Barriers and facilitators to specialist service referrals for sleep disorders from healthcare professionals perspective: A scoping review of qualitative research evidence

BackgroundAccess to specialist sleep centres can lead to timely diagnosis and management of sleep disorders, improving the health and quality of life of people with these conditions. Evidence describing factors that influence referral to specialist sleep services is needed to inform improvements to the referral process. ObjectiveThis scoping review identifies and summarises qualitative evidence on barriers and facilitators to referrals to specialist sleep services by healthcare professionals. Eligibility criteriaThe review considered qualitative studies published in any language between 1995-2024 that explore the barriers and/or facilitators to referral to specialist services for sleep-related disorders from healthcare care professionals perspective. Sources of evidenceA systematic search of six databases (Cochrane Library, MEDLINE, PubMed, Scopus, EMBASE and Open Grey) was conducted. ResultsOut of 3507 records, seven heterogeneous studies from two countries (Australia and USA) and one multi-country study met the inclusion criteria. Referrals were from a range of settings including primary care (two studies). Major themes identified as influencing referral included clarity of roles, referral experiences and options, knowledge of sleep disorders, funding, and views on treatment. Specific barriers and facilitators varied between countries, healthcare professionals and sleep disorders. ConclusionsAlthough specific barriers and facilitators vary between settings, cross-cutting themes influencing referral to sleep centres reflect a lack of awareness of sleep disorders among healthcare professionals, poorly defined referral pathways, and funding issues. ImpactsThis is the first scoping review to synthesise qualitative evidence on factors influencing referrals to specialist services for sleep disorders. The themes identified can be used in further research to inform improvements to referral pathways in different settings. Reporting MethodAdherence to the PRISMA-ScR checklist was maintained.