Following an initiative by a group of research scientists from the Department of Psycho-Biology of the Federal University of São Paulo (Unifesp), studies into sleep disturbances begun in Brazil in the 70s, even before the first international classification of the illness. These studies were part of the first wave of thematic projects approved by FAPESP. Currently the multidiscipline team, made up of 12 doctors, has two laboratories for the development of basic research into pediatrics, neuropsychiatry and breathing illnesses and 26 offices rooms for clinical examinations, besides the development of programs for professional training.
With the support of FAPESP, the Center for Sleep Studies intends to expand its activities in partnership with the private sector and invest in technology for the manufacturing of Canadian-made CPAPs, equipment that injects air with continuous pressure into the nostrils. Sérgio Tufik, director of the Center, wants to develop a manufacturing capability here in partnership with the Canadians. Other piece of equipment is an oral instrument for the resetting of the mandible. Both items are used in the treatment of apnea. In the opinion of the specialist group making up the selection board for the project, “the experience of the group in the interaction with private industry is reasonable and will tend to consolidate as time goes on. The group has a strong perception of the market, which is an emerging one in this case”.
Sleep disturbances have a high social cost. “We are world champions in traffic accidents, whose causes in the majority of cases are due to alcohol and sleep problems. And the major reason for accidents involving buses is because the driver falls asleep at the wheel”, Sergio Tufik reveals. With the help of FAPESP, the Center is to perform polysonographs tests on 300 drivers of a bus company. The polysonograph tests the respiratory, heart and neurological conditions of the patient during sleep. “If the patient suffers from apnea, which is a night espiratory pause, day sleepiness will be the consequence. This condition has to be treated.”
Apnea and snoring are disturbances, which affect at least 40% of the male population. “Research reveals that those people that snore die between the ages of 60 and 70 because they have lower oxygen intake and reduced saturation levels which in turn overworks the heart”, says Tufik. This kind of respiratory difficulty can on many occasions produce cardiac arrhythmia. “There are many people with pace makers that could have solved their problem with CPAPs.” Among women, the most frequent disturbance is insomnia, which results in the use and abuse of benzodiazepines, which cause dependency. “Of every three medicines sold in Brazil, one is a psychotropic and among these, the second most sold are the benzodiazepines. There are other methods, such as behavioral medicine or the bio feedback, that can help solve the problem”, says Tufik. The Center plans a wide campaign directed at the population on the most frequent sleep disturbances with information on the effects of the illness and appropriate treatment.
Besides basic research and the development of local technology and wide-reaching campaigns, the Center plans to invest in the training of specialists in sleep disturbances. “There are more than 130 sleep disturbance laboratories in Brazil but the colleges are not well prepared to teach the subject. Only Unifesp, formerly the Paulista School of Medicine, has a specialized course, besides past graduate and Ph.D. courses on the subject. We are preparing teachers to train specialists in the subject.”
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