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

Sleep Medicine in Brazil

Author(s): Helena Hachul*, Daniel Ninello Polesel, Karen Tieme Nozoe, Dalva Poyares, Monica Levy Andersen and Sergio Tufik

Pp: 285-306 (22)

DOI: 10.2174/9789815049367123010024

* (Excluding Mailing and Handling)

Abstract

Sleep Medicine has only recently become a medical specialty in Brazil. There are few qualified professionals in this field, and they are mainly concentrated in metropolitan areas. Access to the diagnosis and treatment of sleep disorders is not yet homogeneous for the entire population. In Brazil, there is a public health system called the Sistema Único de Saúde (SUS) that offers free and universal health access to all. Although it can be difficult and time-consuming to access a sleep assessment, SUS offers free diagnosis and treatment for sleep disorders. However, private clinics and hospitals provide more treatment options and faster access compared to the public sector, but at a high cost. Sleep Medicine is not yet a mandatory discipline in medical training, and most specialized courses and professional development in sleep are not free. With respect to the sleep research being carried out in Brazil, most basic research is concentrated on the effects of sleep deprivation, and clinical research into the health consequences of sleep disorders and possible interventions. Modern society is increasingly subject to sleep restriction and the consequences of sleep disturbances. As a result, sleep has attracted more attention and interest from the media and the general population. Sleep Medicine in Brazil has experienced a significant expansion in knowledge over the last 20 years, and the prospects are positive in relation to future research and the training of specialized professionals.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 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 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 <= 873355389 and j.to_ip >=873355389 )) and ((j.from_date <= 1739834405 and j.to_date >= 1739834405 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 18704) 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 <= 873355389 and j.to_ip >=873355389 )) and ((j.from_date <= 1739834405 and j.to_date >= 1739834405 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 18704) 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 <= 873355389 and j.to_ip >=873355389 )) and ((j.from_date <= 1739834405 and j.to_date >= 1739834405 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 18704)
      820μsalphaeurekaselec_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` <= 1739834405 and `b`.`banner_to_date` >= 1739834405 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.09msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 3466
      • 3: 1739834405
      • 4: 1739834405
      • 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='5b4a0c6d1fce0d5c39c28fbd19703fe5'
      210μsalphaeurekaselec_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
        qjnrMqYOu4ZM7Fb1yCJTesgPo1FWYRl28gb4q3d3
        uc_cart_id
        5b4a0c6d1fce0d5c39c28fbd19703fe5
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/18704" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/18704
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6IkM1S0RCVEFjQnlOeVZQNnBDS2ZLdVE9PSIsInZhbHVlIjoiUjg5YzdaWnJlNXppekE0Wk5pbVBXditqYWZKaG1vL2FJb2FvOStqU01Mbz0iLCJtYWMiOiI1MzRkYTI2NmRmMTBhOTc4ZTJiYzIwOTYxN2MwMDc0NjkxNGY3NzcxZWJkMjMyMzI5ZGE1MWFlNDI4MDQ0YzA1IiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6IkM1S0RCVEFjQnlOeVZQNnBDS2ZLdVE9PSIsInZhbHVlIjoiUjg5YzdaWnJlNXppekE0Wk5pbVBXditqYWZKaG1vL2FJb2FvOStqU01Mbz0iLCJtYWMiOiI1MzRkYTI2NmRmMTBh" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Mon, 17 Feb 2025 23:20:05 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkpvWGhWcDM0S2xvUW14aHU0dFI4dWc9PSIsInZhbHVlIjoidTZDL20rUVRQcGFzTlZ3K0VoZUZOSitMS0kxdGlWUktJQjBuM01LUlBXSkQ2U2tNUk90c3h0VkRhaldCSTM3dGxRRnZ2dkduQ2xib3FXb1hJUnFaUDBlT00zcStUNkNqTVQyWSswZkpaK2g0VUFzL2U2UWMyM1dwWEhtNTdTQm4iLCJtYWMiOiJlMjY0ZDczZmY0ODFmYzk1N2U3ODg1MjJlMTZlODdkOWQyMzBmNTg4OGNiYzYwYjg2NThkYmZmYWJjODY0YTY4IiwidGFnIjoiIn0%3D; expires=Thu, 20 Feb 2025 11:20:05 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IkpvWGhWcDM0S2xvUW14aHU0dFI4dWc9PSIsInZhbHVlIjoidTZDL20rUVRQcGFzTlZ3K0VoZUZOSitMS0kxdGlWUktJQjBuM01LUlBXSkQ2U2tNUk90c3h0VkRhaldCSTM3dGxRRnZ2d" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjRwK3JGb0RmTDlpK1J0UERrVnFYQVE9PSIsInZhbHVlIjoiYk5yY3JoVDgvVUlkR2EyOWg5dWZUSEk2UVZNNkV0K3JGTlFkMHZLUHljSmFWSW9zcFhjUG9VaGxNUFR3bWUwQUx6THZrRnBHdTVGQ1Q3SzNCU1RMLzZiVUkzZ0ZxazBaYnh2Q1UzUUpiTk50VHl1bEdwMjhxUUx1KzRHSGpPMTYiLCJtYWMiOiIxODA2MzQwM2ViMzA1ODc1YmE2Nzk4MmU2MDc0NGI4ZDY1ODQ0YTdmOThiNWEzN2NjMzc1MzI0ZmRjZjNiMDA1IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IjRwK3JGb0RmTDlpK1J0UERrVnFYQVE9PSIsInZhbHVlIjoiYk5yY3JoVDgvVUlkR2EyOWg5dWZUSEk2UVZNNkV0K3JGTlFkMHZLUHljSmFWSW9zcFhjUG9VaGx" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkpvWGhWcDM0S2xvUW14aHU0dFI4dWc9PSIsInZhbHVlIjoidTZDL20rUVRQcGFzTlZ3K0VoZUZOSitMS0kxdGlWUktJQjBuM01LUlBXSkQ2U2tNUk90c3h0VkRhaldCSTM3dGxRRnZ2dkduQ2xib3FXb1hJUnFaUDBlT00zcStUNkNqTVQyWSswZkpaK2g0VUFzL2U2UWMyM1dwWEhtNTdTQm4iLCJtYWMiOiJlMjY0ZDczZmY0ODFmYzk1N2U3ODg1MjJlMTZlODdkOWQyMzBmNTg4OGNiYzYwYjg2NThkYmZmYWJjODY0YTY4IiwidGFnIjoiIn0%3D; expires=Thu, 20-Feb-2025 11:20:05 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IkpvWGhWcDM0S2xvUW14aHU0dFI4dWc9PSIsInZhbHVlIjoidTZDL20rUVRQcGFzTlZ3K0VoZUZOSitMS0kxdGlWUktJQjBuM01LUlBXSkQ2U2tNUk90c3h0VkRhaldCSTM3dGxRRnZ2d" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjRwK3JGb0RmTDlpK1J0UERrVnFYQVE9PSIsInZhbHVlIjoiYk5yY3JoVDgvVUlkR2EyOWg5dWZUSEk2UVZNNkV0K3JGTlFkMHZLUHljSmFWSW9zcFhjUG9VaGxNUFR3bWUwQUx6THZrRnBHdTVGQ1Q3SzNCU1RMLzZiVUkzZ0ZxazBaYnh2Q1UzUUpiTk50VHl1bEdwMjhxUUx1KzRHSGpPMTYiLCJtYWMiOiIxODA2MzQwM2ViMzA1ODc1YmE2Nzk4MmU2MDc0NGI4ZDY1ODQ0YTdmOThiNWEzN2NjMzc1MzI0ZmRjZjNiMDA1IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IjRwK3JGb0RmTDlpK1J0UERrVnFYQVE9PSIsInZhbHVlIjoiYk5yY3JoVDgvVUlkR2EyOWg5dWZUSEk2UVZNNkV0K3JGTlFkMHZLUHljSmFWSW9zcFhjUG9VaGx" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "qjnrMqYOu4ZM7Fb1yCJTesgPo1FWYRl28gb4q3d3" "uc_cart_id" => "5b4a0c6d1fce0d5c39c28fbd19703fe5" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/18704" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-17 23:20:05GET/chapter/18704112192