Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697636465204.pdf (Australia)
SENATE INQUIRY INTO SLEEP HEALTH AWARENESS IN AUSTRALIA Executive Summary Red Nose, Australia’s national voice on reducing sudden and unexpected death in children under five, applauds the national parliamentary Standing Committee on Health, Aged Care and Sport for commencing an inquiry into Sleep Health Awareness in Australia.

Thank you for investigating this significant health issue.
As leaders in the field of safe sleeping and the key player in reducing SIDS in Australia by 85%, we remain strong innovators of community education and bereavement support and are recognised for these attributes on both the national and international stage.

We believe that all parents, carers and health professionals have the right to receive free safe sleep education that is easy to access and understand in order to keep babies and children safe.
We believe that the continual provision of safe sleep education, along with sleep hygiene education, has the potential to prevent future long term health issues.

We believe that more work needs to be done to ensure the numbers of deaths of children occurring in pregnancy, infancy and childhood decrease and lives continue to be saved.

Red Nose Vision A future where no child dies suddenly and unexpectedly during pregnancy, infancy or in childhood.
Red Nose Mission Statement Saving the lives of children during pregnancy, infancy and childhood and ensuring all people affected by the death of a baby, infant or young child, are supported, cared for and connected to what they need to continue engaging with life.
Red Nose Senate Enquiry into Sleep Health Awareness in Australia 1 Inquiry into Sleep Health Awareness in AustraliaSubmission 119 Introduction Founded in 1977, Red Nose (formerly SIDS & Kids) is a not-for-profit organisation providing health promotion and education with regard to safe sleeping practices, research and bereavement support for all Australians.
For the past 40 years, Red Nose has been committed to saving the lives of babies and children with particular attention to stillbirth, sudden unexplained death of an infant (SUDI), sudden infant death syndrome (SIDS) and fatal sleep accidents.

Through our world leading safe sleep recommendations, and facilitating one of Australia’s most successful public health campaigns, Red Nose reduced the incidence of SUDI in this country by 85%.
Having invested upwards of $17 million in research, our evidence- based safe sleeping recommendations help prevent the sudden loss of a child during pregnancy and childhood.

In accordance with our core values, we offer an extensive suite of bereavement services to anybody impacted by the loss of a child.
Red Nose Commitment to National Change Recently, we learned of changes to the National Quality Framework handed down by the Australian Children’s Education and Care Quality Authority (ACECQA) in October 2017.

The changes were prompted by the death of a five month old girl from SIDS in a childcare setting in 2012.

In handing down the recommendation, ACECQA acknowledged Red Nose as a recognised national authority on safe sleeping practices for infants and children.
In response to these changes, Red Nose developed an eLearning program enabling early childhood education and care services to meet new regulations requiring them to have policies and procedures for the safe sleeping of infants and children.

This program was developed in conjunction with our National Scientific Advisory Group, made up of leading researchers and health professionals.
Earlier this year, Red Nose responded to the senate inquiry into Stillbirth with an action plan to drive down the unacceptably high rate of stillbirth in this country.

In collaboration with the Chief Medical Officer of Scotland, Dr Catherine Calderwood and modelled on the Scottish framework, we developed an efficient package that could easily be implemented into our current health care setting.
We are very excited to continue developing this innovative package and look forward to being able to make national change in this significant health issue.
Red Nose Senate Enquiry into Sleep Health Awareness in Australia 2 Inquiry into Sleep Health Awareness in AustraliaSubmission 119 GOALS  All Australians receive access to up to date evidence based safe sleep information and support  All babies sleep safely and well establishing healthy habits for adulthood  Continue to drive research, turn breakthroughs into education, advocacy and positive change for Australians and our international counterparts.

Terms of Reference 1.


The potential and known causes, impact and costs (economic and social) of inadequate sleep and sleep disorders on the community The importance of sleep, good sleep hygiene and how this can impact on long- term health and well-being cannot be underestimated.

It is an important part of overall physical and mental health for both adults and children.
The total cost of inadequate sleep in Australia was estimated to be $66.3 billion in 2016-2017 (Asleep on the Job: Counting the Cost of Poor Sleep Health – 2017 report from Sleep Health Foundation).
This total consists of:   $26.2 billion in financial costs to the health system, loss of productivity and informal care costs $40.1 billion in loss of wellbeing, estimated using World Health Organisation and Australian Government metrics, which assess the non-financial costs of healthy life lost through disability and premature death from inadequate sleep and associated conditions.
These costs warrant substantial investment in preventive health measures to address the issue through research, education and support.

Red Nose Senate Enquiry into Sleep Health Awareness in Australia 3 Inquiry into Sleep Health Awareness in AustraliaSubmission 119 Red Nose is in an optimal position to assist with making a positive impact into the current economic situation the government is facing with regard to the impacts and costs of sleep problems.
As evidenced by our successful safe sleeping campaigns, we can educate and support young families to ensure best practice outcomes for early childhood, particularly in establishing good sleep hygiene and strategies for safe sleep contributing to healthier futures.

In addition, Red Nose can help parents and carers directly have a better quality and quantity of sleep by ensuring they have access to up-to-date, evidence-based information for keeping their babies safe through the night.
This will improve overall well- being and will promote positive parenting interactions, giving parents a sense of success in their parenting skills and confidence to return to work.

To date, there has been little research into the economic impact of sleep disorders in children due to insufficiencies in data.

While new data is emerging on the relationship between childhood sleep disorders and long- term health conditions, more research is needed.
What we do know is that the effects of disordered sleeping on the overall health and well- being of the child may include poor growth, adverse behavioural and learning effects, mental health problems and poor quality of life (Waters, et al 2013).

During infancy, sleep is at a lifetime maximum, and the maturation of sleep is one of the most important physiological processes occurring during the first year of life, particularly the first 6 months (Horne, et al 2007).
This is why it is vital that we ensure from the very beginning, healthy and safe sleep practices are introduced, forming good habits that are continued throughout the child’s life.

Good sleep health is extremely important across the full continuum of care from pregnancy to birth, during infancy and into childhood.
Red Nose remains true to its commitment to actively seeking research opportunities that can be translated into the provision safe sleep education to the community as well as support to families who need it most.

Our most vulnerable babies with a higher risk of SUDI, SIDS and sleep accidents are those born pre term or of low birth weight.
Further, these babies often require more sleep than their well-grown term counterparts, to assist them to cope with emotional and psychological development and their ability to cope under stress (Schwichtenberg, et al 2013).

If these babies are not given the appropriate opportunities to sleep, in a safe way, from early on in life, they become at risk of developing social problems as they develop.
Red Nose provides support and education to hospitals and parents about safe sleeping however, more could be done for this high risk group of babies.

Through our parallel focus on stillbirth, we are seeing emerging research breakthroughs that will shape vital educational programs and reduce the number of stillbirths, babies being born pre term or of low Red Nose Senate Enquiry into Sleep Health Awareness in Australia 4 Inquiry into Sleep Health Awareness in AustraliaSubmission 119 birth weight.
Through the implementation of our Red Nose Stillbirth Prevention Package, will be able to reduce the numbers of pre-term and low birth weight babies being born, in turn reducing the economic burden on hospital NICUs.

In addition, pre-term birth is a major cause of family separation; of babies from their mothers, and of women from their families and communities.
We have the ability to make a positive impact on costs incurred from parents’ suffering inadequate sleep due the stress of having a child in the NICU, their inability to return to work and function well.

Our submission to the Senate stillbirth inquiry outlining our package included the following five elements to address stillbirth and/or the prevention of pre term and low birth weight babies being born: 1.
A tailored patient education campaign with clear messaging that stillbirth can happen to anyone and some are preventable 2.

Implementation of a new package to reduce smoking in pregnancy across all maternity units in Australia 3.

Raise awareness for reduced fetal movement 4.

Risk assessment and fetal surveillance for fetal growth restriction 5.

Implementing a new Perinatal Mortality Review Tool 2.
Education training and professional development available to healthcare workers A key focus of Red Nose is its education provision, which is designed to ensure all health professionals have access to, and are trained in, our key recommendations to reduce risks associated with SUDI.

This also applies to parents and carers.

Currently, Red Nose provides vital safe sleeping education to expectant parents, families, and health care professionals nationally.
Our research-backed and evidence-based education recommendations and practices are developed and reviewed by leading experts in the area of optimal infant care practices.
Resources include:    Education sessions to parents, families, child care centres and health professionals Evidence-based resources including safe sleeping brochures and posters Smart phone applications providing evidence-based education on Safe Sleeping, Tummy Time and Safe Wrapping in five languages including English, Chinese, Vietnamese, Hindi and Arabic.
Available for iOS and Android  Safe sleeping workshops, advice and information at parenting expos Red Nose Senate Enquiry into Sleep Health Awareness in Australia 5 Inquiry into Sleep Health Awareness in AustraliaSubmission 119  Programs assisting health professionals and child care workers in compliance with national policy and standards in the area of safe sleeping and child safety Red Nose education has two government contracts: Reducing the Risk of SUDI in Aboriginal Communities (RROSIAC) in WA and the ACT Health Program.
Under the RROSIAC program, educators undertake regional visits, train the trainer sessions, host Aboriginal Men’s Focus Groups and take part in an Aboriginal Advisory Group.

Most recently and in partnership with the University of Adelaide, Red Nose launched a book titled SIDS, Sudden Infant and Early Childhood Death: The Past, the Present and the Future.

This resource is available as a free download.


As a leading national authority on safe sleeping, Red Nose has the ability to create evidence-backed and affordable education resources which are easily accessible by all members of the community.

3.

Current national research and investment into sleep health and sleeping disorders Red Nose proudly supports research under the guidance of its National Scientific Advisory Group (NSAG) made up of leading researchers and health professional.
This guidance in turn supports our resources, programs and products targeted to parents, families and health professionals.

Vigorous research into SUDI and stillbirth-related sleep health continues in Australia and overseas.

From this clinical research and systematic evidence reviews, NSAG and Red Nose can in turn decide on effective interventions and combat emerging challenges.
Currently, Red Nose is co-funding an exciting research project lead by Dr Adrienne Gordon into maternal going-to-sleep position and the risk of stillbirth.

The prevention of stillbirth remains one of the greatest challenges in modern obstetric practice and yet, despite advances in the care of women and estimated 2.64 million babies die before birth globally each year.

In Australia, we lose six babies per day to stillbirth.

In order to reduce this statistic, modifiable risk factors need to identified.
Aside from those that rely on the clinical management of the pregnancy, going-to-sleep position in the last three months of pregnancy is a recently identified and modifiable risk factor that women can change themselves.

The results of this research continues to evolve and the results will provide vital evidence to help clinicians change the sleeping messages provided to women.
Building on ongoing efforts and existing structures, Red Nose will in turn create a public health campaign to guide all Australian families to reduce their stillbirth risks.
Red Nose Senate Enquiry into Sleep Health Awareness in Australia 6 Inquiry into Sleep Health Awareness in AustraliaSubmission 119 Conclusion Thanks to the enormous efforts of everyone who believed that we could make a difference and drive change, we were able to demonstrate tremendous success in one of Australia’s largest public health campaigns – the reduction of SIDS.
This success ensured that we have secured our position as a well- credentialed and trusted brand, a symbol of hope for families and best placed to be at the centre of any future public health project implementation.

At Red Nose, we are in a strong position to create and distribute evidence-backed, high quality and meaningful education resources and public health campaigns that are easily accessible to all members of the community.
As a leading, national authority we are confident in our ability to continue educating the wider Australian community in vital safe sleeping practices.

Red Nose greatly appreciates the opportunity to provide a submission to the senate with regard to sleep health in Australia and we thank you for your consideration.

We look forward to working collaboratively with you to enhance the current support services within Australia.

Together, with your support, we can end preventable deaths and reach zero.
Recommendations  All Australians continue to receive access to up-to-date, evidenced-backed safe sleep information and support through research and innovation  Digitally delivered interventions that work   Better access for all Australians, especially those in CALD communities and those living in rural and remote areas Improvements to digital access points  Resources to mature the current systems to continue to support the community and evolve  More staffing and education  Continue to drive research, turn breakthroughs into education and advocacy, and affect positive change for Australians and our international counterparts.
Red Nose Senate Enquiry into Sleep Health Awareness in Australia 7 Inquiry into Sleep Health Awareness in AustraliaSubmission 119 References Horne, R. S., Nevsimalova, S., and Bruni, O., (2017), Sleep Disorders in Newborns and Infants.

Sleep Disorders in Children.


129-153 Meltzer, L., Moore, M., (2008), Sleep Disruptions in Parents of Children and Adolescents with Chronic Illnesses: Prevalence, Causes, and Consequences Journal of Pediatric Psychology 33(3), 279-291 Accessed online: https://doi.org/10.1093/jpepsy/jsm118 Waters, K., Sadasivam, S., and Nixon, G., Sleep Disorders in Children.
Medical Journal of Australia 2013; 199(8) s31-s35 Accessed online: https://www.mja.com.au/journal/2013/199/8/sleep-disorders-children Schwichtenberg, A., Shah, P,.Poehlmann, J., (2013) Sleep and Attachment in Preterm Infants.

Infant Mental Health Journal Jan-Feb 34(1), 37-46 https://www.sleephealthfoundation.org.au/public-information/special-reports/asleep-on-the-job.html Red Nose Senate Enquiry into Sleep Health Awareness in Australia 8 Inquiry into Sleep Health Awareness in AustraliaSubmission 119