Millions of people in Canada suffer from sleep apnea. The problem is that not everyone realizes this
Dosage26:00What should I know about sleep apnea?
Christa Biddescombe never thought she had sleep apnea.
Biddescombe, 58, spent more than a decade unable to sleep and consulted family doctors in two counties, who misdiagnosed her symptoms as perimenopause. While working in a high-pressure policy role for the federal government, she was prescribed sleeping pills and muscle relaxants that improved her sleep, but did not cure her condition.
Finally, in 2023, after Biddescombe moved to Alberta, she consulted a doctor who suggested she might have sleep apnea.
She now uses a continuous positive airway pressure (CPAP) machine to sleep, and says sleep is “a whole other world.”
“When I sleep, I stay asleep,” she said.
Doctors say that while there are millions of Canadians suffering from the same condition, which leads to disrupted sleep and increased risk of other health problems, many don’t know it. Sleep apnea is treatable, but cost and accessibility can vary greatly across Canada.
What is sleep apnea?
There are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea.
Obstructive sleep apnea is the most common. People with this condition experience collapse of the upper airway during sleep, leading to “frequent interruptions in breathing,” according to Dr. Sachin Pendharkar, a sleep and respiratory scientist and physician.
He described it as a “mechanical problem.”
“The normally nice open airway, like a tube through which we can breathe, begins to gradually narrow as those muscles relax,” Pendharkar said. Dosage Host Dr. Brian Goldman.
Central sleep apnea, on the other hand, is a “signaling problem,” where the brain fails to accurately send breathing signals while people sleep, Pendharkar said.
Sleep apnea affects men more than women, however About 5.4 million Canadians Living with this condition. According to Pendarkar, who is also medical director of the Sleep Center at Foothills Medical Center in Calgary, an additional 80 per cent of people with sleep apnea go undiagnosed.
What are the symptoms of sleep apnea?
People with sleep apnea often report normal levels of sleep and are usually able to stay asleep throughout the night.
But they wake up feeling as if they have never rested at all.
“It kind of continues the day,” Pendharkar said. “They feel sleepy during the day, and may have difficulty concentrating or staying alert.”
Snoring is also a common symptom of sleep apnea. But it can be difficult for people who don’t have bed partners to know whether they snore or not.
If left untreated, sleep apnea can lead to a range of medical conditions, including heart disease, type 2 diabetes, and high blood pressure.
In some cases, untreated sleep apnea can also lead to neurological concerns, according to Dr. Andrew Lim, a neurologist at Sunnybrook Health Sciences Center who specializes in sleep disorders.
In the long term, people are more likely to develop strokes, cognitive impairment and dementia, according to Lim, who is also an associate professor of neuroscience at the University of Toronto.
Biddescombe’s undiagnosed sleep apnea led to mental health concerns, memory challenges, as well as other complications.
“At one point, I remember sitting on the couch, and I can’t describe it any other way, but I actually felt like my internal organs were rotting because I was so exhausted,” she said.
How do you diagnose sleep apnea?
Polysomnography is the “gold standard” for diagnosing sleep apnea, according to Pendharkar.
“This is an overnight in-lab sleep study where the patient goes into the lab,” he said. “They’re linked to a whole bunch of different equipment.”
The machines measure brain waves, muscle activity, breathing and oxygen levels, among other metrics, while microphones also record sounds patients make while sleeping.
However, laboratory tests are not accessible everywhere.
“In some parts of Canada and in other parts of the world, there are challenges that people face in actually getting to the lab because there are not enough laboratory resources,” Pendharkar said.
“And so over the last 20 or 30 years, there has been an emergence of what we call at-home sleep apnea testing.”
Bidscomb, who lives in Sherwood Park, Alta., was not offered a lab test. Instead, I relied on a home test.
“It’s a great tool,” she said. “You have to tape this mask to your face, have a microphone attached to your neck, have a (pulse oximeter) attached to you to measure your oxygen levels… You have tape everywhere and then you’re supposed to go to sleep.”
Experts look for a decrease in overall airflow, a decrease in oxygen, changes in blood oxygen, as well as snoring, Pendharkar says.
“This is the same whether you do the home test or the lab test,” he said.
Testing costs vary depending on whether the study is done in a laboratory or at home. Complete in-laboratory sleep studies are covered by many regional health plansBut home tests are sometimes paid for by patients out of pocket. In Biddescombe’s case, her home test was free.
How do you treat sleep apnea?
After her at-home sleep study confirmed the diagnosis of sleep apnea, Biddescombe purchased a continuous positive airway pressure (CPAP) machine for about $2,400 to help her breathe during sleep.
CPAP machines are the “first-line and gold standard” treatments for sleep apnea, Pendharkar says.
“This is basically a small box that sits on a bedside table, connected to tubes, and attached to a mask that fits either the nose or the mouth and nose,” he said. “The box blows compressed air through the mask and basically blows air into the airway to keep it open, to keep it from collapsing.”
CPAP machine users can adjust the amount of pressure to the amount needed to keep their airways open.
Some people with mild to moderate sleep apnea can also benefit from a mandibular advancer — a type of dental appliance that pulls the lower jaw forward to improve breathing.
“These are actually very good treatments for reducing not only the number of these respiratory events that occur, but also improving drowsiness and quality of life,” Pendharkar said.
Pendharkar admits that some patients have difficulty adjusting to sleeping with a CPAP mask.
Biddescombe started with a mask covering her nose, which quickly proved uncomfortable.
“My nose was so sore, it wasn’t funny,” she said. “I spent the whole day making sure it was constantly covered in Vaseline. It was terrible.”
Despite the discomfort, her continuous positive airway pressure (CPAP) machine was working.
“I actually finally got to sleep,” Biddescombe said.
Pendharkar recommends consulting with a healthcare professional before purchasing a CPAP machine.
A cure for sleep apnea remains elusive
Pendharkar conducted research on the cost of sleep apnea treatment across Canada. Ontario, Saskatchewan and Manitoba are currently the only provinces that fund CPAP treatments through government programs, he said.
“Everywhere else in the country, there are programs for very low-income people, but otherwise people pay out of pocket through private insurance,” he said.
“And that’s too bad, because I think that really limits access.”
Biddescombe hopes additional regulation will equalize the cost of CPAP devices across the country.
“I don’t understand why someone in Ontario can buy the same machine I bought for $800, and I in Alberta pay $2,400,” she said.
Even with the device, she says she still doesn’t sleep fully Seven to nine hours recommended by doctors.
“I think it’s just the stresses of life and work and other stressors that come into your life when you’re my age,” she said.
Since receiving the diagnosis and starting on a CPAP machine, she says she has seen a significant improvement in her health and well-being.
“I have more energy, I have greater cognitive abilities than I had before, and I can actually focus,” she said.
She hopes women — especially those experiencing perimenopause — will learn from her extensive experiences navigating the medical system.