Patients continue to wait in limbo following license suspension of Paris sleep lab

While the license suspension of a sleep lab in Brant County has brought comfort for some patients who said they waited months — or even years — on sleep test results, others are left uncertain of what it means for their medical treatment moving forward.

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Last month, the Ministry of Health confirmed it suspended Paris Sleep Lab’s license due to “concerns regarding noncompliance and the delivery of timely patient care.”

Since then, The Spectator has heard from multiple patients asking how to access their results or renew prescriptions previously managed through the Paris Sleep Lab — part of the AccqSleepLabs group, which also operates a sleep clinic in Owen Sound, and previously had ties to a Waterloo sleep clinic.

Numerous patients said they haven’t heard from the sleep lab or ministry about next steps, although some people who reached out to the ministry directly were told they could take a second, OHIP-insured sleep study at a new facility.

‘A huge burden’ on the health-care system

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It’s unclear just how many patients are affected by the suspension, and the ministry would not tell The Spectator.

But AccqSleepLabs’ CEO Nick Tadross told The Spectator Paris Sleep Lab was approved by the ministry to operate 12 beds, seven days a week.

The sleep lab can bill the Ontario Health Insurance Plan (OHIP) close to $400 for each patient’s initial overnight diagnostic sleep study, according to the May 2024 schedule of facility costs.

The same charge would be rebilled to OHIP if patients need to take a repeat test at another sleep lab.

But it’s not just the money. Untreated sleep issues can place “a huge burden” on the health-care system, Paul Edwards, a consultant who has worked in the sleep industry since 2019, told The Spectator.

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He cited fatal accidents due to drowsy driving, and the comorbidities associated with obstructive sleep apnea — like Type 2 diabetes, mental health, cardiovascular disease and hypertension.

‘Gold standard’ diagnostic test for sleep disorders

Family physicians may refer people for a sleep test for a variety of reasons — such as to confirm suspected obstructive sleep apnea, or to rule it out before investigating other health issues.

The Ontario government subsidizes therapy for patients diagnosed with obstructive sleep apnea — conditional on being diagnosed through a level one sleep study, the “gold standard” diagnostic test for sleep disorders, Edwards said.

The overnight lab test is overseen by a technician and can help a sleep physician diagnose multiple disorders — including sleep apnea — by measuring indicators like heart rate, airflow, sleep position, leg movement and snoring.

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The test data is then scored by looking at 30-second intervals, and marking “events,” such as a pause in breathing that lasts 10 seconds or more. The scored study goes to a board-certified sleep physician, who interprets it with the patient’s medical history to make a diagnosis, Edwards said.

For some patients at Paris Sleep Lab, getting through the door for the initial sleep test didn’t seem to be the problem. It was the follow-up afterwards.

After an overnight stay in April, Melinda Lubbers said her family doctor received a report from the sleep clinic saying “you have apnea, you have an obstruction, and they’re suggesting a CPAP (continuous positive airway pressure machine).”

But despite calling and emailing, Lubbers previously told The Spectator she wasn’t able to reach anyone at the clinic to book a follow-up appointment with the clinic’s physician for next steps.

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She said she even tried to get her own CPAP machine but was told she’d need a prescription, and that her family doctor couldn’t write one.

While Lubbers considered taking another test elsewhere, OHIP will only cover one diagnostic study within a 12- to 24-month period — depending on the referral reason.

A compounding factor for patients who have been waiting more than a year for their results is that data is generally accepted as “invalid for interpretation” at that point, Edwards said.

‘Severe shortage’ of specialists

Tadross agreed there is indeed a problem, but a “severe shortage” of sleep medicine physicians in the area is to blame, he said in an email to The Spectator on Oct. 28.

“Without these specialists, patients are not able to obtain the required clinical assessments and follow-up care as needed,” he said.

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There have been challenges recruiting sleep medicine specialists over the lab’s 30 years of operation, but “we have never experienced the circumstances before us at present time,” Tadross said.

He pointed to the pandemic for creating significant delays and wait times, which were compounded by “the exodus of health-care professionals” for “various reasons.”

He reaffirmed that the clinic “voluntarily” suspended operations because their specialist physician retired in August 2024 before new specialist physicians could start.

He is hopeful operations could resume “as early as December 2024,” he said.

In the meantime, administrative staff remain on-site Monday to Friday from 9 am to 5 pm to “assist patients and provide updates as they become available,” he said.

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Still, multiple patients told The Spectator they haven’t heard from the sleep lab or ministry about next steps.

When asked whether it is contacting all patients rostered with the lab to let them know about the suspension, the ministry said it “cannot comment on specifics of the ongoing review.”

But even if the ministry does make an allowance for the patients to be studied again within a two-year period, it raises multiple issues, Edwards said.

“Acq got paid and didn’t deliver; the province is going to pay again; and … it’s just going to exacerbate the wait time for other patients,” he said.

Celeste Percy-Beauregard is a Local Journalism Initiative Reporter based at the Hamilton Spectator. The initiative is funded by the Government of Canada.

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