January-February 2005
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Reviewed by Lynne Lamberg |
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"It takes me too long to fall asleep at night." "I keep waking up throughout the night; it seems like every hour." "I haven't slept in months." "I have to drag myself out of bed every morning." Though diverse, these reports voice a common theme: "I can't sleep, and I'm suffering." The actual minutes or hours a person sleeps—or tosses and turns without sleep—don't define insomnia, says David Neubauer, a psychiatrist and associate director of the Johns Hopkins sleep disorders center in Baltimore. Two people may take a comparable amount of time to fall asleep or wake up equally often in the night, and get about the same amount of sleep overall. Yet one may be satisfied, and the other distressed. In the sleep laboratory, objective tests often show that people with insomnia sleep longer and more soundly than they believe they do. "It is the experience of insufficient sleep that creates the insomniac," Neubauer writes. He explores that experience in this book. Neubauer assesses motivations that govern how people organize their daily life, vulnerabilities that may predispose some to insomnia (such as an inherent need for more than the average amount of sleep), life events that impinge on sleep, and diseases in which insomnia is a symptom. (For this multifaceted approach to understanding a patient's predicament, Neubauer credits Paul McHugh, professor emeritus and former chair of psychiatry at Hopkins, and colleague Phillip Slavney, who describe it in their book, The Perspectives of Psychiatry.) About one in three American adults reports trouble sleeping. About one in six sleeps poorly most nights or every night. Most insomniacs also say they feel fatigued or sleepy in the daytime. Yet some feel edgy and wound up in waking hours. Drawing from his clinical practice, Neubauer provides dozens of vignettes that show the impact of insomnia on daily life. Only a tiny fraction of people with insomnia seek treatment, Neubauer notes. Most report serious daytime consequences of poor sleep, such as difficulty at work, or falling asleep while driving or in social settings. But many insomniacs believe nothing can be done to improve their sleep. Some think their complaints too trivial to merit a doctor's attention; others don't want to take sleeping pills. Some use non-prescription medications or herbal or other so-called alternative remedies. While aimed at clinicians, this book's conversational style and anecdotal examples will appeal to lay readers, too. Troubled sleepers will find plenty of good reasons to make an appointment with the doctor. |
© 2005 WebSciences and Lynne Lamberg |
UNDERSTANDING SLEEPLESSNESS: