Sergio Tufik, the greatest Brazilian sleep specialist: “The first reflection of humanity was on sleep”

Brazilian specialist in sleep medicine Sergio Tufik, founder of the Sleep Institute (Instituto do Sono) in São Paulo, says in an interview to iSleep that two major questions about sleep remain unanswered: What is sleep, and why do we sleep?
How is it possible to convince people to sleep more, when there are so many stimuli, like television, the internet, social networking, bars and nightclubs?
There are more and more opportunities in life and people want to sleep less. You cannot convince them to sleep more. But they have to sleep in order to make a homeostasis, to live well, be healthy, to avoid immunosuppression and catching “the flu” all the time and suffer from episodic diseases. That is the big problem, the greatest challenge for sleep medicine.

You say that dating couples should undergo a sleep study before embarking on marriage…
There is no doubt. It seems clear to us that many women have insomnia problems while men tend to have breathing problems. So there is a good chance that a man who snores a lot marries a woman who has insomnia, which means they will end up having a terrible life. The tests should be part of the pre-nuptial exams, so that they could have a better life together.

It seems that flu vaccines are ineffective if people do not sleep well the night before and after taking it. Is that so? What phenomenon is implied here?
Indeed. Most elderly people have sleep apnoea, which causes sleep deprivation. This fact is due to the many awakenings during the night and this induces immunosuppression. There is no use giving the vaccine, because it will not be effective. We have repeatedly denounced this problem to the Brazilian health authorities, but they do not take action.

What was the great scientific advance in sleep medicine?
In my view, the big event in sleep medicine, in this decade, was polysomnography. What did we know before that? The patient would constantly complain that he did not sleep, and we would prescribe an anaesthetic, and then the person would faint. With polysomnography everything changed. We started to find out what happens during sleep. I would also highlight, also in this decade, the discovery of sleep apnoea and CPAP.

Aristotle wrote extensively on sleep and wakefulness. It seems that scientific curiosity about the mystery of sleep began very early…
I think it started when man became aware of reflection. The first reflection of mankind was certainly on sleep. First of all, the mystery of standing still when we sleep. After that, the relationship with death. You sleep, you wake up, and this goes on and on – this homeostatic process of our body is most fascinating. But then one day you do not wake up anymore…

Which will be the future scientific discovery capable of revolutionizing the study of sleep and sleep disorders?
I think two major questions about sleep remain unanswered. What is sleep? And why do we sleep? To understand them would be a revolution. Then we would have control over sleep and would know how to adapt it.
Today many people ask me if it is all right to sleep less because everyone wants to live more. They fail to do many things because they spend half or one third of their lives sleeping, so they ask me: would it not be possible to sleep only two or three hours and concentrate the refreshing phases so that I could live more and in a better way? This would also be a great revolution.

Can you tell us a funny story related to sleep or lack thereof of a patient you have treated?
What complicates the relationship with patients is the issue of sleep perception. There are many people who have the perception that they have not slept at all, when actually they have. I have several patients who claim in my queries not to sleep. But then they undergo tests in our laboratory and I see that they have slept for six hours. When I show them the results showing that, they get very angry and feel insulted. They think that I am telling them something that is not true. It is a clash with the doctor. There are cases where a person not only did sleep, she also went through sleep phase 1, 2, 3, 4, REM sleep, DELTA sleep…

You say that “life is the art of solving problems”. How can this secret be taught, so that people can live happier?
First I would say that people get angry because they have problems. My first advice is to never feel angry about having problems, because life means having trouble all the time. You should be glad that you do have problems and try to solve them. The more you solve them, the happier you will be.
As to sleep, this is the most important behaviour there is for a homeostase to take place in our body. We have to know how sleep works, at what time it starts, how many hours we have to sleep to be fine. This is a personal discovery of each one, to know what your sleep window is. It is a fundamental learning that brings great balance in life.

I believe you know Portugal. What do you think of our country?
Well, being Brazilian of course I inherited the Portuguese culture. Of course I love Portugal, from the cooking part that I like a lot, to the affective part of the Portuguese. I consider the Portuguese top experts in human relations. I use to say that the Portuguese technology of mixing people is key. You notice that Anglo-Saxon attitude in Americans and you do not see this ability to relate. The Portuguese came to Brazil and began to mingle with everyone, blacks, mestizos, Indians. It is this culture which remains in Brazil. So, of course I hold a high opinion of the Portuguese, I think they are the best in affectivity and in social and human relations.