Sleep disorders for the masses

Abstract

According to the authors of Sleep Disorders their intended audience is all health-care workers apart from those with specialist training in sleep medicine. I believe they have succeeded in writing a book in an attractive style for nonexperts. Part one covers basic science and part two covers clinical aspects of sleep. Tables and case studies have been liberally used to illustrate common clinical scenarios and to emphasise a pragmatic approach. I particularly like the clear information about history taking; the chapter on insomnia is very good in this respect and shows that this book has been written by those who actually manage patients with the problems they are writing about. As usual, I could not resist the temptation to initially skip the basic science section and go straight to the end. The chapter on sleep and the law is illuminating. Medicolegal topics are often covered by television documentaries providing lurid details about how someone murdered his entire family in his sleep. This chapter provides a more measured but fascinating discussion of cases of sleep violence and impaired performance due to sleepiness. Diffi cult legal concepts such as sane versus insane automatisms in sleep violence are discussed. The distinction is important since if the court verdict is sane automatism then the defendant goes free, but a verdict of insane automatism could lead to commitment to a mental hospital. The last chapter, returning to more everyday problems, covers non-invasive ventilation, including case studies of ventilatory failure due to chronic obstructive airways disease and various neuromuscular disorders. There is practical advice on whether the procedure is appropriate and how to monitor treatment. Most health-care professionals get little formal training in sleep medicine but have to look after patients with sleep disorders. This book will help fi ll a knowledge gap and will be particularly useful for neurologists, clinical neurophysiologists, anaesthetists, and respiratory physicians who are often asked to investigate and manage such patients. Those making a defence in court about shooting someone in their sleep may also fi nd this book useful, but if the loaded gun was carefully placed under the pillow before going to bed then their chances of success are slim.