Customer Reviews

The Promise of Sleep

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"The Promise of Sleep" is the eminent Dr. Dement's magnum opus for the masses. It contains more information than most of us will ever want to know about sleep. It is a long and intricate book, and it reads like a grant proposal. Most of us will read the sections that apply to us, and will use the book as a reference. I didn't read the whole thing and neither did any of you. So if you plan to read the whole thing... you are dreaming. But I find myself returning to this book repeatedly, for various health-related reasons. Here I discuss the people I think will benefit from this book, and why. Then I discuss what I believe to be Dr. Dement's biases, for better or worse. Finally, I discuss some other books which you might consider in addition to, or instead of, this one.

Here are the people who will benefit from this book, and why.

1) PEOPLE WHO WANT TO TURBO-CHARGE THEIR SLEEP. You want to optimize sleep's restorative powers, and to optimize your mental functioning while awake. I believe that you are unlikely to find a better source of practical information than this book, though of course there are free sources available online. The fourth part of the book (about 125 pages) is devoted to "The Principles of Healthy Sleep." This section includes 6 chapters that include self-assessment procedures, ways to set priorities and seek professional advice, strategies for dealing with specific situations (e.g., driving, flying, difficult work schedules), ways to optimize sleep across the lifespan, ways to manage caffeine, alcohol, other drugs, diet, and exercise to improve the quality of sleep, and more. Personally, I found the tips for dealing with jet lag to be very helpful, and non-intuitive in some instances. And I've reduced my "sleep debt" significantly. And... I've used tips to optimize creativity.

2) PEOPLE WHO SUSPECT THAT THEY HAVE A SLEEP DISORDER. You want to diagnose yourself or someone you know. First off, let me assure you that you are right to try to educate yourself in this way. Managed care medicine (which dominates the US) is not exactly geared toward diagnosing and treating sleep disorders, and you are likely to know more about sleep disorders and their consequences than many medical professionals. So go for it. Have the facts ready when you go to battle with clinical professionals who can't or won't do their jobs. I'm not advocating that you diagnose yourself without proper medical assistance. But knowing what to look for, and knowing implications for diagnoses makes plenty of sense. Appendix A lists the menu of sleep disorders. I found this list very helpful relative to sources that I use professionally, as a psychotherapist. Therapists typically use the DSM-IV diagnostic scheme, which is OK but highly limited. Dr. Dement's list is MUCH more comprehensive than the diagnostic schemes that I've seen elsewhere, but his list seems credible because HE is so credible. Additionally, Part 2 of the text (about 100 pages) is titled "When Sleep Fails." This section contains 5 chapters with considerable information about diagnosis and treatment. It contains sections on (among other things) the insomnias and their causes (e.g. mood issues, fibromyalgia), snoring and sleep apnea (a hugely important chapter; obstructive apnea is vastly under-diagnosed but treatable), narcolepsy, sleepwalking and sleep terrors, and chronic fatigue syndrome.

3) PEOPLE WHO HAVE A SLEEP DISORDER, AND WANT TO LEARN MORE. There's plenty in the book about theory, methods, and applications. If you want to become a walking encyclopedia on your (or your loved one's) sleep disorder, this book is an excellent place to start. Moreover, Dement provides websites which provide good information. You'll want to consult these websites to find out about new developments. For instance, CPAP machines for sleep apnea continues to improve, so find out the latest.

4) MEDICAL AND HEALTH PRACTITIONERS. Many clinicians don't know much about sleep disorders, and so this is a good place to start. Diagnostic tools like the DSM-IV are highly limited. (see 2 above). As a mental health practitioner who asks about sleep and who teaches group stress reduction courses, I've found that I'm in a good position to screen for things like sleep apnea. For instance, I'll sometimes have a room full of people doing a "body scan" or "progressive relaxation" and a fair number of people will fall asleep, and begin to snore. When I mention sleep apnea to these people, they usually haven't heard of it. But more than a few of them got the official diagnosis, and are benefiting from treatment. If you refer your clients to a sleep lab / sleep study, Appendix A gives you a language and classification scheme that you'll find very helpful.

5) INSTRUCTORS WHO WANT TO TEACH ABOUT SLEEP. I can imagine this book being used as a textbook for a course on sleep. There's plenty of theory, methods, and clinical interventions discussed in this book. I teach grad psychology classes that touch upon these topics, but this book is WAYYYY too long for that. I plan to review Appendix A in my classes, and to find a short chapter on sleep disorders (preferably by Dr. Dement). Once again, the DSM-IV offers a very basic coverage of sleep disorders, but Dement's coverage is more thorough.

Here are Dr. Dement's BIASES, as I see them.

1) Dr. Dement has a bias that causes him to emphasize some treatments while dismissing (more or less) other treatments. The reader will want to be aware of these things. I'm not saying Dement is right or wrong, but if your bias differs from his, you should know the following. Dr. Dement tends to favor the judicious use of medicines like sleeping pills in some instances, and he's less enthusiastic about many "alternative" strategies, such as herbs.

2) I've heard some people suggest that sleep treatments (like CPAP machines for sleep abnea), have become something of a racket. The suggestion is that if you go for a sleep study, it is worth it to the practitioners to diagnose you and sell you a CPAP machine. If that's the case, then perhaps Dr. Dement feeds into this conflict of interest, which leads to unnecessary treatments. Personally, I don't buy this. I think Dr. Dement is on to something BIG, and that we'll be better off if we diagnose and treat sleep disorders, with greater frequency.

Here are a couple other books that tackle many of the same topics. This book is not the only or final word on this topic.

Principles and Practice of Sleep Medicine, 4th Edition (Principles & Practice of Sleep Medicine) by Meir H. Kryger, Thomas Roth, and William Dement (2005). For clinical professionals.

Sleep Disorders for Dummies by Max Ph.D., A.B.S.M. Hirshkowitz, Patricia B. Smith, and William C. Dement (2004)

So... I recommend the book and thank Dr. Dement for his remarkable contributions to sleep medicine.


****UPDATE**** March, 2007. There's a GREAT program on sleep that is viewable online via The Science Network and Roger Bingham. Search for "The Science Network" and "Waking Up to Sleep." The program contains hours of entertaining by leading sleep researchers. (Dement is not included among the speakers.) MUST SEE...

Yes, it's too long; and the lack of an index is frustrating. But Dement presents ideas here that need to be heard, and haven't before. Sleep is not a simple process that can be distilled into a soundbyte - and his scientist's training won't let him devolve this into a mere list of "tips to sleep better". So, it it worth wading through 450 pages? A resounding yes. My own sleep problems were helped the very night I skipped ahead to the sleep hygeine chapter (the closest things to tips in the book). My understanding of jetlag and "prime time" for creative work will help me in the future. My respect for sleep has grown and will change my decisions. My realization of how close I have been to falling asleep at the wheel is terrifyingly clear. I am sending the book to one friend who I am sure suffers from a life threatening sleep lack. And unlike the reader who found Dement's career history self serving, I hear instead a plea for more research on this vitally important subject. Fascinating, readable, likeable, surprising, and worth every minute of your time to read. Although the writer's style is easy and readable, it alone would not rate five stars. But the content is five star plus. Buy it!

When a friend of mine recommended that I read this book, I was slightly doubtful. I didn't really believe that a book about sleep could be all that interesting. When I did get around to reading The Promise of Sleep, however, I was really pleasantly surprised. Dr. William Dement wrote this book in a manner that neither condescends to the reader, nor confuses him or her with overly technical terms, as one might expect from the world-renowned expert on sleep. It is friendly and amusing with entertaining anecdotes form Dr. Dement's career. In this respect, the book has some autobiographical aspects to it, allowing the reader to take a look into this fascinating man's life and work. One gets the sense that this book is intended for everyone who can read it, not only for people who can't sleep at night. The sleep patterns of people of all ages are discussed: infants, children, adolescents, pregnant women, the middle-aged, and the elderly. Dr. Dement makes it clear that sleep affects every area of our lives, and he does this by providing us with fascinating, but little-known, information. For example, in spite of the fact that 9 out if 10 people are either sleep-deprived or have a sleep disorder, a large number of these cases remain undiagnosed, because most doctors are untrained in this area. And sleepy drivers have a part in about a third of traffic accidents, but few people are aware of this. It makes the reader indignant to find out about this, and the author's anger shows through as well. After all, people are dying from sleep disorders, car accidents, and industrial disasters because the public is ignorant about sleep. The Promise of Sleep serves as a self-help book as well. I did not realize that I was sleep-deprived, or that sleep debt accumulates, until I read this book. The book includes a three-week plan to improve one's sleep. I actually tried it, and now sleep is a priority for me. As a result, my days are much more productive. This book was excellent. I would unhesitatingly recommend it to anyone, on the basis that it will change, and even save, lives. It would serve as a good gift, as well.

William Dement knows more about sleep research than anyone, and this book should have let us all in on what he knows. It doesn't. I suspect that the problem was the publisher's pushing too hard to make it "readable" and "popular". We are given too many stories about Dement's personal life, often irrelevant to his point (by contrast-- to name a terrific science writer-- Steven Pinker's stories and anecdotes always illustrate a point). Some of Dement's ideas and key points are repeated too often; some of his other ideas need more detailing. We are talked down to. The lack of an index creates incredible inconvenience (there's an interesting comment on caffeine that I'm sure is in there somewhere but I don't know how I'll find it without reading the whole book again). Also, the lack of endnotes is unacceptable in a book of this sort (see Pinker or Jonathan Weiner for examples of how it should be done). Yes, there is a lot of insight; and as I said, the man knows more about the subject than anyone, so you will learn useful things. But I wish he'd try again, and write a book that doesn't underestimate the reader's attention span and ability. It would be much more useful.

+++++

Answer true or false to these ten statements:

(1) Depriving people of dreams causes mental illness.
(2) Drowsiness, that feeling when the eyelids are trying to close and we cannot keep them open, is the first step and not the last step before we fall asleep.
(3) Generally, people need to sleep one hour for every two hours awake.
(4) Insomnia is a disease.
(5) The purpose of sleep is to rest the body, especially the muscles.
(6) Although sleep needs vary, people who sleep about eight hours, on average, tend to live longer.
(7) If you are well rested, it should take about five to ten minutes to fall asleep.
(8) The single symptom most frequently found in all severe sleep disorders is daytime fatigue.
(9) Sleep gets lighter and more fragmented as we age.
(10) We know what sleep is for, how it works, and how it affects us on a cellular level.

If you answered true to any one of statements (1,2,4,5,7,10) or false to any one of (3,6,8,9), then you may need the help of this book co-authored by Dr. William Dement, "a pioneer in sleep medicine."

This easy-to-read book is divided into four parts (where each part except the first part begins with a brief preamble):

(i) The Fundamentals of Sleep (5 chapters)
Covers such topics as rapid eye movements, sleep debt, fatigue, the biological clock, and circadian rhythms.

(ii) When Sleep Fails (4 chapters)
Some topics mentioned are insomnia and its treatment, snoring, apnea, sleep disorders, and sleep deprivation.

(iii) When Sleep Works (5 chapters)
Topics include longevity and the immune system, mood and vitality, dreams, creativity, productivity, and learning.

(iv) The Principles of Healthy Sleep (6 chapters)
The chapters in this part center around five main areas "for reclaiming healthy sleep."

This book, I feel, is strongest at conveying how to understand sleep. There are some instances regarding sleep remedies but the authors warn that for medical advice and treatment, you should consult the appropriate medical person. However, for those with sleep problems, part four of this book should be most helpful since it offers practical advice.

This book ends with three appendices that I feel are excellent. The third appendix is especially good since it lists ten important internet sites.

There's only one major problem with this book: it's way too long. It is too long because Dement wants to tell his biography at the same time and give anecdotal stories. The result is that the reader has to read through all this detail before encountering a point of importance. This problem gets worse as one proceeds through the book. Summary pages of key points at the end of each chapter would have been most helpful.

However, this problem does not make the book unworthy of reading since the information conveyed is important. Impatient readers will probably disagree with me though.

Finally, I should WARN prospective buyers of this book that it is only the paperback version that has an index. An index, especially for this long book, is important because it allows one to access important information quickly.

In conclusion, this is a good book that "explores the vital connection between health, happiness, and a good night's sleep." If you want to understand this important part of your life, then this is the book to get!!

(first published 1999; acknowledgements; introduction; 4 parts or 20 chapters; main narrative 450 pages; afterword; 3 appendices; index for paperback version only)

+++++

Their sure are some strange negative reviews and some very positive ones on this book. I am extremely positive on this book. Of course, the book is too wordy and has too many human interest stories for the accomplished reader. Have not these people learned to read more rapidly when they get it and more slowly when they don't? Look at what the author said and did. He said the subject needs to be understood by everybody--not just his professional colleagues. He selects a co-author that has the skills to make book accessible to the lay person.

Why is sleep important? In this book you will learn that you are probably shortening your life span by poor sleep. Accidents from poor sleep are about as serious as drugs and alcohol. There are sleep diseases that MD's are doing a poor job on--particularly apnea. Most parents are failing to protect their teen age children from serious health problems and school performance problems through careless guidance on sleep. People are damaging their careers by poor sleep. How could this not be an important book for the average person. Their is no reason that MD's should not read this book. They ought to at least go far enough into the subject that they start reading professionally and stop letting their patients die from the doctors lack of knowledge about sleep. The lack of citations in the book is missed by the accomplished, interested reader.

The discussion of chemical events that transpire during sleep helped me understand how to start managing my sleep problems. The detailed discussion about normal sleep is really excellent. He gives me a renewed understanding about learning how the healthy human body works by understanding disease. It so easy to forget that the study of disease is tightly related to understanding the healthy human.

The paperback edition not only has an index it has two excellent appendix. One lists all the worthy sleep centers in the USA. This alone could save many lives as their are so many MD's that are failing to diagnose sleep problems. The appendix that summarizes the various sleep disorders is excellent. Don't let a few goofy reviews distract you from seriously considering this book. I have reread some parts of this book several times. I have given several speeches largely based on this book. This is one of the ten most important books in recent decades.

Dear Amazon readers!

Anyone troubled with sleep difficulties or interested in the science of sleep should definitely read Dr. Dement's book, which has fundamentally changed my understanding of and attitude towards sleep, and as a result, radically improved my health (both mental and physical). I'm a graduate student in the final semester of writing my dissertation, and I have always had terrible sleep problems; things grew so bad this term that I decided I had to learn whatever I could about sleep, and happily, found this book. I read it all the way through and was helped immensely, both by Dement's practical suggestions and by his wonderfully lucid, accessible and thorough presentation of the science of sleep.

If you want to only read one book on the subject, this is the one to choose: Dement is one of the foremost researchers in the subject, and has devoted a long career to the study of sleep. He also has a gift for conveying this information to laypeople, and an an urgent sense of why it's important that it be widely disseminated. He's concerned about the public health effects of sleep deprivation (including automobile and other transportation accidents, as well as many individual health problems). Reading this has made me really prioritize sleep, and encourage my friends and family to do the same.

I find myself weeding through the book trying to pick out the actual informative content regarding sleep because so much of the content is autobiographical and self-laudatory -- not so much about sleep but about the good doctor himself; and even when he is discussing sleep, he never fails to point out how he and no other discovered this or that. If the doctor simply stuck with the subject at hand -- sleep, I would have given more stars. Rather, I feel as if I am reading the CV of an egomaniac.

As you read this tome you realize that it being written by somebody with the odd balance of ego and humility that comes with being both a tenured professor and leading expert in a specific field.

To be sure, you'll learn everything there is about sleep that you never knew who to ask. There is a lot of good information that is written in layman's terms. The problem is you're going to have to [rummage]through a lot to read the important information.

The book is 540 pages long and could have been at least 200 pages shorter with better editing. There is way too much information about the author that isn't necessary. I really don't care about his love of Jazz music--unless it's going to help me sleep! He spends a lot of time lambasting the medical community for not knowing enough about sleep--some of it well deserved. One excellent point that Dement makes is regarding the use of sleeping pills. They have been demonized by the medical community when they could do a lot of people good with little actual downside. He recounts a story of one college student who was in desperate need of sleep. He tells about trying to get the school's infirmary to write a prescription for sleeping pills, which they flatly refused. I kept wondering why Dement himself didn't simply write the script?

Also, while sleep disorders make life miserable for a lot of people and lead to a lot of problems (such as Dement's accurate description of the cause of the Exxon Valdez) the whole world isn't about to die from sleep depravation. There's too much "the sky is falling" in the book.

With a good editor this could have been the definitive book on the subject of sleep. As it is you'll just have to skim through it to find the relevant information.

I have wanted to learn something about sleep, and particularly about insomnia, for quite awhile. When I came across The Promise of Sleep in my local bookstore, I was a little put off by its size. I expected that getting through it would not be easy. Was I ever wrong! Dr. Dement's book reads like a novel. I couldn't put it down, and I carried it around for several days, reading every chance I got until I was finished.

Dr. Dement says at the outset that his goal is to give people the fundamental knowledge they need to change the way they sleep and live. Having read the book, I can now say that I received an excellent basic education about sleep. What's more, I was taught by the number one man in the field. On top of all that, it was fun and enjoyable.

In addition to solving my own particular difficulty sleeping, I have been able to help a couple of close relatives with their sleep problems. In fact, I am now known as the "guru of sleep" by my family and friends giving advice and recommending the book at the drop of a hat. For example:

Do you feel fatigued and exhausted? This book is for you. This vast majority of fatigue problems arise from disordered sleep.

Do you want to succeed in life? This book is for you. You must manage your sleep and you must know how much sleep you need. And accumulating sleep debt, as Dr. Dement describes with marvelous clarity, can lead to bankruptcy, failure in school, and failure on the job. Not to mention failure in bed.

Do you snore, or more to the point, do you share a bed with someone who snores? This book is for you. Loud snoring is bad news and you must do something about it. Fortunately something can be done.

Are you a parent of young children? This book is for you. Healthy breathing during sleep may be the single most important issue for a growing child. If your child has noisy breathing during sleep, do something. The consequences for adult life may be tremendous.

Do you have trouble sleeping? This book is for you.

Are you wondering if you should use sleeping pills? This book is for you.

Do you know anyone who has suffered from a stroke or a heart attack? There is a strong likelihood that sleep apnea played a major role.

Are you wondering if you should consult a physician about your sleep? This book is the best thing you could possibly read before doing so.

Are you concerned about safety in your home, in your job, in your traveling? This book is for you.

Do you wonder what your dreams mean? This book is for you.

Now that I have completed Sleep 101, I am looking for a more advanced book that focuses on biological rhythms. Later, I might want to read more about sleep disorders or about dreams. I counted 127 different books on various aspects of nutrition the last time I was in my bookstore. Surely we could have at least a dozen books dealing in depth with one or other of the many different manifestions and abnormalities of sleep. I hope a few will soon be forthcoming, and I hope they will be as readable and entertaining as The Promise of Sleep.