Waiting List Grows for Saskatoon Sleep Disorders Centre

SASKATOON, October 9, 2003

If you are waiting for an overnight sleep test at the Saskatoon Health Region Sleep Disorders Centre, be prepared to wait even longer - maybe even indefinitely.

The Saskatoon Health Region recently reduced the number of sleep apnea tests being done by 33%. As a cost-cutting measure, the technician time allocated to the centre was decreased. The bed space, the equipment and the sleep specialists are all there - ready, willing and anxious to test more people, but they are currently able to test only 16 persons per week.

This action is at odds with the recent success of the Saskatoon Health Region and the U of S College of Medicine to successfully recruit additional Specialists in Sleep Medicine to Saskatoon.

Obstructive Sleep Apnea is a breathing problem that occurs only during sleep. The upper airway keeps blocking because the tongue and muscles in the throat relax, causing an obstruction in breathing, lasting from 10 to 60 seconds. These obstructions, or apneas during sleep, occur repetitively, about every 12 minutes, and in severe cases, as frequently as every 30 seconds. The apneas are always terminated by a very brief disruption of the brain’s sleep pattern that is not perceived by the patient, but leads to sleep deprivation. Those who observe the patient sleeping typically witness periods of silence during the apnea, which are terminated by loud gasping, or snoring sounds and thrashing. Obesity, having a large thick neck and alcohol consumption prior to bedtime predispose to sleep apnea.

The Saskatoon Sleep Disorders Centre gets about 30 requests per week for sleep apnea testing. With testing limited to 16 per week, 14 more people will be added to the waiting list every week The backlog for overnight sleep studies in Saskatoon, which is already over 2000 people, will now be growing even faster. For someone going on the list today, the theoretical time on the waiting list will be two years. By this time next year the waiting list will grow by another 750 people.

Currently, about five patients a day call to ask how much longer they will need to wait to be tested.  Even more disconcerting is the large number of callers (ten per day) who ask how they can get their name on the waiting list!

The unfortunate reality is that the waiting list is already indefinite for many people. Urgent cases are bumped to the top of the list, which means that the wait for less urgent referrals keeps increasing. In addition to the sleep apnea testing, the sleep centre is also used to assess patients with other sleep disorders and patients with a host of other medical conditions that affect sleep.

Even before the reduction in sleep testing, the growing waiting list was a major cause of concern. Since the sleep centre opened in 1995, the number waiting has grown from 500 to over 2000, despite the fact that the Saskatoon Health Region approved increases from the initial number of 8 studies per week to a high of 24 studies per week. Prior to the recent reduction in support, plans had been actively underway to increase the number of tests to 36 per week, an action more than justified by enormous need.

Sleep apnea is grossly under-diagnosed in Saskatchewan. Population studies indicate that 20% of adults have at least a mild form of sleep apnea. Five percent of the adult population has sleep apnea severe enough to cause incapacitating daytime sleepiness. In Saskatchewan, this translates to 40,000 residents whose lives are impaired by sleep apnea. It is in this group that prompt diagnosis and treatment is urgently needed.

Although up to 3% of children suffer from sleep apnea, overnight sleep laboratory testing for children is not available in Saskatchewan. Children with sleep apnea have learning problems, behavioural problems and impaired growth. The most common predisposing factor for children is having big tonsils and adenoids.

Relatively inexpensive, but very effective treatments for sleep apnea are available to alleviate the sleep deprivation, allowing patients to live a normal, healthy life. Without treatment, they are at high risk of traffic or work-related accidents, mental deterioration, poor concentration and judgement, memory loss, irritability, depression, morning headaches and sexual impotence. They are also at greater risk of developing high blood pressure leading to strokes or heart disease – conditions which are far more expensive to treat and cause permanent damage to the body. Untreated sleep apnea also leads to behavioural changes frequently resulting in depression, divorce, loss of employment, and other social problems.

The financial costs to the health care system of not treating sleep apnea are far more than the costs of treatment. And those who sit untreated on the waiting list pay with their money, their health and their quality of life.

Sleep apnea is a serious, common condition for which there are highly effective treatments. To speed the diagnosis and treatment of this incapacitating disease, and reduce the waiting list for overnight sleep studies, the Lung Association of Saskatchewan is initiating a project to examine alternative methods of diagnosing sleep apnea. If successful, this may be helpful in the future, but thousands of people need help today. The Lung Association urges the Saskatoon Health Region to expand the capacity of the Sleep Disorders Centre rather than reduce its priority for testing for sleep apnea.

Editorial by:
Dr. David Cotton, Acting Director, Saskatoon Sleep Disorders Centre, and
Brian Graham, President and CEO, Lung Association of Saskatchewan