Review of Sleep Medicine

By Teri J. Bowman, MD. Burlington, MA: Butterworth Heinemann, 2002; 450 pp; $48.99

Review of Sleep Medicine has the distinction of being the first, and thus far only, book designed specifically as a preparation aid for the sleep medicine board examinations. The book is divided into a didactic section trod a mock examination section, and these are further divided into a wide range of topics with articles authored by a variety of sleep specialists from the fields of neurology, pulmonary and critical care medicine, pharmacy, behavior health, pediatrics, and electrodiagnostics.

The first chapter provides an outline of particularly important (from Dr. Bowman's point of view) topics that are apt to be included in the hoard examinations in sleep medicine. As a fellow in sleep medicine with a background in internal medicine, I frequently found myself depending on this outline to guide my initial study. The next chapters provide a review of sleep neuroscience, sleep physiology, insomnia, excessive sleepiness, medication effects on sleep, and polysomnography. All of these chapters are excellent reviews that are appropriate both as am introduction to the field for a new trainee in sleep medicine as well as a concise, board-targeted review later in the training year. Particularly excellent are the chapters on insomnia and polysomnographic technique. Notably absent is a review of sleep breathing disorders. This likely reflects a prevailing sentiment that any trainee in clinical sleep medicine becomes suitably proficient in this area, which consequently tends to be relatively underemphasized on the board examinations. Although it may be "low yield" in terms of board preparation, more coverage of pulmonary physiology and the sleep-related effects of lung disease, neuromuscular disease, and obesity would have been welcomed.

The chapter entitled "Highlights of Sleep Neuroscience'" tackles the subject that inspires the most fear and loathing in the average trainee from fields outside of doe neurosciences (and perhaps a few from within the neurosciences as well). This chapter would likely benefit from more diagrams to help foster understanding of complex physiologic relationships and also from a few tables designed to facilitate the rote memorization of material expected to appear on the board examinations. However, even without these suggested additions, using this chapter as a learning tool is distinctly less painful than using multiple disparate textbooks for this purpose.

Virtually dl of the material is covered again by way of multiple choice questions and detailed answers in the muck examination. The questions are organized into the topics of sleep neuroscience, normal sleep patterns, sleep disorders, polysomnographic pearls, seizure and artifacts, pediatric sleep medicine, pharmacologic mechanisms, and clinical case studies. Questions in the seizure and artifact section, and a few in the ease studies, are accompanied by polysomnogram segments. The questions are pertinent, thoughtful, suitably challenging, and are all accompanied by comprehensive answers that I found particularly well-written and satisfying.

Finally, the book concludes with appendices that contain basic, highly accessible information on sleep scoring and EEG montages. These have proven useful on numerous occasions during my year of fellowship training.

Overall, although not designed to be comprehensive, Review of Sleep Medicine is a valuable book for any trainee in sleep medicine and especially for those preparing for the board examinations. Reading this book will not cure insomnia, but it will cure sleep (knowledge) state misperception when preparing for the board examination ordeal.