It was in 1997 that my insomnia started, combined with an annoying twitching in my feet whenever I did manage to get to sleep. The symptoms were for the most part dismissed by doctors. It wasn’t until I was diagnosed with sleep apnea in 1999, that I realized I had a potentially life-threatening problem and began to research sleep disorders. That’s when I found this book.

Dr. William Dement is a legend when it comes to sleep research. He founded the world’s first sleep disorder center in 1970. He has personally witnessed the gamut of sleep problems, from the most bizarre to the increasingly common sleep apnea. And he knows that a simple lifestyle habit such as intentionally skimping on sleep can have dangerous consequences. All of these subjects and more are included in this book.
According to Dr. Dement, sleep disorders are commonly misdiagnosed or ignored by the medical community due to simple lack of awareness. A man might be treated for heart disease not knowing that the cause of his recent heart attack was that he stopped breathing repeatedly during the night while asleep. A child might be diagnosed with a learning disorder when the real cause of her inattentiveness in school is unrefreshing sleep the night before.
And ignorance about the importance of sleep affects people who are completely healthy as well. Dr. Dement states that half the population does not properly manage its sleep, to the point that they risk their own safety. Many auto accidents are caused by a sleepy driver dozing off.
The book begins with a section explaining the basics of sleep: why we need it, what happens when we sleep, circadian rhythms and the concept of sleep debt. It explains how our need and ability to sleep changes as we age. And there is a quick overview on the history of sleep research.
The term sleep debt refers to lost sleep over a period of time. If, say, you only sleep five hours one night when you need eight, your sleep debt is three hours. The reason it is referred to as debt is that unless you “pay” it back by getting an equal amount of extra sleep the following night, your body will try to make up for the loss by causing you to be drowsy during the day in an effort to encourage you to get the sleep you need. A person with sleep debt may experience loss of energy, mood changes and problems with cognition.
Chapter Four covers circadian rhythms, our biological clocks that determine when we are tired or alert. It explains jet lag and what happens when we disrupt our normal sleep times. Other than travel, other reasons our sleep schedules get out of synch include the fact that our bodies actually run on a 25 hour clock, our brain’s perception of night and day is disrupted with electric lighting, and trying to follow a schedule inconsistent with your own circadian clock (as in working a day shift when you are a night owl).
Part Two of “The Promise of Sleep” delves into sleep disorders, from the myriad causes of insomnia and its treatments to sleep apnea, narcolepsy and sleepwalking. I highly recommend the insomnia chapter, as many with chronic illness have one or more of the problems described and may benefit from the treatment suggestions listed. Even a person with none of these problems might find the anecdotes on the more unusual cases fascinating.
Chapter Nine deals entirely with chronic sleep deprivation and its effects. Dr. Dement chronicles a study he performed that indicates few people who are sleep deprived are able to accurately assess the severity of their own sleepiness, and many will doze off briefly without even realizing it. This has profound implications for professions such as airline pilots, doctors and drivers. Even mild cases of sleep deprivation affect one’s ability to concentrate, make decisions, and be motivated.
Part Three outlines the many benefits of good sleep, including mood, longevity, creativity and productivity. The chapter on the immune system and sleep is particularly valuable as it explains how proper sleep helps the body heal. Also of interest is the segment that explains why sleep is better for you than caffeine, nicotine or other artificial ways of boosting your energy.
My favorite chapter is 13, “The Real Life of Dreams”. It explores what happens physiologically and neurologically during a dream, how much bearing our dreams have on our waking life, whether dream interpretation has value, and why we might remember one dream and not another. There are also segments in chapter 14, “A Little Night Muse: Creativity, Productivity, and Learning”, on dreams as inspiration and for problem solving as well as the fascinating topic of lucid dreaming (being aware that you are dreaming as the dream is happening).
Part Four is the advice section. It covers how to determine how much sleep you really need (it does vary from person to person), how to get to the bottom of whether or not you have a sleep disorder, dealing with sleep debt and jet lag, sleep tips broken up into age groups, and developing good sleep hygiene. The final chapter has instructions for a “sleep camp” – three weeks of planned activities to enhance and encourage good sleep.
There are also three appendixes containing useful information. The first is a state by state listing of sleep centers. The second is an alphabetical listing and description of 78 sleep disorders. And last is a list of sleep web sites.
Although the edition I have at home is nine years old, none of the information in it seems particularly outdated. In fact, many of the concepts introduced in it are only now starting to become common knowledge. I have seen several articles on sleep in various publications where Dr. Dement is quoted.
So whether you have a sleep disorder, want general tips on how to sleep better or are just curious about the science of sleep, this is a book you’ll want to keep around. I referred to it when my insomnia stopped responding to my prescribed medication, and again when I was diagnosed with periodic limb movement disorder. I also just like to peruse the unusual case studies from time to time.
Just don’t stay up too late reading it.

Title: The Promise of Sleep: A pioneer in sleep medicine explorers the vital connection between health, happiness, and a good night’s sleep
Authors: William C. Dement, M.D., Ph.D. and Christopher Vaughan
Publisher: Delacorte Press
IBSN: 0-385-32008-6
Submitted by: Karen Brauer, Butyoudontlooksick.com, © 2008