title: Paediatric sleep resources in Canada: The scope of the problem.
abstract: BACKGROUND
  Sleep-disordered breathing (SDB) is prevalent in children and is associated with significant comorbidity.
  
  
  OBJECTIVE
  To describe paediatric sleep physician and diagnostic testing resources for SDB in Canadian children.
  
  
  METHODS
  A 38-item, Internet-based survey was sent to the 32 members of the Canadian Pediatric Sleep Network (CPSN). A shorter telephone survey was administered to all 182 non-CPSN sleep laboratories across Canada.
  
  
  RESULTS
  Responses were obtained from 29 of 31 (91%) CPSN members and 121 of 182 (66%) non-CPSN sleep facilities. Sixty-seven of 121 (55%) of the responding non-CPSN facilities reported that they see children <18 years of age. Thirty-six of 121 (30%) and 23 of 121 (19%), respectively, see children ≤12 years of age or ≤8 years of age. Marked disparities across provinces/territories were observed, with no practitioners or polysomnography in the Yukon, Northwest Territories, Nunavut, Saskatchewan, New Brunswick, Prince Edward Island, and Newfoundland and Labrador. Alberta has the smallest ratio of children to practitioners (approximately 167,000 to 1) and Ontario has the smallest ratio of children to polysomnograms performed per year (approximately 487,000 to 1). Reported wait times for polysomnography ranged from <1 month, to 1.5 to 2 years. In paediatric tertiary care centres, the number of polysomnograms performed per year ranged from 55 to 700 (median 480) and in other laboratories the range was 400 to 4000 (median 1100).
  
  
  CONCLUSIONS
  The present study demonstrates a significant lack of resources and services for paediatric SDB care across Canada, with pronounced geographical disparities. Even if only affected children were tested with polysomnography, the authors estimate there are 7.5 times more children with SDB than current testing capacity.
authors.affiliation: Division of Respiratory Medicine, Children's Hospital of Eastern Ontario; ; Faculty of Medicine, University of Ottawa, Ottawa, Ontario;
authors.forename: Sherri Lynne
authors.initials: SL
authors.lastname: Katz
authors.affiliation: Faculty of Medicine, University of Alberta, Edmonton, Alberta;
authors.forename: Manisha
authors.initials: M
authors.lastname: Witmans
authors.affiliation: Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa;
authors.forename: Nicholas
authors.initials: N
authors.lastname: Barrowman
authors.affiliation: Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa;
authors.forename: Lynda
authors.initials: L
authors.lastname: Hoey
authors.affiliation: Division of Respiratory Medicine, Children's Hospital of Eastern Ontario;
authors.forename: Santana
authors.initials: S
authors.lastname: Su
authors.affiliation: Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa;
authors.forename: Deepti
authors.initials: D
authors.lastname: Reddy
authors.affiliation: Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario; ; Faculty of Medicine, University of Toronto, Toronto, Ontario.
authors.forename: Indra
authors.initials: I
authors.lastname: Narang
keywords: Health services; Paediatrics; Polysomnography; Respirology; Sleep clinic; Sleep physicians; Survey