A world-first approach that empowers physiotherapists to address sleep in order to treat chronic pain is set to transform the lives of 3.6 million* Australians.
The pioneering initiative, led by Australian Neurosurgeon Professor Tony Goldschlager and physiotherapist Peter Allen, integrates sleep assessment into physiotherapy care as an evidence-based tool with the potential to dramatically reduce reliance on strong medications or invasive procedures.
Despite strong emerging evidence linking sleep disorders to chronic pain, Australian clinical care standards for back pain do not currently include sleep screening or an assessment of bed support. Now, a team of experts across neuroscience, physiotherapy, and sleep medicine is bridging this gap by developing a practical, evidence-informed model that empowers physiotherapists to screen for sleep disorders and prescribe tailored bed support.
The model provides physiotherapists with the additional training and tools required to be able to screen for sleep disorders and prescribe patient bed support under video guidance during their usual physiotherapy clinic-based consultations.
Patients in a recent feasibility study, who had ongoing pain despite months of standard physiotherapy care, experienced significant pain relief after integrating sleep-focused interventions. Among them was Carlton AFL legend Wayne "The Dominator" Johnston, who described the program as "life-changing."
"Sleep is often completely overlooked in pain assessment," said Professor Scott Ayton, "but research clearly shows that people with chronic pain frequently have sleep disorders such as insomnia or obstructive sleep apnoea. Addressing these issues can profoundly reduce the brain's sensitivity to pain—sometimes making the difference between needing painkillers and managing without them."
The team includes physiotherapist and researcher Associate Professor Jon Ford, and sleep physician Dr. Harshan Jeyakumar.
A key component of the model is a fully adjustable bed system, designed to give physiotherapists unprecedented control over their patients' sleep posture and support at home.
"Physiotherapists are the frontline in the fight against chronic pain, seeing patients regularly over many years," said Allen. "Despite our best efforts, some patients continue to struggle with persistent pain. This new approach has been eye-opening—I had no idea sleep could have such a major impact. Now, it's one of the first things I address with my patients because I'm confident it has the potential to make a significant difference to their quality of life."
Professor Goldschlager believes the intervention could be a game changer:
"If you are one of the estimated 3.6 million* Australians suffering chronic pain, before you consider taking strong painkillers or seeking invasive treatments, I would recommend focusing on your sleep pain cycle. Our message is to start by seeing a physiotherapist and one that is trained to assess your sleep" said Professor Goldschlager.
"Working on your sleep can significantly improve your quality of life," he added.
A New Model of Care for Physiotherapy
The team is now working towards designing a Randomised Control Trial (RCT) to further validate this approach. The trail is expected to run for 3-6 months with around 30-40 participants experiencing persistent pain, will measure pain levels, quality of life improvements, and inflammatory markers before and after undergoing a physiotherapist-led sleep intervention and using an innovative bed system designed to optimise sleep posture.
This ground-breaking approach equips physiotherapists with an adjunct model of care to:
Identify sleep disorders using a clinical screening tool
Prescribe personalised sleep solutions tailored to each patient
Adjust patient sleeping posture using an advanced bed system, ensuring they maintain optimal support at home
"Physiotherapists are at the frontline of pain management, but sleep is rarely addressed in treatment," said physiotherapist and co-researcher Peter Allen. "We're working to change that by developing a practical, evidence-based framework that physiotherapists can use in their clinics."
Reducing the Burden of Chronic Pain on Patients & the Health System
Chronic and persistent pain, including back and neck pain, comes with a significant economic and human cost. The expected benefits of this trial include:
Reduced pain and improved quality of life for patients
Lower reliance on invasive surgical procedures and emergency departments
Less strain on Australia's healthcare system, which is estimated to cost an estimated $215.6 billion by 2050*.
Bringing Sleep Training to More Physiotherapists for Better Patient Outcomes
More than 30 physiotherapy clients in Australia are already integrating sleep assessment and interventions into their practice. In collaboration with SD Laboratories, led by Professor Goldschlager and Peter Allen, this program is set to expand to 100 clinics by mid-2025, giving more physiotherapists access to training and tools to help patients sleep better—and hurt less.
Patients interested in participating can register via www.sdlaboratories.com, and physiotherapists can sign up for upcoming training workshops.
Key Facts:
*https://chronicpainaustralia.org.au/resources/
