Sleep Blog

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3 August 2018

Private Health Insurance Reform Amendments

The Sleep Health Foundation recently became aware that the Department of Health is seeking public feedback on their planned reforms of private health insurance, due to come into effect from 1 April 2019. The reforms include mandating 4 tiers of hospital products – Gold, Silver, Bronze and Basic. We were not invited to have any input into the process and have only just become aware of the outcomes. Along with the ASA we are concerned that with these reforms, cover for sleep studies will be limited to Gold level cover policies.

The Foundation Board has submitted a formal response to this consultation (see below). However, we advise members and other interested parties to make their own individual responses. The documentation is available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/exposure-draft-subordinate-legislation-private-health-insurance-reforms-amendment-rules-2018 .

 

Dear sir/madam

Private Health Insurance Reform Amendments

I am writing to you on behalf of the Sleep Health Foundation (‘The Foundation’), of which I am Chair, to express our serious concerns with the proposal to restrict access to private insurance rebates for sleep studies to the proposed Gold tier of health insurance.

The Foundation (www.sleephealthfoundation.org.au), as the major national advocate for sleep health, is very disturbed about restricting access to investigation of sleep disorders, which are common and associated with serious impacts on health, safety, productivity, well-being and mood.

Sleep disorders are one of the major health concerns in Australia. Until recently, their health and economic effects have been seriously underestimated and it is particularly disturbing that just as these impacts are becoming widely appreciated there is this move to restrict access to an important aspect of their diagnosis.

It is estimated that 22.4% of the Australian population have a sleep disorder, including 8.3% having obstructive sleep apnoea (OSA), a condition where study of overnight sleep is an essential component of diagnosis. OSA is associated with an increased risk of cardiovascular disease, stroke, dementia, depression, motor vehicle accidents and increased mortality1. The amount spent on investigating and treating this problem, and other sleep disorders, is little relative to the huge costs of leaving them untreated in terms of the cost of managing medical co-morbidities (heart d, stroke, diabetes, depression, workplace and vehicle accidents), non-medical accident costs, costs of informal care, productivity losses and loss of well-being. In a 2010 analysis of the economic cost of sleep disorders undertaken by Deloitte Access Economics on commission from the Foundation, it was estimated (using conservative prevalence estimates) that the total cost of OSA (financial and non-financial) to the community was $21.2 billion per annum yet only $250 million per annum was spent identifying and treating it.1 This huge imbalance between expenditure on the condition and the costs of it if left untreated emphasises the economic danger of investing even less in pursuing this enormously costly condition.

The gold standard diagnostic test for sleep disorders is an overnight sleep study, performed within a hospital sleep laboratory. This usually involves a 1 night admission to a private or public hospital. Although home diagnostic tests are available, they have limitations and they are not suitable for all patients.

While we support the concept of simplifying private health insurance we are seriously concerned about the classification of sleep studies in the draft hospital treatment product tiers of the Private Health insurance reform amendments. We note that sleep studies are proposed to be limited to those who hold policies classified as Gold tier. Limiting sleep studies to the Gold tier is likely to severely limit or prevent access of part of the population to an appropriate diagnosis of their sleep disorder, and put additional stress on the public hospital system, which already has demand for sleep services exceeding supply. This will create inequity of access to sleep diagnostic testing among the population.

At the Sleep Health Foundation, we work with a number of self-help groups including:
• Sleep Disorders Australia
• Narcolepsy Australia
• NODDS
• Hypersomnolence Australia
whose personal perspectives underline the importance of supporting the need to identify and treat sleep disorders in the wider community.

We have found that often people with sleep disorders have limited finances due to an inability to maintain full time work. Limiting sleep studies to the Gold tier is likely to severely limit or prevent access of these and other community members to an appropriate diagnosis for their sleep disorder, and put additional stress on the public hospital system, which already has demand for sleep services exceeding supply. This will create inequity of access to sleep diagnostic testing across different sectors of the population.

The Sleep Health Foundation strongly recommends re-classifying sleep studies to allow them to be covered by all tiers of private health insurance, in order to provide equity of access to diagnosis and treatment for these extremely common medical sleep disorders.

Yours sincerely

 Dot Bruck signature

Emeritus Prof Dorothy Bruck
Chair, Sleep Health Foundation

 

1 Re-awakening Australia. The economic cost of sleep disorders in Australia. Deloitte Access Economics, 2010. Available at: https://www.sleephealthfoundation.org.au/pdfs/news/Reawakening%20Australia.pdf

 

Nine expert tips to beat jetlag

Sleepless night and hazy days on holiday – be gone!
Already dreading your next long-haul flight? Then keep reading as Professor Dorothy Bruck from the Sleep Health Foundation shares her expert tips on how to combat jetlag so you can get the most of your next holiday!

Get adjusted to the time difference
A few days before your leave for your trip start thinking about what time it is at your destination and start to reset your body-clock closer to the new time. If you are traveling from east to west, for instance from Australia to the Middle East or Europe, your body clock needs to be delayed so you should try to wake up a couple of hours later and go to bed later. If you are going west to east, say from Australia to the US, you need to wake up earlier and go to bed earlier.
Get app-happy
A really helpful tool to help your body-clock combat jetlag is the app Entrain, which has been developed by researchers at the University of Michigan. By typing in your sleeping habits and your new destination, it will recommend how you can best adapt to the new environment with the help of daylight exposure. Research shows every one-hour time distance takes one day for your body clock to readjust to, so a nine-hour time difference can take nine days! However, by following the tips in the app, you can scale the readjustment period down to four days.

A Good Night's Sleep and a Good Memory Go Hand in Hand

by Melissa Gibbs, guest blogger

As exam time looms ahead at most modern day Universities, it is common for students to stay up all night cramming, convinced that a few more crucial hours of study can seal the deal in so far as remembering important information is concerned. A recent study by scientists at the Griffith Lab, however, has shown that the mechanism that promotes sleep also consolidates memory; in other words, it is our memory neurons that make us feel sleepy, since we need to sleep in order for our short-term memory to be converted into long-term memory. Previous to the study, scientists already knew that sleep deprivation resulted in problems remembering facts and events; however, they did not know whether the same mechanism that promoted sleep also consolidated memory, or whether two independent processes worked side-by-side.

Researchers, Paula Haynes, Leslie Griffith and Bethany Christmann focussed their research on dorsal paired medial neurons (DPM), which are known as memory consolidators in small fruit flies (Drosophila). They noted that when DPM neurons were activated, the flies slept for longer periods; when they were deactivated, the flies stayed awake.

Sleep your way to health

Your body doesn't switch off when you shut your eyes – it's working for your mood, weight loss and overall wellbeing. Here's how:

  • Sleep is as essential as keeping fit and eating well.
  • Sleep is the third part of a healthy lifestyle along with healthy eating and regular exercise.
  • Sleep plays a role in weight management.

Research shows that people who slept eight and a half hours a night lost almost twice as much weight as people who got five and a half hours sleep each night. And women with poor sleep habits gain more weight than women who sleep well too. So if your weight has hit a plateau or the scales are creeping up, you might want to reassess your sleeping hapits. Without enough sleep your hormones are out of whack and you body craves sugar, fat and high-GI foods.

The Sleep Journey

We think about it constantly. It's as important as eating, breathing and walking the dog, but for many people sleep often plays hard-to-get.
Here are some easy tips to help maximise those eight+ hours a night.

1. Set your alarm clock for the same time each day
Getting up in the morning is never pleasant but going to bed and getting up at similar times each day is the best way to train your body. This lets our internal body clock build a strong sleep wake cycle. Yes, even weekends, although sleeping in makes sense if you have had a series of late nights and have to catch up on lost sleep.

2. Make your bedroom as sleep friendly as possible
The bedroom should be quiet, dark and always comfortable. Getting the right room temperature is essential, along with a comfortable bed, pillows and bedding. Electronic devices, such as mobile phones, tablets and laptops are a danger zone for distraction, so best to leave them outside the bedroom. If you have a clock that you can see in the night, turn it around to face the wall.

Sleep disorders and cardiovascular morbidities training

The Heart Research Centre, in Melbourne is organising a 'Sleep disorders and cardiovascular morbidities' one day training course on Thursday 19 March 2015.

Training booklet information:
Sleep disorders and cardiovascular morbidities
Sleep disorders in cardiovascular patients are widely undiagnosed or even dismissed as a natural part of life. Recent research has shown that they considerably increase the risk of
coronary disease, stroke, heart failure, atrial fibrillation, depression and hospital readmission. Untreated sleep disorders substantially impede rehabilitation.
We focus on three common sleep disorders: Obstructive Sleep Apnoea (OSA), insomnia, and snoring.

Sleep’s Marketing Problem: You ‘Have To’ Go to Bed.

It's 7 p.m. My children should be winding down for sleep, but my 6-year-old cannot fathom leaving his Lego X-Wing Fighter incomplete. My 3-year-old won't brush her teeth. When she finally does, she decides she "must" change her pajamas again.

I hear my husband — running low on patience — say, "Guys, if we can't keep moving on our routine, we're going to have to go to bed tonight without stories."

At first glance, it's a perfectly reasonable parental plea. Nothing wrong with stating a simple fact about the clock and the reality of time marching on. But it dawned on me that, in this situation, sleep was definitely the bad guy. My husband didn't mean it that way, but his tone and his words made sleep sound like the evening's dreaded down point.

Bedtime Secrets Help Babies Sleep Like Babies

An innovative new web tool reveals the sleep secrets of babies, spelling the end of sleepless nights for hundreds of Australian mums and dads.

Studies show a third of new parents struggle to get their baby to sleep, and this frustrating problem triples the risk of postnatal depression among mothers.

Sleep experts are hoping to turn the tide on these statistics with an interactive online infant sleep program that educates health professionals giving advice to worried parents.

The hour-long eLearning course sets out clear guidelines on how parents can get children aged six to 18 months to fall asleep alone and self-settle when they wake in the night.

Seeking High profile person with sleep health interest

Do you have a patient, colleague or friend who could become a 'champion' for sleep disorders and sleep issues? The person we are looking for should be well known in Australia and have a media profile. The Sleep Health Foundation is interested in working with such a person to help promote awareness in the community about sleep. It may, for example, be someone who is being successfully treated for sleep apnoea and is a sportsperson, actor or public identity.
If you know of someone who may be suitable please confidentially email SHF on for initial approval to approach the person to determine their interest and availability.

Smartphones for Smarter Sleep and Mental Health

Sleep plays a key role in the way that people think, feel, and behave. For approximately 20% of the population, poor sleep regularly impacts upon their physical and mental wellbeing. For those suffering the effects of inadequate sleep, smartphone-based sleep improvement applications (apps) may provide an opportunity to access readily available sleep interventions. However, there is a distinct lack of evidence-based research examining the efficacy of sleep-related apps.

Canberra Meetings Update

As promised in the recent Foundation e-newsletter here is an update on the meetings I recently attended in Canberra with colleagues from the Australasian Sleep Association.

Parliamentary Seminar
On March 19 the Foundation and the ASA presented a seminar entitled “Poor Sleep: A Challenge to National Health, Productivity and Safety”. While a small meeting (parliament was in session at the time and our meeting coincided with Senator Sinidonis’ address to the Senate in which he announced he was stepping aside) it was attended by all our key senator supporters and their staff and a number of other parliamentarians. The session was recorded for circulation to parliamentary staff. The programme covered Poor Sleep: A Challenge to National Health, Productivity and Safety and was sponsored by Senators Madigan, Xenophon, Di Natale and Bilyk.

Employee Smartphone Usage, Sleep and Productivity

Smartphones are ubiquitous in modern life. They are an essential tool for communication, information storage and retrieval as well as entertainment. Many organisations supply smartphones, as well as similar technology (e.g. tablet PCs and laptops) to their employees in order improve productivity. There is no argument that this technology can expedite employee responses to time critical events and allow faster responses to internal and external customer enquiries. With their mobility, smartphone technology can allow employees to work regardless of the venue, or the availability of a desk. But does this technology come at a cost?

Back to School sleep tips

Now is the time to start getting your children back into the school time sleep routine. 

Top tips for getting into a back-to-school sleep schedule:

  • Move bedtimes up by 30 minutes each night until you’ve hit the target time for bed.
  • Turn off the television, electronics such as video games and iPods about an hour before bedtime.  
  • Make sure your kids are getting the proper amount of exercise each day.  Exercise can help your body increase the deep sleep it needs each night. 
  • If your child cannot sleep in total silence, invest in a white noise machine or turn on a fan.
  • Don’t confuse your child’s sleep pattern by changing the bedtime on weekends.  Keep the same sleep time all week long.

Are some insomnia symptoms easier to treat than others? 

Many insomnia symptoms are readily treated with interventions such as encouraging, teaching, and reinforcing healthy behaviours, as well as eliminating poor sleep habits that contribute to sleep difficulties.  A simple example: removal of technology from the bedroom and eliminating computer use one hour before sleep.  This is an example of identification of an issue, education on why it’s likely an unhelpful behaviour, and teaching a change. The next step is execution.

Can't sleep, want more information

Sleep and mental health

Life constantly throws up challenges and difficulties. Resilience is the ability to manage and cope with these. It is believed that having enough sleep is an important factor in our ability to deal with adversity and the demands of a busy life. Sleep in many respects is a built in biological source of resilience and the ability to bounce back.  Although the relationship between sleep and mental health is not clearly understood, we believe that a good night's sleep helps foster both mental and emotional resilience. Chronic sleep disruptions set the stage for negative thinking, depression, anxiety and emotional vulnerability.

During the day, we are bombarded with new information. Sleep gives the brain some ‘down time’ to process all of this information and store it in our memory banks. This way, it is available and accessible when it is needed. Having enough sleep improves concentration, creativity and assists with learning.

CFS:How Does It Affect Sleep?

Researchers at Australia's Victoria University Professor Dorothy Bruck and Postdoctoral Research Fellow Melinda Jackson have conducted a review of research related to sleep and chronic fatigue. Their analysis sheds some light on possible reasons for poor sleep among patients with chronic fatigue.

People with chronic fatigue syndrome (CFS) are more than “just tired”. They suffer from an intense fatigue and exhaustion that won’t go away. Physical or mental activity can make their CFS symptoms worse. To recover, the person must rest for longer than usual. People with CFS have less energy to do everyday tasks. This can apply to both physical things (e.g. to go for a walk), and mental things (e.g. to focus at work).

People with CFS have sleep difficulties as well. These can include finding it hard to get to sleep, waking up often during the night and/or waking up too early in the morning. Having a bad night of sleep can make it harder to remember things. It can also be harder to focus on tasks and increases moodiness or irritability. Poor sleep can also increase sensitivity to pain. For people with CFS, poor sleep can make the feelings of being fatigued even worse.

You can read the full article here.

Poor sleep affects mood & mind

Chill out: disturbed sleep plays havoc with your mood and mind.
This article has been reproduced with the permission of the author and The Conversation.
A poll by Lifeline released earlier this week shows almost two-thirds of Australians reported sleep loss because of stress relating to work or their finances. The findings went largely unremarked, even though a chronic lack of sleep has serious public health implications.
Sleep theory tells us that there are two key things that determine when we feel like going to sleep. One is simply how long we have been awake, and the other (as any shift worker knows) is the timing of our body clock (this clock controls all our natural rhythms, making us both alert and sleepy across a 24-hour period).

Senate recognises Sleep Health

Canberra was a busy place on Thursday 27 June.  While you are all aware of events later in the day, you should also know that a very important moment in the sleep health of our country occurred earlier, in the Senate.  A motion, sponsored by Senator John Madigan and his colleagues, Senators Nick Xenophon, Dean Smith and Richard Di Natale, concerning sleep health was passed unanimously.  The motion notes the role and aims of the Sleep Health Foundation and the findings of the economic evaluation of the cost of sleep disorders commissioned by the Foundation (Deloitte Access Economics.  “Reawakening Australia”,October 2011, available on the

Technology and sleep

For quite some time now we have heard about how technology is bad for sleep. Staring at blue light emitting devices such as televisions, computers, tablet PCs and smart phones can all reduce the production of melatonin (our natural sleeping hormone) at night, causing increased sleeping difficulties and more daytime drowsiness. The best way to reduce this blue light exposure in order to improve sleep is to turn off all gadgets about an hour before bedtime. However for those technophiles who cannot detach themselves from their devices there are two good ways to reduce blue light exposure before bed.

Sleep and mood are closely connected

We all know what it feels like when we don’t get a good night sleep – we may feel tired and irritable the next day, and little things can get to us. Poor sleep can worsen stress and other health problems, such as depression, heart disease and diabetes. Depression can also cause poor sleep, with difficulty getting off to sleep and then waking up during the night. Sometimes, if we are able to get a few good nights of sleep, our mood will improve. Healthy sleep is important for our well-being and quality of life.

$70m Boost for Research

Prime Minister, Minister for Tertiary Education, Skills, Science and Research.

The Gillard Government will invest over $70 million to help Cooperative Research Centres (CRCs) improve the lives of Australians by driving world class research in areas including cell therapy, autism, eye care in remote communities and workplace safety.

The Government will fund three new CRCs – focused on Alertness, Safety and Productivity; Cell Therapy Manufacturing; and Living with Autism Spectrum Disorders – and provide additional funding to the existing Vision CRC to expand its research programs.

Sleep and happiness

If you are a ""worrier"", you are at greater risk of having insomnia.

  • Worrying about your sleep can make it worse. This may create a vicious cycle of poor sleep and worrying.
  • Worrying may disturb your sleep even you if you are not an anxious person.
  •  If you have a regular pattern of poor sleep and feeling tired during the day,  you may feel less sure of your ability to ever sleep well again.
  • Insomnia that began in a time of high stress might not go away, even after the stress has been dealt with.
  • To treat insomnia, one of the main things you should focus on is being more relaxed and drowsy before going to bed
  • Using alcohol for relaxation may lead to worse sleep. It is a popular myth that alcohol improves sleep."

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