This book on Sleep and Psychosomatic medicine is written by a group of experienced authors who are mainly from the USA. There are a few other contributors particularly from South America and the Far East but none from Europe. The title of the book might suggest that this was mainly concerned with the psychological aspects of sleep medicine but the authors take a wider view. They cover the effects of sleep disorders and sleep deprivation on a broad range of general medical conditions and in most chapters the effects that these disorders have on sleep itself are also examined. The interaction of organic disease with psychological problems is a theme in many of the chapters.
Important topics that are covered include, for instance, the cardiovascular risk factors and metabolic and endocrine consequences of obstructive sleep apnoeas. Current issues such as the relationship between stress and sleep and the role of sleep deprivation as an antidepressant and the sleep-related aspects of fibromyalgia are well covered. There are, however, some surprising omissions and areas of under-emphasis. There is very little information on the effects of sleep on respiration in nocturnal hypercapnia. Respiratory failure in neuromuscular and skeletal disorders is not touched on and there is only a short section on asthma and sleep. The important topics of nocturnal cardiac ischaemia and angina and the relationship of cardiac dysrhythmias to non-REM and REM sleep are hardly mentioned.
The content of the chapters varies rather more than would be anticipated. Some are more suitable for the generalist who wishes to have an overview of the subject but others are more incisive in the way they deal with the detail of the topics and aspects which are of current interest. These include the chapters dealing with headaches, dreams and drugs in sleep. Most of the chapters suffer from not having many recent references. This suggests that this multi-author book has taken some time to be completed and it would have been preferable for the chapters to have been updated prior to publication.
The chapters are clearly laid out and the information is easily accessible. The style of most of the chapters is clear and the tables, figures and scans are all well chosen. There are sufficient references in the text to direct the general reader to the original sources.
This book should be of interest to all those who deal with patients with sleep disorders and to internal physicians who wish to have a wider view of the medical conditions that they treat. There is much in this book which is absent from the usual textbooks of internal medicine and which most physicians would find of benefit both in their clinical practice and in directing their research. The book should be of particular value to psychologists, psychiatrists and those dealing with the effects of sleep on daytime performance as well as internal physicians. I would recommend it for the breadth of topics that it covers and its holistic approach. It is a welcome addition to the expanding range of books now available which cover the rapidly developing field of sleep medicine.
