Hefty price of sleep apnea machines tying up hospital beds

The Lung Association of Nova Scotia says the high cost of sleep apnea machines is tying up much-needed hospital beds, while hundreds of others are depending on the charity to help them sleep at night.

It's looking to the province to help bridge the gap and provide more people with continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP) machines.

The Lung Association is the only one in Canada to set up a program that recycles used machines, which provide continuous airway pressure for those who have obstructive sleep apnea.

The machines allow a steady airflow to people who have difficulty breathing while they sleep. Sleep apnea has been linked to everything from obesity to depression.

The charity estimates the average machine costs about $2,500.

While some private insurance plans cover some of that, the machines are not publicly funded in Nova Scotia. The only exception is those who are clients of Community Services, who can ask for one-time assistance.

Carolyn Ray/CBC
Carolyn Ray/CBC

Everyone else is left asking the Lung Association for help. It works with Lions Clubs, which collect donated machines that are fixed and cleaned by volunteers, and handed out to those who can't afford one.

Demand is so high, the waiting list now has 400 names of people with prescriptions they can't afford to fill.

"We have calls on a daily basis at this point," said Robert MacDonald, president and CEO of the Lung Association of Nova Scotia.

Extra nights in hospital

Those on the list may wait a year to receive a donated machine, but MacDonald says what's more concerning is that some patients in hospital can't be released unless they have a machine at home.

In those cases, hospital staff call the Lung Association for help.

"That puts some extra costs on the system, with some people staying seven, eight, nine extra days until they're able to acquire a machine," said MacDonald.

He said that situation comes up once every few weeks, something that the head of the sleep clinic at the QEII Health Sciences Centre confirmed.

"These are patients who are at risk of going into respiratory failure if they go home without a machine," said Dr. Debra Morrison, a respirologist.

"These patients will spend extra time in hospital while people try to figure out how they can pay for it, who is going to pay for it, is it going to be something that the insurance can help with if they have private insurance."

Carolyn Ray/CBC
Carolyn Ray/CBC

The hospital's sleep clinic also has a long list of people waiting to be diagnosed. Morrison points to a national survey that estimated 25 per cent of adults have symptoms of sleep apnea.

Morrison said she hears concerns from patients about the cost all the time.

"It is a difficult problem. There are some patients who choose not to take treatment until they say, 'I'll come back and see you when I think I can afford this.' It's a difficult situation to see."

Funding under consideration

Morrison said the Lung Association's program is filling a gap in the system. Both she and the charity would like to see change. Some provinces offer a co-pay program, subsidizing the machines.

The Lung Association has formally asked the province to help fund the recycling program. The money would help purchase machines, parts and pay for the labour to recondition them.

The province says the proposal is under consideration, and it is following up with the Nova Scotia Health Authority.

Carolyn Ray/CBC
Carolyn Ray/CBC

So far, the charity estimates it's helped 1,000 people access a free machine. John Eagle is one of them.

Eagle, 79, has needed a CPAP machine nearly his whole life. But when his last one broke, he said he faced a difficult decision. He lives on a fixed income.

"I may have tried to get a bank loan of sorts, to have come up with some of it. Which would have taken quite a bit of time to pay off of course," he said.

"I don't know what we would do for the rent, the meals, the electricity, that one has to pay for now. Something would have had to have been dropped off the payment list."

Eagle's case was deemed a priority and he received a machine in a matter of days.

"It has been a lifesaver for me. I really appreciate what they're doing."

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