A new Flinders University study shows that nurses working in general practice could play a major role in improving access to sleep‑health treatment, but only if patients and general practice staff are involved in designing these services.
Published in BMC Primary Care , the study is the first to explain why effective nurse‑delivered sleep‑care models have not yet made it into everyday GP clinics, despite strong evidence that they work.
Researchers from FHMRI Sleep Health reviewed and combined the findings of 85 studies exploring nurse-delivered models of care after seeing growing delays for specialist sleep services and limited access to recommended treatments such as cognitive behavioural therapy for insomnia (CBTi) and CPAP machines for obstructive sleep apnoea (OSA).
“General practice nurse‑delivered models of care for the management of sleep disorders have already been shown to be effective, but they still haven’t been adopted into routine care,” says lead author, Nicole Grivell , a sleep researcher and registered nurse.
“Until now, no research had explored the real‑world barriers and enablers that affect whether GP clinics can successfully put these models into practice, especially in sleep health.”
The review found strong potential for GP nurses to deliver assessment and treatment for common sleep problems like chronic insomnia and OSA, conditions frequently raised in everyday GP appointments.
“We know nurses in general practice are well placed to deliver treatments like CBTi and to support patients to commence CPAP,” says co-author and senior researcher, Associate Professor Ching Li Chai-Coetzer , a respiratory and sleep physician.
“These approaches can improve sleep quality, daily functioning, and long‑term wellbeing.”
“With specialist wait times rising and limited access to CBTi, empowering GP nurses to deliver proven sleep care could change lives and ease pressure on the wider health system.”
The study also revealed that if models of care are not designed to meet the needs of patients and general practice does not have sufficient funding, particularly for nurses to deliver the care, many new models of care will struggle to get off the ground.
The authors say that this leads to services that work well in trials but could fail in real‑world practice.
The researchers urge policymakers, clinicians and researchers to co‑design services with patients and GP clinic staff from the start to improve uptake, sustainability, and outcomes.
Key findings:
“Despite strong evidence that nurse‑delivered models of care work, they haven’t made it into everyday practice,” says Ms Grivell.
“Our review shows that involving patients and GP clinic staff in the design of these services is critical for real‑world success.
“Done well, these models could reduce demand on specialist services and improve long‑term health outcomes for thousands of Australians.”
Acknowledgements:
Funding for this project is in the form of Doctor of Philosophy scholarship funding, from a Flinders University Research Scholarship, Flinders Foundation Nick Antic Sleep Research Scholarship and an NHMRC Centres of Research Excellence grant “Positioning Primary Care at the Centre of Sleep Health Management”
The paper, ‘ Factors influencing the implementation of general practice nurse-delivered models of care for chronic conditions: a mixed-methods systematic review to inform models of care for chronic sleep disorders ’ , by Nicole Grivell, Brandon Brown, Jeffrey Fuller, Ching Li Chai-Coetzer, R. Doug McEvoy and Elizabeth Hoon (Adelaide University), was published in BMC Primary Care . DOI: 10.1186/s12875-025-03078-4 .
BMC Primary Care
Systematic review
People
Factors influencing the implementation of general practice nurse-delivered models of care for chronic conditions: a mixed-methods systematic review to inform models of care for chronic sleep disorders
14-Apr-2026
The authors declare no competing interests.