SNORING from A to ZZZZ

SNORING from A to ZZZZ
Derek S. Lipman, MD
Portland, Oregon: Spencer Press, 1998
237 pages, paperback, $24.95
ISBN 0-9650708-1-6

Reviewed by Lynne Lamberg

"I am desperately trying to find a cure for my husband's snoring. After being married for 27 years, I am convinced that there is no cure other than killing him," an anxious wife wrote to a popular newspaper columnist. Lipman also quotes Anthony Burgess' famous epigram: "Laugh and the world laughs with you; snore and you sleep alone."

After describing causes of snoring and the nature of sleep apnea, Lipman, an ear, nose, and throat specialist, practicing in Portland, Oregon, provides self-tests for readers. Among the questions: "Does your snoring disturb others in the next room? Have you been told that you stop breathing for long periods between snores? Does your bedroom partner leave the room to sleep elsewhere because of your snoring?" After readers calculate their "snore score," Lipman explains what different answers mean, when to see a physician, and how to find the appropriate specialist.

He tells what to expect in an overnight sleep study in a sleep laboratory, and also describes in-home monitoring. A home study, he notes, may serve both as a screening test, and as a follow-up to assess the effectiveness of medical or surgical treatment.

The book includes a whimsical survey, including sketches, of the more than 300 patented shoulder-braces, chin straps, and other, often torture-like devices, devised over the years to silence snoring. A solid review of contemporary treatment follows. Lipman describes the various approaches thoroughly, and supplements his text with helpful black and white illustrations. Those depicting nasal continuous positive airway pressure (CPAP), for example, show the mechanics of both an open and an obstructed upper airway during sleep, and how CPAP opens the obstruction. Additional illustrations show the CPAP mask in place, and how the device is used in the home.

In his last chapter, Lipman addresses future research, emphasizing the need for both the general public and the medical community to know more about sleep and sleep disorders. Appendices include a glossary and a guide to medical insurance codes for sleep apnea treatment, useful for patients who want to better understand their doctor bills. This is an authoritative and broad-ranging book.