Testing and treatment for obstructive sleep apnea in Canada: funding models must change

The Public Health Agency of Canada has estimated that a quarter of adult Canadians are at risk for obstructive sleep apnea (OSA). Despite a large potential disease burden, insufficient public funding for sleep diagnostic testing and treatment of OSA in most of Canada leads to underdiagnosis and undertreatment. There is a mix of reimbursement models across provinces, ranging from almost complete public funding to mostly private care of patients with OSA; consequently, the way that Canadians with suspected OSA obtain care differs substantially based on province of residence and financial means. This interprovincial and interindividual variability leads to differential access to diagnostic testing, particularly for low-income or rural populations. Current funding models for sleep diagnostic testing and treatment of OSA in most provinces in Canada have put many patients in the position of having to make a decision to pursue care based partially on their financial means rather than solely on clinical need.