Sleep disorders and the NDIS: What you need to know

Key points:

• Major sleep disorders affect roughly one in five Australians

• Although severely detrimental to personal, professional, health and interpersonal wellbeing, the National Disability Insurance Scheme (NDIS) does not provide funding for all sleep disorders

• Sleep disorders include: insomnia, obstructive sleep apnoea (OSA), restless legs syndrome (RLS), circadian rhythm sleep disorders and hypersomnolence disorders

This edition of Disability Support Guide assesses what sleeping disorders are, the symptoms of each respective disorder, and lastly, the role the NDIS plays in providing support and how you can find help.

For reference, the following age groups are supposed to get this much sleep:

Newborns — 14 to 17 hours

Infants — 12 to 15 hours

Toddlers — 11 to 14 hours

Pre-schoolers — 10 to 13 hours

School aged children — nine to 11 hours

Teenagers — eight to 10 hours

Young adults — seven to nine hours

Adults — seven to nine hours

Older adults — seven to eight hours

Insomnia

People with insomnia experience persistent troubles with falling asleep on-time and for the recommended duration. Those with the condition may find that despite their best efforts, they cannot experience the same refreshing sensation upon waking up, should they be able to close their eyes and attempt to get some rest.

Causes of insomnia may include:

• Shift work (late or sporadic working hours)
• Personal, professional or emotional stress and anxiety
• Alcohol, narcotics, prescription medicines and nicotine
• Poor hygiene, mental health or medical issues
• Old age
• Other existing sleep disorders, such as OSA

Insomnia can lead to:

• Poor memory and focus
• Lack of motivation
• Feeling zombie-like (ie. slow movement, reflexes and a lack of spatial awareness)
• Mood swings and aggression
• Potential symptoms of psychosis (severe lack of sleep for many nights may lead to delusions and/or hallucinations)

Insomnia is not currently supported by the NDIS as it is not classed as a permanent impairment, despite being chronic in nature. However, insomnia has a high rate of comorbidity, meaning that those seeking support for funding may be able to access support to psychosocial or other sleep disorders (such as OSA-related continuous positive airway pressure (CPAP) machines) under the Scheme.

Obstructive sleep apnoea (OSA)

OSA is a sleep disorder which prevents someone from breathing for 10 to 90 seconds, causing the person to wake up, known as an arousal, adjust themselves and go back to sleep intermittently. Although the person themselves may be unaware of it due to their sleeping status, the impact can be felt the next day due to an inconsistent rest. Apnoeas (pauses in breathing) relate to a blocked airway (obstructive) in people with OSA, as opposed to central sleep apnoea (CSA), which is related to how the body regulates breathing itself.

Causes of OSA may include:

• Snoring
• Old age
• Obesity
• Narrow throat or nasal passage
• Family history of sleep apnoea

OSA may lead to a higher risk of:

• Cardiovascular disease
• Diabetes
• Headaches
• Decreased sex drive

For people with moderate to severe OSA or CSA, a CPAP machine — which pumps air and holds the throat open for safe breathing — may be required as a form of treatment. CPAP machines may be covered under the NDIS and may resolve other comorbid conditions, such as insomnia.

Restless legs syndrome (RLS)

Very little is known about RLS, such as its underlying causes or likelihood of progressing/resolving itself. RLS is characterised by jerking or twitching of the leg in unpleasant or erratic ways which may disturb a good night’s sleep. RLS is particularly common in late stages of pregnancy, but tends to resolve itself after the child is delivered. RLS is not covered under the NDIS, as it is not deemed a permanent impairment. 

Hypersomnolence

Hypersomnolence is defined as a greater sense of feeling tired, with disorders in this category — in particular, narcolepsy, defined by an inability to stay awake during the day and function as per usual.

Some people with narcolepsy have what is known as narcolepsy-cataplexy (also known as narcolepsy type-one). A cataplexy attack is a brief moment where a person will feel their nervous system or ability to function begin to decline prior to falling asleep (slurred speech, droopy eyelids or unusual movement). People who do not experience cataplexy are considered to be type-two narcoleptics.

Narcolepsy may be caused by:

• A dysfunction in the hypothalamus (think of it as the boss of your nervous system)
• Deficiency in wake-proteins such as orexin or hypocretin
• Poor sleeping habits

People with narcolepsy will experience:

• Potentially passing out or falling asleep in an undesirable situation
• Sleep paralysis (feeling immobile and/or mute after waking up for a brief period of time)
• Hypnagogic hallucinations (not quite asleep, not quite awake — inability to tell reality from dreams; seeing or hearing things which are not there)
  

Narcolepsy is not considered a disability under the NDIS, nor is it considered eligible for the disability support pension (DSP). An April 2019 inquiry report to the Australian Parliament includes feedback from people with the condition and their issues with finding support. One participant says the following:

“The most suitable payment is [the DSP] which currently does not have the condition, or any other sleep disorder listed as a medical condition to begin with. This means that they have to try to relate their impairments to the current impairment tables, [and] then be assessed under those tables by an assessor who in most cases hasn’t even heard of narcolepsy, never mind have [sic] any concept of how debilitating the condition can be.”

Getting help

To find support for sleep disorders in Australia, please visit some of the following websites to keep up to date with the organisations available to you:

• Sleep Foundation
• Sleep Health Foundation Australia
• Sleep Disorders Australia
• Health Direct (Australian Government)
• Beyond Blue

Related content:

Disabilities not supported by the NDIS

I don’t have NDIS funding

What if my NDIS application is not successful?