars of good health.
We have known the importance of sleep for decades yet for many reasons, sleep health has not received the attention it deserves within our community and in the health programs run by state and federal governments. In part this is because there are still many who think that it’s a sign of ‘toughness’ and a badge of honour to be able to get by on less sleep. The reality is that such an approach does harm — in some cases with very serious consequences.
In reality very few people are able to operate optimally on minimal sleep. In addition to the health impacts, fatigue results in decreased productivity and is the cause of more road accidents than alcohol and drug use combined.
My hope is that this report will help bring attention to the central function of sleep to overall health and wellbeing and increase the focus placed on sleep among policy makers and in the broader community.
Four in every ten Australians are not getting the sleep they need. The direct financial cost of this inadequate sleep is currently estimated to be $26.2 billion annually. If health and wellbeing costs are considered the cost rises to $66.3 billion annually. Of even greater concern, in 2016-17 inadequate sleep was estimated to contribute to 3017 deaths in Australia.
Some people are not gaining adequate sleep due to experiencing a sleep disorder such as Obstructive Sleep Apnoea (OSA), insomnia, or narcolepsy; while for others work patterns or lifestyle pressures are restricting their ability to get sufficient sleep. In both cases the health impacts of long-term inadequate sleep are significant.
One of the most commonly diagnosed sleep disorders is OSA, which is linked to age and weight and is more prevalent in men than women. In addition, there is likely to be a high rate of undiagnosed OSA as it occurs during sleep and many people may not be aware that they have the condition. It is estimated that as many as 80 per cent of people experiencing OSA may be undiagnosed. In response, the Committee has recommended the Australian Government consider whether extending Medicare coverage to simpler and more affordable diagnostic tests for sleep disorders may reduce the level of undiagnosed OSA in the community.
Without treatment OSA can have serious health impacts. Untreated OSA (apart from the associated weight gain) can contribute to the possible development of type II diabetes and can increase the risk that a person will develop cardiovascular health problems including high blood pressure, stroke, and heart disease.
Currently, there is considerable variation across Australia in the support provided for the treatment of OSA using Continuous Positive Airway Pressure (CPAP) therapy. The Committee has therefore recommended that all Pensioners and Health Care Card holders with moderate to severe OSA, regardless of their location, should have access to free CPAP therapy. In addition, the Committee has recommended the Australian Government review the benefits of extending subsidised CPAP therapy across the broader community.
While not as prevalent as OSA, narcolepsy and associated conditions such as idiopathic hypersomnolence can have a debilitating impact on a person’s quality of life. There is a need to improve the awareness of these conditions both within the community and among medical practitioners. Further consideration should be given to emerging treatment options that may provide some people experiencing these conditions the opportunity to improve their quality of life.
Sleep health is not merely a question of the treatment and management of sleep disorders, as there are also many people who do not have a sleep disorder but who are not currently getting enough sleep. Insufficient sleep can be caused by a range of lifestyle pressures including shift work, and the increased use of the internet and electronic media.
Shift work, especially when it involves night shift, can be extremely disruptive to sleep patterns and often results in shift workers regularly not getting sufficient sleep. In the longer term this disrupted sleep can have serious health impacts and shift work has been linked to the increased risk of obesity, sleep disorders, mental health conditions, and cancer.
Additionally, many shift workers are employed in safety critical occupations such as healthcare, road transport, and mining. In each of these industries the fatigue caused by disrupted sleep can result in serious workplace accidents. To address the health risks faced by shift workers the Committee has recommended the development of a nationally consistent approach to working hours and rest breaks for shift workers and guidelines on how organisations should optimise rosters to minimise the potential for disruption to employee’s sleep patterns.
In addition, the potential for smartphones and internet usage to impact sleep patterns is an emerging area of concern. People are increasingly engaging in activities such as watching streaming services, internet gaming, and using social media late into the evening, potentially at the expense of sleep. Of particular concern is that many children are having their sleep continually disrupted by their smartphones or other devices. This regular sleep disturbance can negatively impact childhood development, behaviour, and performance at school.
The Committee has recommended the development of a national education and awareness campaign to help address these barriers to improved sleep health. This campaign should emphasise the important role of sleep in a healthy lifestyle as well as the health and wellbeing risks that are associated with inadequate sleep. In addition, the awareness campaign should provide people with practical advice on how they can improve their sleep health.
Some of the great leaps in public health have happened because of successful national campaigns — be it in fitness (for example the Life. Be In It campaign), smoking prevention or our efforts to halt the spread of HIV.
I would like to thank the many organisations and individuals who contributed to this inquiry, including those individuals who provided the Committee with a personal account of their experience of sleep disorders. In addition, I would like to thank representatives of the University of Western Australia and the Sir Charles Gairdner Hospital, who provided the Committee with a tour of their sleep medicine facilities and put me through a sleep lab experience.
I would also like to thank my fellow Committee members for their engagement with this important topic and contributions throughout the inquiry. This is a Committee that has worked well during the 45th Parliament because of the constructive contribution all members make. Finally, I extend the Committee’s thanks to the Committee staff who continue to provide such professional and skilled support.
Sleep well!
Mr Trent Zimmerman MP

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