The Enchanted World of Sleep

Interest and concern about sleep continue to capture the public’s imagination, as evidenced by magazine cover stories and record sales of herbal and over-the-counter sleep preparations. Sleep complaints are a frequent symptom reported to psychiatrists, and untreated insomnia is associated with greater risk of subsequent depression and substance abuse (1). Despite their prevalence, very little instruction is given to medical students and residents about the issues that disturb a good night’s slumber. This English translation of the 1993 Hebrew text provides a solid introduction to sleep and its disorders. It is a first-person narrative account of modern sleep research and sleep medicine, as told by a pioneer in the field. Throughout this volume, Dr. Lavie’s sincere passion as both a clinician and researcher is readily apparent.

From the investigation of sleep stages and the endogenous circadian pacemaker to the discovery of the sleep- and wake-promoting centers of the hypothalamus, Dr. Lavie covers most of the major findings regarding the regulation and possible functions of sleep. The scientific drama behind these discoveries is nicely captured in the narratives of the personal lives and intellectual quests of modern sleep scientists like Michael Jouvet, William Dement, and Allan Rechtschaffen. Dreams, perhaps the most fascinating aspect of sleep, are examined from both philosophical and scientific points of view.

In addition to weaving together the history of sleep and dreams, Dr. Lavie takes the reader through his own life journey as a sleep researcher and clinician: from his doctorate work, studying human circadian rhythms in isolation, under the tutelage of Bernie Webb at the University of Florida; to his present role as Dean of the School of Medicine and Director of the Sleep Laboratory at the Technion-Israel Institute of Technology in Haifa. Dr. Lavie addresses some very interesting public policy issues, such as the effect of nighttime SCUD missile attacks on the sleep of the Israeli populace during the Gulf War.

The second half of the book is devoted to the clinical diagnosis and treatment of sleep disorders. There are chapters on common complaints like insomnia, circadian rhythm abnormalities, excessive sleepiness, and even “children who refuse to sleep.” Dr. Lavie has a very down-to-earth approach to these issues, and he is an advocate of avoiding sleeping pills in favor of promoting proper “sleep hygiene” or behavioral rules. There is also advice for dealing with such problems as jet lag and shift work.

This book will appeal to anyone who is interested in the scientific and clinical aspects of sleep, including the practitioner as well as the general public. The subject matter is presented with humor, and frequent references to classic literature and ancient mythology make for lively reading.