Sleep Disorders For Dummies

book review
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BOOK REVIEW
Sleep Disorders for Dummies

by Max Hirshkowitz and Patricia B. Smith, 355 pp, with index, $19.99, ISBN 0-7645-3901-9, Hoboken, NJ, Wiley Publishing, Inc.
Wolfgang Schmidt-Nowara, M.D.
Sleep Medicine Institute, Presbyterian Hospital of Dallas, Dallas, TX
J Clin Sleep Med 2005;1(1):98
hose of us who have used the self-help guide, PC for

Dummies, may be surprised to learn that similar help is now
available for such non-digital challenges as Golf, Feng Shui, and
various medical disorders including Diabetes, High Blood
Pressure, Fibromyalgia and Thyroid. The books feature simple
language, short paragraphs, checklists, and frequent sub-headings and icons to assist the reader with limited time or interest.
Sleep Disorders .. is dedicated to the sleepless, i.e. the reader
who seeks help for ineffective sleep, and it largely succeeds. The
books scope is broad, encompassing the full range of sleep complaints and all categories of sleep disorders. The emphasis on
sleep behaviors as the basis for many sleep problems is appropriate for the majority of likely readers. Physicians may be surprised
at the relatively lesser emphasis on important medical problems.
For example the chapter on obstructive sleep apnea devotes 16 of
26 pages to uncomplicated snoring, has little to say about cardiovascular complications of OSA, and offers no advice on how to
succeed with CPAP. Readers are appropriately directed to medical help for more serious disorders. The description of what to
expect in a sleep laboratory is particularly helpful. Advice is provided on virtually every page. Consistent with the focus on self
help, much advice falls in the categories of common sense, sleep
nostrums and popular lore. The style is encouraging (you are not
alone) and supportive (I feel your pain) and contemporary (lists
of top ten tips).
Sleep Disorders .. joins a considerable lay literature advocating attention to sleep for a better life. A common failing of this
paradigm, and Sleep Disorders .. is no exception, is a tendency
to exaggerate, to stretch the truth by allusion and frank misstatement. For example, I object to the claim that poor sleep may
cause increased mortality. Even when qualified with the ubiquitous may, the association with every day insomnia or fatigue is
junk science at best and certainly a kind of puffery that most professionals would avoid. Ditto for poor sleep and infections.
Breathing problems are invariably associated with a lack of oxygen, which is conceptually simplistic and sometimes (e.g. yawning) plain wrong; and so on. When it comes to treatment suggestions, the book includes remedies that have no basis in clinical
science or routine medical practice. For example, does clutter in
the bedroom promote insomnia? Does a jet lag visor really help
anyone other than the manufacturer? Does drinking lots of water
correct snoring, a problem that anti-histamines are said to promote by virtue of their drying effect?
Of course a self-help book for non-professionals does not need
to observe the restraints of scientific evidence, and Sleep
Disorders .. certainly does not. My problem is that the distinction between sleep medicine and non-scientific information is
missing in this book. The holistic and unorthodox approach to
sleep disorders presented here is quite different from the majority vision of sleep specialists that attempt to base clinical practice
on scientific evidence and wish to place their specialty in mainstream medicine. Thus this reader is not likely to use this book in
his clinical practice. For the uninitiated reader, however, who
seeks an introduction to the world of sleep, Sleep Disorders ..
will provide lots of information along with comfort and reassurance. And no one can disagree with the basic message that poor
sleep does not have to be and that help is available.
Disclosure Statement
Dr. Schmidt-Nowara has indicated no financial conflict of interest.
Submitted for publication October 2004
Accepted for publication October 2004
Address correspondence to: Wolfgang Schmidt-Nowara, M.D., Sleep Medicine
Associates of Texas, 8140 Walnut Hill Lane S100, Dallas, TX, 75231; Tel: (214)
750-7776; Fax: (214) 750-4621; E-mail: wsn@sleepmed.com
Journal of Clinical Sleep Medicine, Vol. 1, No. 1, 2005
98

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book review

Sleep Disorders for Dummies

J Clin Sleep Med 2005;1(1):98

hose of us who have used the self-help guide, PC for

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