It was on the 5th of June that World Environment Day was celebrated, a date celebrated with some fears on the part of several organizations for the defence of the Environment, which are afraid of setbacks in the goals defined for the climate, biodiversity and climate change, due to the strong impact caused by the pandemic. It is, therefore, increasingly important to think and rethink environmental issues. We must look at the Environment in a more comprehensive way, taking care of it with the same attention, responsibility, civility and affection that we have when protecting a precious asset, because the value of the Environment exceeds the limits of the quantifiable.
Environmental Health is, therefore, an area of great relevance and becomes essential when addressing aspects of human health and quality of life, "determined by physical, chemical, biological, social and psychological factors of the environment", referring also to the assessment, prevention, mitigation and control of factors that are present in the environment and can adversely affect our health. And it has never been more important than to invest on the training of professionals capable of intervening in these problems. This is the case of Cátia Reis, who obtained a Ph.D. in Environmental Health from the Faculty of Medicine of the University of Lisbon, who recently defended, with great success, her Ph.D. thesis on sleep patterns in Portugal (Sleep patterns in Portugal: European and International comparisons).
The FMUL EnviHealth & Co Doctoral Programme in Environmental Health was inaugurated in 2016 and is part of the Doctoral Programme of the Lisbon Academic Medical Centre (CAML). It is a strongly innovative Programme as it is the only one in the Health field recognized and approved by the FCT (Foundation for Science and Technology) as a Doctoral Programme to be conducted in a business environment, being co-funded by the FCT and by Partner Companies of EnviHealth & Co, awarding 24 Ph.D. scholarships that span over a period of 4 years each.
Cátia Reis works at the CENC - Centre for Electroencephalography and Clinical Neurophysiology, the “host company for the Ph.D.”, where she has been working with Professor Teresa Paiva since 2015. With great spontaneity, she explains that her path started with a degree in Marine Biology at FCUL (Faculty of Sciences, University of Lisbon). But still in the first year of the degree, Cátia decided to get a job. And it was her experience as a flight attendant and her curiosity that she defines as a state of being that aroused her interest and the aspiration to study “people”.
“My curiosity has always been very great, which makes things difficult when it is necessary to stay focused and abstract myself from my surroundings. She shared a room with three other people in a SASUL residence and was unable to study”, she recalls, explaining that she had no alternative but to find a job that would allow her to pay for a room in Lisbon, since her roots are in the Algarve, more precisely in Portimão. “A little as a joke, and because I would have to find something other than a job from 9 am to 5 pm, I applied for the first job that appeared in Expresso Emprego: Flight Assistant. As foreign languages had always been easy for her, Cátia was promptly, to her great surprise, accepted.
The huge desire to study "people" arose from her interest in understanding, first, what was happening to her own body which, "to be able to work and study at the same time", was deprived of sleep.
Meanwhile, at the end of her degree and already with a family, Cátia applied for the Master Degree in Human Biology and Environment at FMUL, explaining that “she intended to find out how the environment could influence humans”.
Admitting to being self-taught, always trying to find answers to her questions in order to quench her thirst for knowledge, she says that “as soon as I finished my master degree, I spoke to the medical department of, at the time INAC now ANAC (National Civil Aviation Authority), and proposed conducting a study on fatigue with civil aviation pilots. In the end, I submitted this study to the American Congress of Aeronautical Medicine (AsMA), the largest in the specialty, and the work was accepted for an presentation”, recalling that it was the first and great experience of communication in congresses. “It was a little scary, not only because it was the first, but because it was in the United States. It took me a month to train the presentation to ensure I wouldn't make mistakes, but it went well and I was very happy at the time, as I was asked several questions and, in the end, some people talked to me and congratulate me for the study”.
This experience, which she recalls with great enthusiasm and pride, made it clear to Cátia that the future would involve a career in research, going further and deepen knowledge about “fatigue, performance and , of course, sleep”.
She saw the Ph.D. as the next step and quickly went about it. She wrote a Ph.D. project and sought out supervisors, including Teresa Paiva, with whom she learned important lessons about sleep. “When we met, I showed her the Ph.D. project I had written and she not only liked it, she accepted the challenge”. Thus, Cátia proposed the project to the CAML and received the confirmation that she wanted, confronted with the financing problem, to which the impossibility of “collecting actigraphy and saliva, in search of biomarkers for fatigue” , for which she was never able to obtain authorization, was added.
“As a biologist, I always thought that I could not have a Ph.D. just based on subjective measures and as such I was not happy”, she explains. The door closed, but the window for the opportunity to join the Doctoral Programme in Environmental Health was opened, which, according to Cátia, “was appropriate for what I intended to do”. She decided to apply, believing that she would “go backwards”, but with a solution to the financing problem, as well as an opportunity to change projects. “However, since biological rhythms are a topic that fascinates me, namely their disturbance, I decided to conduct a project that would allow me to have a comprehensive overview of the most noticeable biological rhythm: sleep”.
In addition to Professor Teresa Paiva, Cátia absorbed the teachings of supervisors who contributed decisively to the success of her work, namely Neuroscientist Luísa Lopes, Professor at FMUL and researcher at the iMM, and Till Roenneberg, Professor at the University of Munich (LMU - Luís Maximiliano from Munich). "I met Professor Luísa Lopes during my first Ph.D., because she intended to carry out a project on shift work and when she found out that I had a project in this area at FMUL, she contacted me". At that moment, Cátia realized that Luísa Lopes was the “ideal person” to teach her everything she needed to know about “basic science”. On the other hand, "to learn more about circadian rhythm disorders, I would have to learn chronobiology (study of biological rhythms)", explains the researcher, recalling that she met Professor Till Roenneberg at a World Sleep Congress, who expressed his availability to teach her, inviting her to work with him in his laboratory. “This was something that for me, as a mother of two young children, would not be easy. So we found a way... I would be one week every two months in Munich. It depended a little on the face-to-face work we had, the rest was done through telework. In other words, this new reality throughout the world due to the Covid-19 pandemic, is something that I have been doing for years in order to learn chronobiology”.
Cátia found a trio of excellence along the way to guide her research. “There was Professor Teresa Paiva, who taught me the clinical component of sleep, Professor Till Roenneberg taught me chronobiology and Professor Luísa Lopes introduced me to the world of Neuroscience”. Thus, and with the mastery of three expert supervisors, Cátia materialized the idea that she cherished in her dreams, dedicating herself to an area that, according to her, is as passionate as it is innovative. “Circadian medicine is something that has been developed in recent years and it brings immense benefits to patients and to the economy. It is something that is very directed and integrated, which requires knowledge of each person’s biology and allows adapting the treatment in an individualized and much more efficient way”, she explains with enthusiasm, emphasizing that Environmental Health is as essential as it is vast, dividing into very different areas of study. "I dedicate myself to only one: sleep and biological rhythms, which are clearly influenced by the social environment and abiotic factors, such as temperature and light"
Cátia imagines a future when Environmental Health can evolve in its various aspects, wishing, mainly, that greater effort be made for the collaborative work between each variant. “We have to think more and more in a global and collaborative way. Onetworking is very important, not only with international partnerships, but also national ones. In my area (biological rhythms), this is common practice in other countries and when financial resources are scarce, it turns out to be the best way to achieve good studies”, she states.
The researcher defends that Man lives in an environment that influences him at several levels and the current pandemic “has demonstrated that we live in a global world and that quickly something that is affecting our 'neighbours' can be our problem too”, believing that some of the new habits established by Covid-19, especially teleworking, will endure.
“Another factor I would like to point out is that we have to learn to respect not only the environment, but also our own body. We tend to think that we can do everything and that sleeping is a waste of time, but if that were the case it would be the nature’s biggest mistake, since we spend a third of our lives sleeping”, she explains.
Cátia regards sleep as “our most noticeable and most fundamental biological rhythm, since it depends on good vigil and good physical and mental health”. According to her, sleep ensures our survival and her research work led to the thesis on the sleep patterns of the Portuguese, trying to compare indicators with other countries. "I was able to verify that there are many adults who report sleeping less than 5 hours a day, which is clearly insufficient", she guarantees, taking into account that the recommended number of hours of sleep for adults is between 7 and 9.
In addition to duration, another factor that contributes to the detriment of sleep "is its quality", which "can be impacted by the existence of a sleeping sickness or even by being the mother/ father of a baby", she says, emphasizing the existence of multiple factors that have a potentially negative impact on sleep. “Our social hours, for example, are a factor that influences our sleep quality. Normally, on working days, we are forced to wake up with an alarm clock, that is, earlier than our body would like, and only at the weekend we are able to sleep at our biological time”. This phenomenon is called social jetlag, she explains, which appears to be associated with a loss of health. “In my thesis, I could see that in patients with sleep pathology, social jetlag was a factor that affected the quality of sleep”.
From the studies carried out with the general population, she concluded that in Portugal there are, “as a rule, late sleep behaviours and activity, although we do not always have this perception”.
The comparative study with the other countries is still ongoing, she says, explaining that the initial plan was readjusted to establish partnerships, in order to increase its representativeness. “But from the preliminary data that I was able to analyse, we are effectively a country of relatively late chronotypes. Even more so than the Spaniards. However, Germans have the most social jetlag, which is essentially related to the fact that in Germany the industries start to work very early”.
Cátia Reis shares with us a journey that “was not at all linear”, but had the added advantage of conferring her “maturity and life experience”. She says she is still at the beginning of a future, which we believe will be promising, scientific career, which is slightly delayed by the circumstances and life goals that she has established. “I had to work and study at the same time and I was a mother, something I always wanted to be. But now I have two grown daughters, aged 11 and 14, who realize that this is my profession and even find it funny to go abroad from time to time”.
She believes that she still has a lot to learn, “in fact, it will happen until the end of my career and that is really one of the best things about research”. The future is to continue researching sleep. “I would like to take advantage of all the partnerships and contacts that I have been establishing in the last few years and contribute to the development of this area of knowledge in Portugal”, says Cátia, whose training path also took place in Europe and the U.S.
The researcher recognizes that Portugal and the world are experiencing difficult times, but giving up is not an option, and believes that it is in the attempt and experience that we make room for the opportunity for something greater.
Sofia Tavares
Editorial Team