The Practice of Sleep Medicine Around The World: Challenges, Knowledge Gaps and Unique Needs

Sleep Medicine in Nepal: Practice Differences, Resources and Gaps in Knowledge

Author(s): Narendra Bhatta*, Deebya Raj Mishra, Avatar Verma, Rejina Shahi, Sion Hangma Limbu, Srijan Katwal and Nishad Bhatta

Pp: 195-202 (8)

DOI: 10.2174/9789815049367123010019

* (Excluding Mailing and Handling)

Abstract

The Federal Democratic Republic of Nepal is one of the most beautiful and stunning Himalayan countries in the world where health care needs of the majority of the population are delivered by a hybrid system of public and private sectors. Public does not perceive sleep disorders to be as critical as other health problems because they remain unaware of the serious consequences of sleep deprivation and sleep disorders. Multiple segments of the Nepalese population are awake across all hours of the 24-hour day because of the large proportions of people working as migrant workforce across the globe in different time zones. Current data reveals a high public health burden of sleep loss and sleep disorders are among them yet these disorders are frequently ignored, readily treatable, and unrecognized health problems in Nepal.

Sleep medicine remains an interdisciplinary field crossing different specialties but in Nepal, it has become almost a subspecialty of pulmonary medicine in the past few years. Nepal does not have sufficient healthcare resources to deliver the appropriate care to patients with sleep-related disorders because of an inadequate number of physicians trained in sleep medicine. Sleep disorders and sleep medicine as a specialty are under-recognized by both the public and health professionals. The government should rethink policies and redesign the programs to address the evolving syndemic of sleep disorders, metabolic syndrome, and tobacco smoking in Nepal and incorporate sleep medicine in undergraduate and postgraduate medical curricula to address the gap in the clinical care of patients with sleep disorders in Nepal.

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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59772390 and j.to_ip >=59772390 )) and ((j.from_date <= 1739834844 and j.to_date >= 1739834844 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 18699) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59772390 and j.to_ip >=59772390 )) and ((j.from_date <= 1739834844 and j.to_date >= 1739834844 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 18699) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59772390 and j.to_ip >=59772390 )) and ((j.from_date <= 1739834844 and j.to_date >= 1739834844 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 18699)
      530μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 3466 and `b`.`banner_from_date` <= 1739834844 and `b`.`banner_to_date` >= 1739834844 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.08msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 3466
      • 3: 1739834844
      • 4: 1739834844
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='160d810a7830d816d0d59c55a7bf8efe'
      200μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        UKM0OC8tswa1dogVMTDexbTMwN801FwCGwQfy7Cx
        uc_cart_id
        160d810a7830d816d0d59c55a7bf8efe
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/18699" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/18699
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
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        response_headers
        0 of 0
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        session_attributes
        0 of 0
        array:5 [ "_token" => "UKM0OC8tswa1dogVMTDexbTMwN801FwCGwQfy7Cx" "uc_cart_id" => "160d810a7830d816d0d59c55a7bf8efe" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/18699" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-17 23:27:24GET/chapter/18699112192