Abstract Introduction Sleep disorders are highly prevalent, yet frequently under-recognised and inadequately assessed in primary care and other health care settings. Empirical evidence suggests that primary care and health care providers have low levels of sleep health knowledge and inconsistent screening practices, which may contribute to under-detection of sleep problems. This study conducted a systematic review of sleep disorder-related screening and diagnosis practices of primary care providers (PCPs) and assessed the sleep health knowledge of health care providers. Methods A search was conducted in PubMed, Scopus, Web of Science, Embase, and CINAHL, including qualitative and quantitative studies from inception to November 2024. Eligible studies examined sleep health service delivery, sleep knowledge, and perceptions of sleep health in primary care. The review was complemented by a quantitative survey of Australian health care providers using the 30-item ASKME (Assessing Sleep Knowledge in Medical Education) tool. Results The review included 37 studies from 19 countries (1996–2024). Studies were organised into four categories, with most focusing on 1) sleep disorder screening practices and sleep-related knowledge of PCPs (n=24) and 2) diagnostic approaches for sleep disorders and gaps in these practices (n=4). For screening and knowledge, key findings indicated limited awareness of screening tools, uncertainty regarding clinical guidelines, and inconsistent screening practices. For diagnostic approaches, delays were frequently associated with low confidence in screening, and PCPs reported unclear referral pathways as a barrier. In the primary data, 89 health practitioners (77.5% female; Mage=42.5 years ±12.94) completed the ASKME survey. Sleep knowledge in this sample was low, with only 34.3% of the sample answering 60% of items correctly (Mscore=15.4 ±5.30). Conclusion This review and data analysis revealed significant sleep knowledge gaps among primary care and other health providers. Lack of training and expertise emerged as key barriers to screening and diagnosis, which may result in missed opportunities and delayed detection of sleep disorders. Improving integration of sleep care into non-specialist health care settings requires enhanced education, standardised screening pathways, and decision-support tools within clinical workflows. Support (if any) The study was funded by an MRFF EMCR grant and a UQ research scholarship.
Kalmadka et al. (Fri,) studied this question.