Collection Development "Sleep Disorders": A Good Night's Sleep

Humans spend about one third of their lives sleeping. Indeed, we can live longer without food than we can without sleep. (Adults require an average of six to nine hours a day.) Yet despite decades of research, scientists still aren't entirely sure what goes on during sleep, how it evolved, or why we need it. They do know that sleep deprivation and untreated sleep disorders cause car crashes, industrial accidents, poor work performance, and a host of other problems.

Unfortunately, the convenience of living in a 24/7 society where work, shopping, and entertainment can be accessed at any time has exacerbated sleep problems in this country. Is it any wonder that excessive daytime sleepiness and insomnia affect some 60 million Americans?

The inability to fall or stay asleep is not so much a disease as a symptom of some other psychological (depression, anxiety, stress), medical (chronic pain, respiratory disorders, certain medications), or lifestyle issues (boredom, or lack of exercise). Garden-variety insomnia can be solved with attention to basic sleep hygiene (decrease consumption of caffeine and alcohol, create a relaxing, soothing prebedtime ritual, etc.), but chronic sleeplessness (at least three nights a week for one month or longer) may require referral to a sleep center.

Indeed, the only way to diagnose many sleep problems properly is via an overnight sleep test in a sleep lab. Also useful is the Multiple Sleep Latency Test (MSLT), which tests the severity of daytime sleepiness.

But what if your insominia is caused by the snoring of your bedmate? Sleep apnea (cessation of breathing during sleep) is a real medical problem affecting 20 million Americans, including ten percent of middle-aged men and four percent of women! Frequently undiagnosed, it is both potentially fatal—with increased risks of hypertension and coronary artery disease—and imminently treatable. Symptoms include loud snoring, episodes of apnea—impaired breathing—and daytime sleepiness. Weight reduction and the use of a continuous positive air pressure device (CPAP) are currently the only treatment options. However, certain individuals may be helped by dental appliances or surgery.

Other sleep disorders include narcolepsy, a rare nervous system disorder characterized by excessive sleepiness; cataplexy, muscle weakness that can lead to collapsing or falling; hallucinations; sleep paralysis; and automatic behavior. Then there is restless legs syndrome (RLS), in which the legs feel itchy and restless and the only remedy is to get up and walk around, as well as sleepwalking, night terrors, and nightmares.

Adult sleep problems tend to be accepted as a fact of life until they interfere with daily routine and require medical attention. This bibliography will focus on resources for adults, although a few titles do mention children's issues. While babies and toddlers can have sleep problems, these tend to be approached within the realm of parenting guides rather than medical texts.

A few authors stand out in this field: snap up anything by Stanford's William C. Dement, Peter Hauri, or Ralph A. Pascualy—all are sleep doctors who are particularly skilled at explaining their work for lay readers.

One caveat: because there are few consumer titles for the rarer disorders, collection development librarians get excited when they find a series that claims to address this gap. Unfortunately, Icon Health Publications' The Official Patient's Sourcebook on Narcolepsy and The Official Patient's Sourcebook on Restless Leg Syndrome do not live up to the publisher's hype. Formulaic with a high percentage of overlap, the volumes provide very little information on the disorders themselves; the rest of the text consists of links to web sites and databases, with minimal instructions for searching them.

The general rule of thumb for weeding medical titles is to discard most within five years of publication. Unfortunately, the paucity of titles on the rarer disorders necessitates retention of older works. Remember that any drug information may be dated.

Starred [*] titles are recommended for all public library collections.

* DEMENT, WILLIAM C., M.D. CHRISTOPHER VAUGHAN. The Promise of Sleep: A Pioneer in Sleep Medicine Explores the Vital Connection Between Health, Happiness, and a Good Night's Sleep. Delacorte. 1999. 524p. index. ISBN 0-385-32008-6. $24.95; pap. Dell. 2000. ISBN 0-440-50901-7. $16.
A leader in the field of sleep medicine, Dement is also a highly entertaining writer who excels at translating his clinical findings into readable texts. Explaining the concepts of sleep debt and circadian rhythms, he makes a strong case for the dangers of sleep deprivation (heart disease, traffic accidents, mental health problems). After discussions of insomnia, sleep apnea, dreams, and narcolepsy, Dement concludes with tips for healthy sleep. The useful appendix includes a list of sleep disorder centers. (LJ 4/15/99)

* HAURI, PETER SHIRLEY LINDE. No More Sleepless Nights. rev. ed. Wiley. 1996. 284p. index. ISBN 0-471-14904-7. pap. $16.95.
Coauthored by a former director of the Mayo Clinic's Insomnia Program, this practical guide to reversing insomnia features step-by-step instructions to analyzing your own sleep habits (including keeping day and sleep logs) and taking measures to improve them. Since the recommended therapies are behavioral rather than pharmaceutical, there is not much here to go out-of-date. A keeper! (LJ 9/1/90)

* HIRSHKOWITZ, MAX PATRICIA B. SMITH. Sleep Disorders for Dummies®. Wiley. 2004. 355p. index. ISBN 0-7645-3901-9. pap. $19.99.
A sleep specialist and a medical journalist explain what normal sleep is and then outline the symptoms, diagnosis, and treatment of insomnia, sleep apnea, sleep walking, night terrors, and pediatric sleep disorders. An excellent appendix lists sleep organizations, products, and web sites. The lack of useful illustrations (other than the series' trademark cartoons) is the only flaw. Libraries on limited budgets won't go wrong with this thorough guide.

MARTIN, PAUL. Counting Sheep: The Science and Pleasures of Sleep and Dreams. Thomas Dunne Bks: St. Martin's. 2004. 416p. index. ISBN 0-312-32743-9. $24.95.
In an engaging manner, scientist Martin explores what we know about sleep and dreams from scientific, historical, and literary perspectives. He includes fascinating trivia on the sleep habits of other cultures as well as other animal species. While less clinical than a sleep medicine text, this is the densest and most "intellectual" of the titles here; appropriate for college and larger public libraries.

All of the aforementioned titles include sections on behavioral therapies and self-care practices such as relaxation, dietary changes, etc. Sleep Disorders for Dummies™ and No More Sleepless Nights include information on herbs and supplements for treating insomnia.

ROSS, HERB KERI BRENNER WITH BURTON GOLDBERG. Sleep Disorders: An Alternative Medicine Definitive Guide. AlternativeMedicine.com Bks. 2000. 275p. illus. index. ISBN 1-887299-20-3. pap. $14.95.
Beginning each chapter with a patient's success story, the authors—a chiropractor and an acupuncturist—discuss the role of the hormone melatonin in sleep and argue that sleep disorders are symptoms of seven root problems, including poor diet or food allergies, disrupted circadian rhythms, and stress and other psychological or emotional issues. They then offer natural remedies (Chinese medicine, herbs, relaxation techniques) for each problem. Despite the lack of scientific rigor (cited sources are to popular books or journals of dubious quality), none of the remedies appears dangerous, and readers who prefer alternative therapies will find this a useful resource.

LAVIE, PERETZ. Restless Nights: Understanding Snoring and Sleep Apnea. Yale Univ. 2003. 274p. tr. from Hebrew by Anthony Berris. index. ISBN 0-300-08544-3. $27.50.
Noted Israeli sleep researcher Lavie (The Enchanted World of Sleep) starts with a history of sleep apnea, including its appearance in mythology and literature (Charles Dickens's Mr. Pickwick is a classic example), followed by a detailed account of the disorder's negative health effects, the risk factors, and current treatments. A bit academic in tone, this is appropriate for readers wanting more clinical and historic background. (LJ 10/15/03)

LIPMAN, DEREK S., M.D. Snoring from A to ZZZZ: Proven Cures for the Night's Worst Nuisance. 3d rev. ed. Spencer. 2002. 244p. illus. index. ISBN 0-9650708-2-4. pap. $14.95.
Writing in a humorous, breezy style and incorporating cartoons and old Dear Abby letters, otolaryngologist Lipman discusses why men snore more than women, outlines surgical options, and notes examples of odd mechanical antisnoring devices. The illustrations of the anatomical problems that can cause snoring—enlarged tonsils, elongated uvula, excess soft palate tissue, deviated septum, etc.—are among the best this reviewer has seen.

* PASCUALY, RALPH A., M.D. SALLY WARREN SOEST. Snoring and Sleep Apnea: Sleep Well, Feel Better. 3d ed. Demos. 2000. 272p. illus. index. ISBN 1-888799-29-3. pap. $24.95.
Pascualy is the physician who treated Soest's husband for sleep apnea. Their highly readable guide discusses symptoms, diagnosis, treatment options (with a focus on CPAP devices), and health problems that can result if the condition isn't treated. Also covered are sleep apnea in seniors and children and the relationship between apnea and sudden infant death syndrome (SIDS). Case studies, line drawings, and photographs highlight salient points. Excellent references, a glossary, and information resources add value.

VOLPI, DAVID O., M.D. JOSH L. WERBER, M.D. Wake Up! You're Snoring: A Guide to Diagnosis and Treatment. iUniverse. 2003. 155p. illus. index. ISBN 0-595-27031-X. pap. $14.95.
The authors, who are ear/nose/throat specialists, discuss not only the health problems caused by snoring but the difficulties it can effect in relationships. They catalog the usual treatments, but their illustrations of the places snoring occurs in the nose, throat, and mouth are good. Be aware that the print quality is mediocre, and the last half of the book is primarily a list of U.S. sleep centers. Still, this might be a good choice for patrons with reading difficulties as the text is written in a simpler style than other guides.

* WALSLEBEN, JOYCE RITA BARON-FAUST. A Woman's Guide to Sleep: Guaranteed Solutions for a Good Night's Rest. Crown. 2000. 303p. index. ISBN 0-8129-3259-5. $24; pap. Three Rivers. 2001. ISBN 0-8129-3260-9. $19.
Women experience higher rates of insomnia, sleep deprivation, and daytime sleepiness than men. The inequity is owing partly to the hormonal fluctuations of menstruation, pregnancy, and menopause and partly to the societal expectations of the "second shift." Walsleben (director, Sleep Disorders Center, NYU School of Medicine) and medical writer Baron-Faust offer a reader-friendly guide that includes more home remedies and practical do-it-yourself suggestions for managing sleep problems than other similar texts. Their title also goes into more detail on women's hormonal cycles and the differences between male and female sleep patterns. An interesting chapter examining the relationship between sleep and sex answers the question: Why is he snoring immediately afterward while she's wide awake? (LJ 9/1/00)

* CARRANZA, CHRISTOPHER RAOUL JANE ROGERS DILL. Banishing Night Terrors and Nightmares: A Breakthrough Program To Heal the Traumas That Shatter Peaceful Sleep. Kensington. 2004. 228p. ISBN 0-7582-0542-2. pap. $15.
Written by a longtime victim of night terrors and the therapist who helped him recover, this well-written book explains the difference between garden-variety nightmares and more severe night terrors caused by trauma. The most effective psychotherapeutic approaches are discussed, along with the pros and cons of medication use.

* UTLEY, MARGUERITE JONES. Narcolepsy: A Funny Disorder That's No Laughing Matter. M.J. Utley, PO Box 383156, Duncanville, TX 75138-3156; 972-298-1740; mjutle@aol.com; also for sale on Amazon.com and barnesandnoble.com. 1995. 166p. ISBN 0-9643328-1-7. $18; pap. ISBN 0-9643328-0-9. $12.
Recommended by U.S., British, and Australian narcolepsy organizations, this self-published book is one of the few titles available on this disorder. The author, who has suffered from narcolepsy for 40 years, offers straightforward information about symptoms, diagnosis, treatment, and coping with the social, emotional, and legal issues. Although the book's section on medications is somewhat dated, Utley's web site (narcolepsybook.com) features updates and links to other organizations and relevant sites. The author hopes to publish a second edition in a year or so.

* WILSON, VIRGINIA N. Sleep Thief: Restless Legs Syndrome. Galaxy Bks. 1996. 316p. ed. by Arthur S. Walters, M.D. illus. ISBN 0-9652682-1-7. $22.95; pap. 1997. ISBN 0-9652682-0-9. $16.95.
Diagnosed with RLS in 1986, Wilson incorporates personal advice stemming from her own experience with medical chapters contributed by such sleep experts as Ralph Pascualy (see above). Despite the dated drug information, this is the best consumer title available.

* MedlinePlus
medlineplus.gov
The National Library of Medicine provides multiple pathways to find needed information—click on the Health Topics tab and then go through an alphabetical listing of topics, or enter your topic in the Search box that appears in the upper-left-hand corner of any page. The Sleep Disorders page includes links to the American Academy of Sleep Medicine, American Sleep Apnea Association, National Center on Sleep Disorders Research, and National Sleep Foundation. There are additional topic pages on RLS, snoring, and sleep apnea.

The Sleep Well
www.stanford.edu/~dement
William Dement's web site is in the process of being updated and integrated with a new page at www.sleepquest.com, which features monthly editorials by Dement, sleep research news, and an audio clip of obstructive sleep apnea.