Public Sleep Clinic Ready, Able to Scale Up to Tackle Backlog


(MHC Provincial Director Thomas Linner speaks, flanked by MACHP President Jason Linklater and Dr. Nancy Porhownik. Photo Credit: Manitoba Association of Healthcare Professionals)

WINNIPEG, MB (TREATY 1 TERRITORY AND HOMELAND OF THE RED RIVER METIS) - The Manitoba Health Coalition is pointing to the significant backlog and long wait times for sleep disorder studies and questioning the Manitoba Government’s private contract to address it, calling instead for immediate investment in the public system. According to the Coalition, an estimated 6,000 Manitobans are still waiting up to 12 to 18 months for medically necessary testing of conditions including sleep apnea and periodic limb movement disorder, with demand rising and new referrals added daily.

“Manitoba has gone out of its way, time and time again, to put private profit over public health care solutions,” said Thomas Linner, Provincial Director of the Manitoba Health Coalition. “This approach doesn’t increase capacity in our hospitals and clinics, doesn’t save taxpayers money and doesn’t improve patient care. Government should listen to what physicians, nurses and allied health care professionals are saying and invest in public health care solutions.” 

In January, private company Cerebra announced a new contract with the province to perform at-home sleep tests. The province confirmed the existence of the contract and has reportedly spent $13.7 million as of April on Cerebra and other related private contracts, but it has so far refused to disclose specific costs and other details. As of last month, Cerebra had reportedly delivered only 20% of the promised 1,000 at-home sleep tests.

At the time the contract was announced, Doctors Manitoba expressed concern about “duplication, fragmentation, or inefficiencies in the delivery of care for patients.” According to the Health Coalition, an undisclosed number of these privately delivered tests have failed and those patients have returned to the public waitlist, causing frustration for patients and duplication of costs. Further, the Coalition has learned that the Level 2 sleep tests Cerebra delivers are not the standard of care and are not used in other Canadian or American centers because they are not considered cost-effective and show no advantage over less expensive, simpler Level 3 tests already delivered and overseen by the public Sleep Disorder Clinic.

Dr. Nancy Porhownik, respirologist, sleep specialist and co-section head of respirology in the University of Manitoba’s department of medicine, says more should be done to build capacity for sleep studies in the public system.

“Manitoba has gone out on a limb, against the advice of sleep experts, to help the private sleep study market gain a foothold in public health care using taxpayer dollars, while simultaneously starving the public system,” said Dr. Porhownik. “We should be focusing on publicly funded care that follows clinical practice guidelines, using local expertise to help patients with symptoms of sleeping disorder symptoms. And Manitoba can start making those investments today."

The union representing respiratory therapists and polysomnography (i.e., sleep study) technologists and technicians agrees.

“Our members at the sleep lab have been asking for more staff and updated equipment to bring down wait times for years,” said Jason Linklater, president of the Manitoba Association of Health Care Professionals. “It is frustrating to see precious health care dollars diverted to private companies instead of investing in what we know works.”

The Manitoba Health Coalition is calling on the Manitoba Government to do the following:

Oversight and accountability for private market:

  • Issue immediate moratorium on further private sleep study contracts
  • Provide public report on Cerebra contract, including clinical criteria and performance, with focus on test duplication, clinical oversight and any out-of-pocket costs (e.g., “upselling”) to patients
  • Establish regulatory standards to prohibit or limit the private sleep-study market from offering simultaneous testing and treatment, protecting patients from conflicts of interest and unnecessary out-of-pocket costs.

Investments in public capacity:

  • Expand capacity of the 10-bed Sleep Disorder Clinic at Misericordia Health Centre through immediate investment in additional staffing and updated equipment
  • Expand Level 3 at-home sleep studies delivered and overseen by the Sleep Disorder Clinic.
  • Ensure access to sleep testing for rural and Northern Manitobans
  • Establish routine public reporting of sleep disorder study backlog and wait times, including how many patients have been removed from the wait list without receiving a test.