Top positive review
165 people found this helpful
An excellent source of info for some people
on July 15, 2006
"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...