Krista Bedscomb never thought she suffered from sleep apnea.

Bedscomb, 58, spent more than a decade unable to sleep, consulting family doctors in two counties, who misdiagnosed her symptoms as perimenopause. While working in a federal government high-pressure policy role, she was prescribed sleeping pills and muscle relaxants that improved her sleep but did not treat her condition.

Finally, in 2023, after Bedscomb 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 sleeping is a "whole other world," "when I sleep, I stay asleep."

Doctors confirmed that while millions of Canadians suffer from the same condition, leading to sleep disturbances and increased risk of other health problems, many are unaware of 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, with people suffering from this condition experiencing upper airway collapse during sleep, leading to "repeated breathing interruptions," according to Dr. Sachin Bindharkar, a sleep and respiratory scientist and physician.

He described it as a "mechanical problem."

Bindharkar told The Dose host Dr. Brian Goldman: "The normally gently open airway, like the tube we breathe through, gradually starts to narrow as those muscles relax."

On the other hand, central sleep apnea is a "signaling problem," where the brain fails to send breathing signals accurately during sleep, Bindharkar said.

Sleep apnea tends to affect men more than women, but nearly 5.4 million Canadians live with this condition. According to Bindharkar, who is also the medical director of the Sleep Center at Foothills Medical Center in Calgary, 80% more people with sleep apnea are 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 never rested at all.

Bindharkar said: "It's kind of ongoing during the day." "They feel sleepy during the day, and may find it hard to focus or stay awake."

Snoring is also a common symptom of sleep apnea. But it may be difficult for people without 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 hypertension.

In some cases, untreated sleep apnea can also lead to neurological concerns, according to Dr. Andrew Lim, a neurologist at Sunnybrook Health Sciences Center and specialist in sleep disorders.

In the long term, people are more likely to suffer strokes, cognitive impairment, and dementia, Lim said, who is also an associate professor of neurology at the University of Toronto.

Undiagnosed sleep apnea led to mental health concerns, memory challenges, and other complications for Bedscomb.

She said: "At one point, I remember sitting on the couch, and I can't describe it any other way, but I actually felt like my insides were rotting because I was so exhausted."

How can you diagnose sleep apnea?

Sleep studies are the "gold standard" for diagnosing sleep apnea, according to Bindharkar.

He said, "This is an overnight sleep study in a lab where the patient goes to the lab." "They are hooked up 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 the patients make while they sleep.

However, lab tests are not accessible everywhere.

Bindharkar said: "In some parts of Canada and other parts of the world, people face challenges actually getting to the lab because there aren't enough lab resources."

"So over the past twenty or thirty years, there has been the emergence of what we call home sleep apnea testing."

Bedscomb, who lives in Sherwood Park, Alta., was not offered a lab test. Instead, she relied on a home test.

She said, "It's a great tool." "You have to stick this mask on your face, have a microphone connected to your neck, have a [pulse oximeter] attached to measure oxygen levels... you have tape everywhere and then you are supposed to sleep."

Bindharkar noted that experts look for overall decreased airflow, decreased oxygen, changes in blood oxygen, as well as snoring.

He said, "This is the same whether you do the home test or the lab test."

Testing costs vary depending on whether the study is conducted in the lab or at home. Full sleep studies in the lab are covered by many provincial health plans, but sometimes patients pay out-of-pocket for home tests. In Bedscomb’s case, her home test was free.

How can you treat sleep apnea?

After confirming her sleep apnea diagnosis with the home sleep study, Bedscomb purchased a continuous positive airway pressure device for nearly $2,400 to help her breathe while sleeping.

Bindharkar says CPAP devices are the "first-line and gold standard" treatments for sleep apnea.

He added, "It's essentially a small box placed on a bedside table, connected by tubing, connected to a mask fitting either the nose or the nose and mouth." "The box blows pressurized air through the mask and essentially pushes air into the airway to keep it open, preventing collapse."

CPAP users can adjust the pressure to the level needed to keep their airways open.

Some people with mild to moderate sleep apnea can also benefit from a mandibular advancement device—a type of dental device that pulls the lower jaw forward to improve breathing.

Bindharkar continued: "These are actually very good treatments not only to reduce the number of respiratory events that occur but also to improve sleepiness and quality of life."

Bindharkar acknowledges some patients find it difficult to adapt to sleeping with a CPAP mask.

Bedscomb started with a mask covering her nose, which quickly proved uncomfortable.

She said, "My nose hurt so much, it wasn't funny." "I spent the whole day making sure it was constantly covered with Vaseline. It was awful."

Despite the discomfort, her CPAP worked.

Bedscomb said, "I was finally actually able to sleep."

Bindharkar recommends consulting a healthcare specialist before buying a CPAP device.

It's also worth noting that both the US Food and Drug Administration and Health Canada have issued recalls of specific Philips CPAP models due to health risks.

Equal treatment for sleep apnea remains elusive

Bindharkar conducted research on the cost of treating sleep apnea across Canada. He said Ontario, Saskatchewan, and Manitoba are currently the only provinces funding 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."

"That's very unfortunate because I think that really limits access."

Bedscomb hopes additional regulation will equalize the cost of CPAP machines across the country.

She said, "I don't understand why someone in Ontario can buy the same machine I bought for $800, and I in Alberta pay $2,400."

Even with using the device, she says she still doesn't sleep the full seven to nine hours recommended by doctors.

She said, "I think life and work and other stresses come into your life when you’re my age."

Since being diagnosed and starting to use the CPAP machine, she says she has seen significant improvement in her health and well-being.

She said, "I have more energy, I have greater cognitive abilities than I used to, and I can actually concentrate."

She hopes women—especially those going through perimenopause—will learn from her extensive experiences navigating the medical system.