Getting insurance to approve the CPAP, though... that is still an open problem. Weeks later, no treatment for diagnosed disease.
It doesnt sound like the situation has improved. Without a friend like you, would she have received treatment?
I think the community has gotten better at addressing the undiagnosed sleep apnea epidemic. When I needed help, there were some discussions about it on forums that I could find with the right search terms. Now, it's become much more common knowledge on the internet that people can spot it in others. which is fantastic.
The Doctors still seem to suck at it. For starters, fatigue is possibly the single most common symptom of disease - and is not something proactively asked about by doctors (in my experience). Every doctor at every check in should be asking "How tired have you been?". The fact that you can notice apnea in your friend before trained professionals even suspect to ask about it is the problem.
And the bigger problem is that even if we address this for apnea, how are we to know how many other issues are going around waiting for the patients to bring it up themselves? I certainly no longer trust that proactive diagnostic due diligence is being done on anything other than blood test result levels.
Doctors rely on patient complaints to govern their behavior. full stop. Check-ins and physicals are way more superficial than most patients understand, imo. Still very helpful, but not nearly enough
I happen to enjoy reading NTSB accident reports in my spare time, and they're always sleep apnea, so it was at the top of mind when I heard things like "headache every morning" and "I randomly fall asleep on my couch". I didn't go to medical school so I'm not sure if those are anxiety/depression symptoms, but a sleep study sounded like it wouldn't hurt. You're absolutely right that doctors should at least be asking these questions ("how tired are you", there is even a scale with more specific questions).
It is far from an ideal solution, but in the 3 months it takes insurance to get their shit together - your friend could have the energy to work a side job to pay off whatever it costs and just be generally happier overall
in my case, i needed to see an orthodontist every 2 weeks to have the mouth piece adjusted. I am not sure how CPAP works to say if it is safe to "plug and play out of the box" so-to-speak