Sleep Medicine in Canada

Canada has an expansive, challenging geography with diverse demographics. The country is an industrialized and democratic nation situated at the northern end of the Americas. Canada provides universal healthcare to all residents through a singlepayer system administered by its provinces and territories. Data suggests common sleep disorders are present at similar rates in other industrialized nations, with the exception of a larger number of shift workers and arctic residents subject to circadian disruption. Canada has ‘punched above its weight’ in contributing to the field of sleep medicine, with numerous well-known pioneering specialists in areas ranging from pathophysiology and diagnostic development, to pharmacologic, therapeutic and device treatment. The practice of sleep medicine is provided by trained physicians in neurology, respirology, psychiatry, internal medicine, family practice, otolaryngology, pediatrics, as well as psychology and dentistry amongst other providers. Major challenges to Canadian sleep medicine include limited public healthcare funding, variable funding mechanisms across the nation’s jurisdictions, limited access to diagnostic and therapeutics, and conflicts-of-interest with business. Certain demographic groups are particularly at-risk, including socioeconomically challenged communities, indigenous populations, and other diverse minority groups. Canada’s characteristics and challenges provide it with substantial research opportunities and a chance to lead in such areas as epidemiology, sleep medicine genetics, ethnic and cultural aspects, circadian and shift work considerations, home polysomnography and post-COVID transitions to more virtual sleep medicine care. 

Keywords: Apnea, Canada, Circadian, COVID-19, Hypersomnolence, Insomnia, Narcolepsy, Restless, REM, Sleep.