FLASS, A new awakening: For the dissemination of clinical and basic sleep science in Latin America

In this first edition of 2015, the Sleep Science journal, diffusion instrument of the Latin American Federation of the Sleep Societies (FLASS), shows chapters of the working program for the years 2014–2016, in which one expects the active participation of all brotherly societies on the clinical and basic investigation of sleep in Latin America. The practice of sleep medicine is happening in our entire continent and within all the disciplines that integrate the emergent and consolidated sleep science, in some countries more than others, and our mission as a Federation, is of following this growth per Associations, as well as per individual members. For this following up, we propose a program entitled A NEW AWAKENING [1] ,with the engagement to respond to all the questions and doubts that were debated during the last Assembly in December 2014, where we analyzed and raised the attention to the reality of the Latin American Federation of the Sleep Societies. Such analysis, were focused on the pressing need of integration, institutionalization and corporative structuring of FLASS, of member appropriation and of constructing with solid basis, the integration and accompanying of the development of the sleep science in the continent.

1. Proposal 1: Membership and contacts

During the last Assembly we determined the need to be more inclusive with the Latin American countries [1], establishing as a priority, and the contact between the existing associations’ leaders and if nonexistent in some countries, with whomever was studying sleep medicine or investigating sleep in each country, reliving the statutes and agreements of Punta del Leste, Uruguay [2]. Doing justice to this goal of the honorable Assembly and with the objective of producing the abovementioned contacts, we propose to establish a MAIN PLAN [1], where a member of the actual group will be in charge of such contacts and secondly, to establish within the same idea, a REGIONAL DIVISION, to effectively promote such coverage and following up. The regional distribution is as follows: North (Mexico, Puerto Rico, El Salvador, Honduras, Guatemala and Nicaragua), Caribe (Venezuela, Cuba, Dominican Republic, Costa Rica and Panama), Andes-Amazon (Ecuador, Colombia, Brazil, Peru, Bolivia and Chile) and River Plate (Argentina, Uruguay and Paraguay). This political division will serve, among other things, to improve the channels of communication for the information coming from the Latin American Federation of Sleep Societies.

2. Proposal 2: Corporate matters

Fort the second programmatic concept [1], there is the urgent need presented during the Assembly, of resolving the corporate aspects, where we propose to revise the statutes and to proceed with the corporate and formal enrollment of FLASS, as an international organism, with headquarters in Mexico City, already approved during the 2014 Assembly. In past years, there have been proposed some statutes during the Punta Del Este meeting in Uruguay, which have been reanalyzed and reconsidered for some central aspects that were raised during such meeting, in order to establish a plan of action that allows for a better growth and consolidation as a Federation, the central aspects of the statutory analysis, being around the following aspects: Validity of the present structure, Vision and Mission, Enrollment of the Latin American Federation of Sleep Societies, Grants Provision and FLASS assets and Membership criteria. We will establish a working group during the meeting and we will present the respective proposition in the FLASS Assembly, previously mentioned.

3. Proposal 3: Present status

For the third proposal[1] we want to revise all the different aspects that were published about the present status as a reflection of what has been done and published in the available literature to date. As a result, we found a couple of short notes that were published in the News Letter [3,4], of the World Association of Sleep Medicine, in the years of 2006 and 2007 and a third revision, a little more comprehensive that was published in SLEEP SCIENCE. In this third revision [5], performed by 9 of the country members of FLASS, the majority of South Americans concluded in such analysis that some aspects of vital importance for the present status, such as the unequal development of sleep medicine in the continent, the variability of the countries’ financial resources to receive technology and capacitation, and the little influence of the existing associations in the pre and post graduation health programs, lack of certification, in order to study sleep medicine. This has already been seen as the associations’ lack of participation in the making of state politics, which demonstrates that we still have some space to work for, considering the high potential for development.

What has called our attention is the little dissemination of the reality of the Central American countries, because no one in the previous revisions has developed the true reality of such countries, amplifying therefore, the possibilities of sleep medicine in our continent. Besides, there seems to be a different dynamics of the previous revisions, with changes where one sees the increase of formation courses, increased number of certified members with university support and with the appearance of pre and post graduation programs, with the implementation of sleep medicine or the basic investigation of the same. It shall be pointed out that the academic plan highlights the positioning and importance of Sleep Science[6] as the journal for the Latin American diffusion of sleep science. This adds up to the technological development led by Brazil and Argentina in having registered teams for the study of sleep. With the exception of Brazil, Uruguay, Argentina and Mexico, are the South American countries where the report of basic investigation of sleep is poor and does not have the same following up and direction as the sleep medicine.

The reality of Central America is similar in some aspects to the South American one in terms of practice and investigation of sleep medicine[1]. In first place, the majority of Central American countries where there is the development of sleep medicine, do not bear the majority of the formal associations of sleep medicine, which constitutes an important segment for FLASS. Secondly, there are no formal courses or meeting about sleep medicine in such countries, neither the presence of organized institutions that would echo the health politics, as the formal educational field, although there are some isolated programs which preclude the formation of its students in sleep medicine and technological development.

There is Latin American associations that teach sleep medicine and on other hand, is that the development of sleep medicine has taken to the active association of non medical professionals, for the approach of sleep medicine. This highlights the fact that in two separate occasions, in Uruguay and now in Colombia, the certification of sleep medicine course was given by Latin American experts. The development of basic science in sleep in the continent deserves the interest of part of FLASS, for the promotion and development of this science.

Latin American Sleep Congresses organized by FLASS, have attracted a very good public within the host members and have demonstrated good academic embrace, however, there is a lack of a more active participation of the country members as far as organization is concerned, as well as their own participation. They also should give FLASS its financial contribution to allow for the development of programs and projects and they raise many doubts as the only space for the meeting and functioning of FLASS.

In general, this has been the vision of the present status of sleep medicine in the continent, however, we expect to see a new characterization with quantitative data which allows for more accurate decisions for the targeting of the Latin American Federation of Sleep Societies.

4. Proposal 4: Programmatic plan

As the fourth proposal [1], we will amass all the programmatic program of the previous two years, based on different scenarios, for the strengthening of our Federation and following up with all the member countries. We propose in accordance with what was discussed during the last Assembly hosted in Mexico City, to organize our action politics, in the following work fronts that are very important and that will serve as a meeting and triggering point of these last two years. These are the following: Corporate Organization, University career and Investigation, Membership and Divulgation, Economics and Financials, Meetings and Latin American Certification.

5. Proposal 5: Certification and FLASS classification

A very important point that always appears naming different FLASS assemblies and reunions, is the Latin American capacitation, qualification and accreditation of the experts in sleep medicine and investigation, given answer to the need for qualification and development of sleep medicine in Latin America, we propose to create two institutions for that purpose, which will be objectively studied and analyzed during the meeting and that will start working as soon as the approval by the assembly, which are: a collegiate for the investigators of sleep medicine and a collegiate for the development of sleep medicine, to be founded as dependent institutions of FLASS and approved by the Latin American experts in such areas of expertise, and nominated by the directive panel for a similar working period as of the main organization. Each collegiate is in charge of design and standardize the politics for certification and Latin American classification of the sleep centers and experts and investigators, who will be approved by FLASS superior council and/or the Assembly. However, it is necessary to do a characterization study, which will serve as a basis for the collegiate groups, besides serving as a source of present status of FLASS, with more quantitative criteria. Such characterization will be performed by means of a structure program of five dimensions: Main data from the associations, Characterization of its members, Basic and Clinical investigation in each country, Pre and Post education in sleep medicine and Politics of existing status related to Certification and Clinical Guidance.

Considerations and conclusions

The pathway to be conducted by FLASS is very wide and will demand a decisive commitment by all associated members of Latin America and all the agents of sleep science in our continent. Some of the most important topics have already being progressing and being discussed. This task cannot be done alone, needing the decisive support of everyone and each one of the country members, which united can and will strengthen sleep science as a new awakening for our continent. The following is the directive council for the years 2014–2016.

Directive council 2014–2016

Hernán Andrés Marín Agudelo (Colombia) President

Javier Velásquez Moctezuma (México) Vice president

Guadalupe Terán Pérez (México) Executive Coordinator

Francisco Guerrero Campos (México) Treasurer

Liliana Estrada (Costa Rica) Vocal

Claudio Cárdenas (Venezuela) Vocal

Carmen Madrid (Panamá) Vocal

Monica Levy Andersen (Brasil) Editor Sleep Science.