May/1999
| THE PROMISE OF SLEEP A Pioneer in Sleep Medicine Explores the Vital Connection between Health, Happiness, and a Good Night's Sleep William C. Dement, MD, PhD, and Christopher Vaughan New York: Delacorte Press, 1999 524 pages, hardcover, $24.95 ISBN 0-385-32008-6 Reviewed by Lynne Lamberg |
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--In 1965, when high school student Randy Gardner decided to
stay up for 11 days to earn a place in the Guinness Book of World
Records, Stanford sleep specialist Bill Dement volunteered to
provide medical supervision. "A serious problem I did not foresee,"
Dement relates, "was that I soon became very sleep deprived
myself. On day 5, I turned the wrong way onto a one-way street
and almost crashed head-on into a police car." Dement also forgot
to pay the fine. (p. 243)
--When a young Morley Safer and his 60 Minutes crew came to Stanford to film a story on sleep, Dement recruited a patient with narcolepsy. Shooting pool, the patient said, often triggered his attacks of muscle weakness, or cataplexy. Dement located a billiards table. Safer and the patient played game after game. In those pre-videocamera days, the crew exposed $10,000 worth of film, nearly all they had, but to no avail. "Don't worry," said Safer. "We'll edit out everything except my one or two good shots and we'll show that." The patient chortled, and collapsed. (p. 199) --In 1991, concerned about the potential of sleep apnea to cause drowsy driving, Dement and his colleagues persuaded a nationwide trucking company to let them interview drivers. They queried 602 drivers, all men, and completed 200 overnight sleep recordings. An alarming 70 percent of the drivers proved to have sleep apnea, 13 percent severely, about three times the rate in the general population. "When we told the company about our findings," Dement reports, "it was as if an iron curtain had fallen in front of us. Everyone in the company suddenly became unavailable." (p. 227) --In 1971, Dement taught his first course on sleep and dreams to Stanford undergraduates. He had just read a book in which two British historians claimed that the average Englishman remembered only one past event, the Battle of Hastings in 1066. Mentioning this in his first lecture, he promised to drill his class in sleep facts they would never forget. In the last question on the final exam, he asked students to report the single most important fact they learned in his course. Several hundred students gave the same answer: 1066. (p. 444) As these stories suggest, the benefits of good sleep--and costs of poor sleep--have been on Bill Dement's mind for decades. He has long been the nation's leading advocate for giving sleep more respect. "Millions of us are living a less than optimal life and performing at a less than optimal level," he writes in The Promise of Sleep, "impaired by an amount of sleep debt that we're not even aware we carry. Ignorance," he asserts, "is the worst sleep disorder of them all." This book strives to change that. It promises that you will gain a richer, fuller, healthier, more productive, and more satisfying life by managing your sleep better. Dement and science writer Christopher Vaughan provide tools to help you achieve this goal. They first tell how we came to know what we now know about the still-mysterious one-third of our lives. Dement is both historian and history-maker. Instrumental in the birth of modern sleep research a half century ago, he has contributed mightily to the field since then. His often humorous stories put faces on the names that top scientific papers, and provide a behind-the-scenes glimpse of events surrounding key advances in sleep medicine, including the inevitable sidesteps and missteps. As a medical student at the University of Chicago, Dement worked in the laboratory of physiologist Nathan Kleitman, arguably the world's most eminent sleep scientist. Kleitman and graduate student Eugene Aserinsky already had observed rapid eye movements, or REMs, Dement says, but did not know their significance. The first to conduct continuous all-night recordings, Dement showed in 1953 that REMs occurred regularly and marked periods of active dreaming. (p. 37) He later opened the nation's first sleep disorders center at Stanford University, which he still directs today. A founder of the American Sleep Disorders Association, the sleep field's leading professional organization, Dement also chaired the National Commission on Sleep Disorders Research. Wake Up America!, the Commission's 1993 report to Congress, prompted the creation of the National Center on Sleep Disorders Research at the National Institutes of Health. The Commission reported that contemporary Americans sleep much less than their grandparents, noting tartly that there is no evidence that we need less sleep or that our ancestors slept too long. The average adult, Dement says, needs about eight hours of sleep each night. A recent poll for the National Sleep Foundation shows American adults typically sleep fewer than seven hours. Lack of sleep, Dement argues, has contributed to major industrial catastrophes such as the grounding of the Exxon Valdez and the crash of the space shuttle Challenger. It figures in 24,000 roadway fatalities in the United States annually, makes teenagers doze in the classroom, and their parents fall asleep at the switch. We build up a sleep debt each day, with each successive hour of wakefulness. We never pay off this debt in full, he says, carrying some of it over from one day to the next. Take two weeks to sleep until you've slept out, Dement suggests, to see how much sleep you need on a regular basis. Individual sleep needs vary. Filling your personal sleep quota will let you fall asleep quickly and sleep soundly for about the same length of time every night, while experiencing full alertness every day. Dement provides a three-week program, with new activities each day to heighten your awareness of sleep strategies that work best for you. (p. 433) The book's lack of an index imposes an unnecessary hardship on readers; it's the reason page numbers are noted above. An index would be a welcome addition to the next printing. This book is going to be around for a long time. (Editor's note: The second printing of this book, published in July, 1999, contains an index.) Although Dement's campaign to wake up America is a Herculean task, he remains optimistic: "I bet most people would give up many late-night diversions," he avows, "if they could feel truly awake throughout the day--fresh and full of hope, senses wide open, the mind receptive to people and ideas."
This rich, warm, and entertaining book may prove the catalyst to
make that happen.
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