Questions over funding for new sleep apnea test
Published Friday, March 7, 2014 6:40PM EST
The wait for a sleep apnea test can be a long one, but the debate over whether to fund a quicker and easier option continues.
Sleep apnea is a very common and potentially serious condition where breathing is interrupted when people sleep.
Getting a diagnosis through a hospital sleep lab can take upwards of a year, however there is an alternative kind of testing that could improve wait times.
But Canadian provinces differ on whether to fund it through the public purse.
Moe McLauchlin has struggled with sleep apnea, "I stopped breathing about 30 to 40 times an hour."
The condition brought him to Dr. David Rawson, a dentist who outfitted him with a sleep measuring device that's worn by patients at home.
"We're evaluating their airway constantly. Do they snore only? Or do they snore and also have periods of not breathing - apnea - for 30, 40, 50 seconds? When that's all put together in a package and the numbers are crunched you can find out how significant their sleep apnea may be."
The cost for these 'ambulatory sleep measuring devices,' as their known, varies. What also varies is coverage by provincial health insurance plans. In Ontario we are still asking 'Should it be covered by OHIP?'
Dr. Brian Rotenberg, an otolaryngolost with St. Joseph's Hospital, co-authored a report on wait times for diagnosis and treatment of sleep apnea.
"Ontario is lagging behind and we know that from our data from our study the wait times for care are huge and they are for the most part bottle-necked by the hospital-based sleep studies. So if patients could have access as an insured benefit to a home sleep study that would probably relieve a lot of the backlog in many situations."
A sleep lab, such the one at the London Health Sciences Centre (LHSC) measures things like brain waves. But is that that always needed in the case of sleep apnea?
"When we look at the data that comes from a level one polysomnogram, it's very rich data, a lot of things can be read from that study. But it's almost too much data, in the sense that you don't need that much information - I don't think - to make the firm diagnosis and perhaps more importantly to initiate therapy," Rotenberg says.
Dr. Charles George heads the sleep clinic at LHSC and says "We diagnose many sleep disturbances, sleep apnea being the primary one or one that we see most often."
He says ambulatory sleep measuring devices won't replace in-hospital assessments, but "There's a large percentage of routine patients with sleep apnea where we can use ambulatory devices to either exclude whether they have any significant sleep apnea or prioritize them for treatment based on the outcomes of that."
As for McLauchlin, by wearing a special mouthpiece that keeps his airway open at night, he's breathing easier, in more ways than one.
"I wake up in the morning just so much more awake and alert and ready to go to work."