Loud snoring, waking unrefreshed, morning headaches or dozing off during the day can all point to obstructive sleep apnea. It is common, it is treatable, and you do not need a referral to start.
1. The assessment
We start with your sleep history and the things that matter most: how you sleep, how you feel during the day, whether anyone has seen you stop breathing, your blood pressure and your medical history. We use STOP-BANG, a short eight-question screening tool, to put a number on how likely obstructive sleep apnea is. We also look for the things that imitate it, including shift work, insomnia, low iron, thyroid problems, alcohol and medication effects, and low mood.
2. Testing
Where the picture fits, a home sleep apnea test is usually the next step. You sleep in your own bed wearing a small recorder. For many adults with a high likelihood of straightforward obstructive sleep apnea, that is enough to make the diagnosis. An overnight laboratory study is the better choice when there is significant heart or lung disease, when central sleep apnea is suspected, or when a home test comes back inconclusive.
3. What happens if the test is positive
Treatment depends on severity and on what you are willing to live with. Options include CPAP, a mandibular advancement device fitted by a dentist, weight management where that is relevant, positional measures, and treating anything else that is fragmenting your sleep. We follow up either way: a treatment nobody uses is not a treatment.
4. CPAP funding, and one thing we cannot do
Ontario’s Assistive Devices Program covers part of the cost of a CPAP machine for people who qualify. The ADP application requires a physician signature. A Nurse Practitioner can carry out the assessment, arrange testing and manage follow-up, but cannot sign that form. Where you need it, we refer you to a physician for the signature so the application can go ahead. We tell you this at the start rather than at the end.
5. Driving and safety
Untreated sleep apnea affects alertness. If you drive commercially, or you have fallen asleep at the wheel, say so at the assessment. It changes how quickly we move and what we document. See also our driver’s medical page.
Common questions
Can a nurse practitioner order a sleep study in Ontario?
What is STOP-BANG?
Is a home sleep test as good as an overnight lab study?
Who signs the CPAP funding application in Ontario?
Do I need a referral?
Sources
General information only, not advice for your situation. Written and reviewed by our clinical team (Nurse Practitioner, RN, RSW) using the sources listed. In an emergency call 911.
Talk it through with us
No referral or OHIP card needed. Fees are confirmed before you book.
