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MRC Healthcare Incorporated, specializes exclusively in CPAP Therapy and Sleep Apnea Solutions. Providing solutions to our patients that are tailored to meet their unique lifestyle needs; ranging from Nasal CPAP Therapy to private in-home and free in-lab sleep test management and support.

While our professionals are happy to visit our clients in their home – MRC Healthcare also welcomes our patients to join us at one of our four warm and friendly offices. They will enjoy the added benefit of the largest selection of masks on display in the Greater Toronto Area, complete with “try – before – you – buy” fitting stations.

• MRH Healthcare is a Ministry of Health Approved.
• CPAP sleep therapy machines are covered by OHIP
• $780 off CPAP machine with approval
• Free Consultation

Free CPAP Consultation

Because it works by increasing airway pressure, significant air leaks and air escape at the mouth can make them ineffective. Make sure your mask interface is properly placed before sleep, but excessive tightening may cause discomfort. Also, if a chinstrap is needed, be sure to wear it routinely!

Is it an oxygen machine?
No. It uses room air that is pressurized by a blower unit, much like a vacuum cleaner in reverse. Oxygen can be added, though, for patients who require it.

Does nasal CPAP cure sleep apnea?
No. They control sleep apnea, as long as they are used consistently: thus protecting patients from sleep apnea complications and symptoms

Does CPAP therapy remain effective over the years?
Yes. Unless other factors (such as sedating drugs or new illnesses) make your sleep apnea worse. Also, sleep apnea can worsen with both age and weight gain. With any change in your medical condition, you should consult your sleep specialist.

How good is nasal CPAP compared to other alternatives?
Much better: from the standpoint of both long-term effectiveness and safety. No other treatment, except a tracheostomy, is as effective at eliminating airway obstruction in sleep. The advantage of nasal CPAP is that it typically keeps the entire airway open, irrespective of where the collapse might have occurred. While children with sleep apnea due to large tonsils and adenoids often seem to respond to surgical treatment, results in adults have been disappointing. Nasal CPAP is safe and immediately effective, without operative risks or the need to wait for surgical healing before effectiveness can be determined.

What if I don’t use my nasal CPAP?
Your sleep apnea will recur quickly, which in some patients can be dangerous.

Can I use it part-time?
NO. One common and potentially serious mistake would be to wake up toward the end of the night, remove your mask and allow yourself to fall asleep. Most of our REM sleep (the stage when most patients’ sleep apnea reaches its greatest severity) occurs during the final hours of sleep, you will have removed it before you needed it more than ever.

Do I use nasal CPAP during naps?
Yes.

Can I travel with my nasal CPAP unit?
Yes. Traveling with your nasal CPAP unit is quite easy.

Are there contra-indications in using nasal CPAP?
YES. Here are some examples:

• History of spontaneous pneumothorax, or large bullae (“blebs”, similar to bubbles on a tire) that could rupture and cause lung collapse.
• Individuals on high doses of steroids (ex. prednisone, Decadron®).
• Severe inner ear problems.
• Individuals with increase pressure in the brain (ex. hydrocephalus, pseudo tumor).

If you encounter problems, what steps should you take?
Refer to the troubleshooting guide. If no solution is found, call your homecare provider. Don’t allow significant problems to persist, and don’t allow yourself to go untreated and unable to use your equipment throughout sleep.

What about maintenance?
Clean your equipment regularly according to the manufacturer’s recommendations. Broken, defective or worn equipment must be repaired or replaced immediately. Be sure to have your machine checked routinely and serviced once a year, even if it seems to be functioning well.

Literature concerning CPAP use that is distributed by MRC Healthcare, Inc. is offered for information purposes only and should not be considered a substitute for the advice of a healthcare provider.

Continuous Positive Airway Pressure (CPAP) Blowers are the generally accepted method of overcoming Obstructive Sleep Apnea (OSA).

A nasal CPAP unit delivers lightly pressurised air through a small nasal mask, and this flow of air acts like an ‘air splint’ to keep the upper airway open and thus prevent apneas from occuring.

Almost immediate relief of the symptoms of OSA occurs with the use of nasal CPAP and patients often report that there is a dramatic increase of daytime alertness and energy after just a few nights treatment. Hypertension is often dramatically decreased thus enabling medications to be lowered or stopped.

Nasal CPAP is only available with your Practitioner’s recommendation.

Initiating treatment requires careful monitoring and adjusting by a qualified sleep professional.

CPAP nasal treatment is for the long-term and mask fit and comfort has been found to be a significant factor in whether patients continue their treatment, or whether the whole ensemble ends up under the bed!

For this reason, MRC Healthcare will only make available masks that meet certain strict criteria including:

• Comfort
• Quality of air seal
• Ease of fit
• Convenience in putting on and taking off
• Air venting
• CO2 washout rates

(All masks offered are supplied as complete systems that are ready to wear and have three month factory fault guarantees.)

Literature concerning CPAPs that is distributed by MRC Healthcare, Inc., including this brochure, is offered for information purposes only and should not be considered a substitute for the advice of a healthcare provider.

Polysomnogram is a test that measures activity during sleep. Each test will vary depending on the individual case, and some of the measurements taken may include:

• Brain waves, EEG (skin, surface, electrodes placed on the head)
• Heart beats, EKG (skin, surface electrodes placed on the chest)
• Eye movements, EOG (skin, surface electrodes placed on the face above and below the eyes)
• Muscle tension, Chin EMG (skin, surface electrodes placed on the chin)
• Leg movement, Leg EMG (skin, surface electrodes placed on the lower leg)
• Breathing effort and movements (stretch gauges placed around the chest and/or the stomach)
• Blood oxygen levels, SaO2 (measured with a device called oximeter which uses a small sensor attached to the end of a finger)
• No blood will be drawn

Frequently Ask Questions

Why record all these things?
During sleep the body functions differently than while awake. Disrupted sleep can disturb daytime activities, and occasionally cause medical problems that can be a significant risk to you overall health.

How can I sleep with all these things on me?
Surprisingly, most people sleep very well. The body sensors are applied so that you can turn or move during sleep. Generally, you will not be aware that you are wearing the devices after they have been on for a short time. Remember that this is not a test, but merely a recording of how you sleep.

Will the sensor devices hurt?
No. Sometimes in rubbing the skin and putting on the electrodes, there are mild and temporary skin irritations.

Will I be given any drugs to help me sleep?
No. It is preferred, to the extent medically possible, that you be off sleeping medications for at least eight days before coming for the test. It is also important not to consume any alcohol or caffeinated beverages on the day of the testing. Do not stop any medications without first consulting your primary care doctor. The only medication, which should be discontinued are those that keep you alert or medications that help you sleep.

What happens to the polysomnogram?
The records of your sleep test will probably be about 1,100 pages long, and it will be scored and then interpreted by a physician.The information will then be used to give a diagnosis and recommended treatment. This final report will then be forwarded to your referring physician. The entire process can take up to a couple of weeks.

Literature concerning polysomnogram that is distributed by MRC Healthcare, Inc., is offered for information purposes only and should not be considered a substitute for the advice of a healthcare provider.

Your nose feels dry and stuffy.
You can try adding a humidifier to moisten the air from the CPAP machine. Some people prefer moist heated air.

Your nose feels blocked up.
Some people with sleep apnea have a nose problem. Ask your doctor if you have a nose problem that can be treated with a nose spray. Surgery also is an option. Some people who breath through the mouths don’t do well with CPAP nose masks. A full face mask that covers both the nose and the mouth may help these people.

You don’t like the pressure.
You may find that breathing out against the air pressure keeps you from sleeping deeply. Your doctor may ask you to use a bilevel machine that lowers the air pressure when you breathe out. The same mask may be used with CPAP and bi-level machines.

You take the mask off during your sleep or don’t wear it every night.
Most people can’t wear the mask all night long, every night, right from the start. Keep trying, even if you can only use the mask for an hour a night at first. Once you solve your comfort problems, you will be able to increase the time you wear the mask. Always try to wear the mask in the early morning hours, when sleep apnea is usually the worst.

You just can’t get used to the mask.
Some people find that wearing a dental device that pushes their tongue forward helps. Or talk with your doctor about having throat or jaw surgery.

Cleaning Information

• Clean masks with Dove Dish Soap – It is the mildest soap on the market and/or Cetraphil sterilizing soap
• Hoses can be cleaned using white vinegar, not maltor warm water only
• CPAP units should be wiped down with a moist paper towel or like napkin
• Head gear should not be washed in a machine – simply submerge in soapy water and air dry

Additional Things to Consider

• CPAP devices are not to be adjusted by patients – CPAP units are prescription devices and must be changed by certified professionals!
• Allow the silicon on the masks at least two weeks to expand to individual patient fitting
• CPAP units are adaptable from 110 to 220 volt requirements with an external adaptor – Adaptors can be purchased at most electronics retailers for a nominal fee.

Literature concerning CPAP use that is distributed by MRC Healthcare, Inc. is offered for information purposes only and should not be considered a substitute for the advice of a healthcare provider.

Julie Carrier, a Université de Montréal psychology professor and a researcher at the affiliated Hôpital du Sacré-Cœur Sleep Disorders Centre, discovered that coffee’s main by-product caffeine meddles with sleep. The lead investigator of the study further found that the side-effect grew worse with age.

Carrier said, “Caffeine is the most widely used stimulant to counteract sleepiness, yet it has detrimental effects on the sleep of night-shift workers who must slumber during the day, just as their biological clock sends a strong wake-up signal. The older you get, the more affected your sleep will be by coffee.”

She added, “We all know someone who claims to sleep like a baby after drinking an espresso. Although they may not notice it, their sleep will not be as deep and will likely be more perturbed.”

Carrier advised those over 40 to particularly cut down on their coffee intake, explaining the combined influence of age and caffeine that made the sleep of middle-aged subjects vulnerable to the circadian waking signal.

Sleep and Alertness Clinic
750 Dundas Street West, Suite 2-221
Toronto, Ontario M5T 2S8
Phone: (416) 603-5075

Toronto Sleep and Pulmonary Centre
123 Edward St, Suite 1011
Toronto, Ontario M5G 1E2
Phone: (416) 813-2277

Cardiopulmonary and Sleep Disorders and Research Centre
585 University Avenue
Toronto, Ontario M5G 2C2
Phone: (416) 340-4719

St. Michael’s Hospital Sleep Clinic
30 Bond St, Room 6015-A
Toronto, Ontario M5B 1W8
Phone: (416) 864-6060 ext. 2283

Centre for Sleep and Chronobiology – College Site
340 College St, Suite 580
(between Spadina Ave and Bathurst St)
Toronto, Ontario M5T 3A9
Phone: (416) 603-9531

Youthdale Child and Adolescent Sleep Centre
227 Victoria Street
Toronto, Ontario M5B 1T8
Phone: (416) 703-0505

Toronto East General Hospital
The Respiratory Centre
825 Coxwell Ave
Toronto, Ontario M4C 3E7
Phone: (416) 469-7777

Hospital for Sick Children
555 University Ave
Toronto, Ontario M5G 1X8
Phone: (416) 813-6248

Toronto Rehab Sleep Lab
550 University Ave.
Toronto, Ontario
M5G 2A2

Toronto Mid-Town

Silent Partners Sleep Lab
1349 Yonge Street
Toronto M4S 1Y2, ON
416-487-7533

Sunnybrook Hospital
Sleep Disorders Laboratory
2075 Bayview Ave
Toronto, Ontario M4N 3M5
Phone: (416) 480-4475

Tri-Hospital Sleep Laboratory
412-5 Fairview Mall Dr
North York, Ontario M2J 2Z1
Phone: (416) 229-0400

Toronto Sleep Institute
507-586 Eglinton Ave
Toronto, Ontario M4P 1P2
Phone: (416) 488-6980

Toronto North

Centre for Sleep and Chronobiology – Wison Site
951 Wilson Ave., Suite 15
Toronto, Ontario M3K 2K7
Phone: (416) 746-3012

Humber River Regional Hospital Sleep Lab
216-2115 Finch Ave East
Toronto,Ontario M3N 2V6
Phone: (416) 740-1832

North York Sleep and Diagnostic Centre
4646 Dufferine Street, Unit 5
North York, Ontario M3H 5S4
Phone: (416) 642-4232

Sleep Diagnostics Centre
3292 Bayview Ave, Suite 205
North York, Ontario M2M 4J5
Phone: (416) 218-8770

Toronto East

Trillium Sleep Lab
405-4190 Finch Ave East
Scarborough, Ontario M1S 4T7
Phone: (416)292-8292

Ellesmere Sleep Centre
248-2100 Ellesmere Rd
Toronto, Ontario M1H 3B7
Phone: (416) 439-5508

Victoria Terrace Sleep Clinic
2130 Lawerence Ave., East, Suite 410
Toronto, Ontario M1R 3A6
Phone: (416) 751-4356

Toronto West

West Park Hospital
82 Buttonwood Ave
Toronto, Ontario M6M 2J5
Phone: (416) 243-3600 ext. 2201

St. Joseph’s Health Centre Sleep Lab
30 The Queensway
Toronto, Ontario M6R 1B5
Phone: (416) 530-6013

Richmond Hill

Richmond Hill Sleep Lab
330 Hwy7 E. Unit 205
Richmond Hill, Ontario
Phone: (905) 764-8808

York Region Sleep Disorders Centre
13291 Yonge St, Suite 300
Richmond Hill, Ontario L4E 4L6
Phone: (905) 773-7843

Markham

Markham Stouffville Sleep Lab
281 Church St
Markham, Ontario L3P 7P3
Phone: (905) 472-7373

Newmarket

York County Sleep Lab
679 Davis Dr, Suite 222
Newmarket, Ontario L3Y 5G8
Phone: (905) 895-3487

Pickering

Centre for Sleep Disorders
Suite 7, 720 Sheppard Ave
Pickering, Ontario L1V 1G5
Phone: (905) 420-8245

Mississauga

Credit Valley Hospital Sleep Laboratory
2200 Eglinton Ave West
Mississauga, Ontario L5M 2N1
Phone: (905) 813-2200 ext. 6060

Studies of night shift workers shows that almost everyone who works through the night suffers from Shift Lag. Some are more able than others to adjust to the differences while others find it very difficult to cope with the extra stress working at night creates. While the stress of night work is hard its the extra problem of lack of quality sleep after the night shift that makes the problem far worse.
Anecdotal evidence indicates Shift Lag also makes shift workers more susceptible to colds, flu and stomach upsets.

What causes Shift Lag?

It hardly seems possible that so many problems could result from merely working at night, but as the comments from night shift workers shows, it affects even those who have been working night shifts for years. There is mounting evidence that the problems from working night shift get worse not better the longer time night shifts are worked. Problems tend to get worse after working nights shifts for longer than five years.

The cause of Shift Lag is being active and working at 3:00am in the morning. This disrupts our body clock (circadian rhythm). This in turn affects body temperature, heartbeat, blood pressure and physiological patterns, leading to disorientation and mental and physical fatigue. In addition, the strange working hours and usual drop in temperature at night can see night shift workers not drinking enough fluids and can cause mild body dehydration. The effects of Shift Lag may be made worse by not eating enough during the shift, excessive coffee drinking, by loss of sleep, and also by being tired or not in good condition before the night shift, although these are not specifically causes of Shift Lag.

How do I improve the sleep I do get?

Although this is obvious some shift workers don’t understand that there are simple things that can be done to encourage quality sleep.

• Maybe sound proofing the bedroom.
• Darkness, using special light proof curtains.
• Temperature control, neither too hot or too cold.
• Humidity control, so that it is comfortable for sleeping.
• A comfortable bed, suitable for the shift worker
• Sleeping aids like blindfolds and ear plugs.
• Going to bed with an empty bladder, visit the washroom before bed.

What treatment is available?

Bright Light Therapy
Bright light boxes which deliver strong light are used by some to reset their time clock and once we now more about light therapy it may be used in night work situations. Some shift workers find when they are finishing a series of night shifts and are about to go back to days, spending as much time outside in bright sunshine helps. They find combining being outside with exercise most effective.

Sleeping Pills
Some shift workers use sleeping pills to try to alleviate shift lag. They do have a down side. The shift worker can become addicted to them. Its true they increase the amount of sleep but they don’t fix the problem of shift lag or increase the alertness of workers during the next shift. In fact some have a “hung over” effect making the shift worker drowsy during the next shift.

Persons suspecting that they may suffer from Shift Lag should consult a qualified healthcare provider.

Literature concerning Shift Lag that is distributed by MRC Healthcare, Inc., including this brochure, is offered for information purposes only and should not be considered a substitute for the advice of a healthcare provider.

Obstructive Sleep Apnea (OSA) is when a person stops breathing repeatedly during sleep. Breathing stops because the airway collapses and prevents air from entering and exiting the lungs. Sleep patterns are disrupted, resulting in excessive sleepiness or fatigue during the day.

What causes the airway to collapse during sleep?

Extra tissue in the back of the airway- such as large tonsils. Decrease in the tone of muscles holding the airway open. The tongue falling backwards and closing off the airway.

What should I do if I suspect I have Sleep Apnea?

See your doctor; evaluation by a doctor specializing in sleep disorders is recommended. Have a sleep study done; a sleep study can provide the doctor with information about how you sleep and breathe. This information will help the doctor determine your diagnosis and treatment options.

What happens if OSA is not treated?

Possible increased risk for:

• High blood pressure
• Fatigue-related motor vehicle accidents
• Heart disease and heart attack
• Decreased quality of life due to stroke

What treatments are available for Sleep Apnea?

The most common treatment is: CPAP (Continuous Positive Airway Pressure) pronounced “see-pap.” other less common treatments include surgery and oral appliances, which may be effective in certain individuals. Any treatments should include weight loss if needed, exercise, and avoidance of alcohol, sedatives and hypnotics.

Does CPAP therapy work?

CPAP treats Obstructive Sleep Apnea by providing a gentle flow of positive-pressure air through a mask to splint the airway open during sleep.

• Breathing becomes regular
• Snoring stops
• Restful sleep is restored
• Quality of life is improved

Persons suspecting that they may have OSA should consult a qualified healthcare provider.

Literature concerning OSA that is distributed by MRC Healthcare, Inc., including this brochure, is offered for information purposes only and should not be considered a substitute for the advice of a healthcare provider.