O034 Insomnia Management in Australia: An Overview of Patient, Clinician and Health System Factors

Abstract

Abstract Introduction Insomnia is the most prevalent sleep disorder in Australia. The recommended treatment is Cognitive Behavioural Therapy for insomnia (CBTi), however most people with insomnia do not access this treatment. Understanding reasons for the discrepancy between clinical guidelines and clinical practice is essential to identify opportunities to increase access to CBTi. This research explores the perspectives of people with insomnia, clinicians, and the health system to provide a comprehensive picture of insomnia management in Australia. Methods A mixed-methods program was undertaken to comprehensively identify facilitators and barriers to CBTi access in Australia. This included two large quantitative surveys of the Australian community and people with insomnia, and semi-structured qualitative interviews with GPs and psychologists. Results Most people with chronic insomnia symptoms reported they did not receive a diagnosis of insomnia, only 37% had discussed sleep with their GP, 9% discussed sleep with a psychologist, and <1% received CBTi. Barriers to effective management of insomnia include low priority of sleep from all perspectives, impaired knowledge and awareness, and inadequate access to care. GPs are under substantial time pressure, other health conditions are often prioritised over insomnia, existing funding mechanisms are not clear, and few psychologists trained to deliver CBTi. Discussion To improve the management of insomnia in Australia efforts are needed to improve clinician and patient recognition of the importance of identifying and managing insomnia. More psychologists and primary care clinicians need to be trained in CBTi delivery, to increase awareness, understanding and access to CBTi in the community.