In Essentials of Sleep Medicine, M. Safwan Badr and colleagues aim to offer readers “relevant facts helping the busy practicing physicians to provide better care for sleep disorders”. The subtitle of the book is “an approach for clinical pulmonology”, meaning that only information useful for comprehensive care in sleep medicine is included.
The authors provide a very didactic and informative review on normal sleep and the pharmacology of sleep, both of which are addressed in a comprehensive way for respiratory physicians. All chapters conclude with recent references and a helpful summary of key points. The main topics of sleep apnoea, including epidemiology, clinical features and consequences, and treatment (continuous positive airway pressure (CPAP), surgery and oral appliances) are covered. The chapters, written by true key opinion leaders, report the basic knowledge for proper sleep apnoea management. The content is appropriate mainly for respiratory physicians in training and for those whose main topic is not sleep apnoea. There is a very practical section entitled “Approach to hypersomnia” that allows the pulmonologist to learn about the basic mechanisms of sleepiness and the differential diagnosis. The section is concluded by a clear clinical algorithm.
A minor criticism of the book is that the number of graphs and illustrations is limited, except in the surgery section. Overlap syndrome and obesity hypoventilation syndrome are important issues and growing concerns for daily practice and clinical research but are under reported. Another small drawback is that the majority of the authors are from the USA and Australia. Logically, some of the proposed clinical pathways correspond more to US than European practice. This is true for split night studies or different indications for auto-CPAP devices. Finally, in the respiratory field, there are two chapters of major interest for physicians working in intensive care units: the “Sleep and critical illness” and “Perioperative care” chapters. Sleep is an underestimated key issue implicated in prognosis, length of stay and noninvasive ventilation failures. As stated by the authors, improving sleep in this situation is key to patient-centred care and good medicine.
For the chapters outside the scope of respiratory medicine (insomnia, movement disorders, etc.), the authors continuously take care to focus on the potential importance of these situations or diseases to specialist pulmonary physicians. For example, the prevalence of insomnia, and indications and safety of medications commonly used in insomnia, are presented with a special spotlight on patients with concomitant pulmonary disorders. Narcolepsy, parasomnias and movement disorders are briefl y, but nicely and clearly, presented for respiratory physicians and internal trainees. The authors give a clear, well written and short but complete summary of each of these topics.
This is now a time of development of examinations in sleep medicine and accreditation of sleep centres at the European level. This involves the development of specifi c training programmes and examinations (through the HERMES project) by the European Respiratory Society. The European Sleep Research Society (ESRS) will soon publish an ESRS Catalogue of Knowledge and Skills. In this context, there is a need for teaching material. Essentials of Sleep Medicine: An Approach for Clinical Pulmonology provides a pragmatic approach for the diagnosis and management of the sleep disorders. The book is mainly devoted to respiratory sleep medicine but also covers, in a very practical approach, the areas of sleep diseases in neurology, psychiatry, psychology and chronobiology.
- ©ERS 2013