Edited by DamienLeger and SRPandi-Perumal . Published by Informa Healthcare , UK , 2007 . Hardback, 245 pages with index. RRP $99 . ISBN 1 84184 535 3. .

Reviewed by Jane Pierson, School of Public Health, La Trobe University, Victoria

To date, the literature on sleep and sleep disorders and the public health literature have developed quite separately from each other, a point noted by Hale, Peppard and Young in the first chapter of this 16-chapter compendium edited by Leger and Pandi-Perumal. Thus, while there has been extensive investigation of a wide range of variables that have an impact upon population health, sleep patterns, sleep quality, sleep disorders and the management of these disorders have rarely been among them.

This is rather surprising, given that the contents of the book provide a good deal of clear evidence of the effects that all of these have on public health. The book represents a novel collection of these two disparate literatures and, as such, makes a valuable contribution to interdisciplinary knowledge as well as to each of the two literatures themselves. The title is somewhat misleading, as the book is not limited to consideration of sleep disorders. It also includes chapters that deal with several other aspects of sleep and their impact on health.

The first five chapters examine sleep and sleep disorders in the context of demographics that have been previously established as having key influences on public health, including chronological age, race, and culture. Among these, the chapter by Monjan, which deals with sleep and ageing, is of particular note, as it is one of only a few contemporary reviews of the somewhat limited literature dealing with sleep in older age. Eight later chapters address a variety of public health effects of insomnia, sleep loss, sleepiness, sleep disorders, sleep-related stress in shift workers, environmentally influenced sleep quality, and pain and poor sleep. A further chapter by Shneerson is a highlight, providing a relatively novel and interesting view into medico-legal aspects of sleep disorders.

Neither of the last two chapters place their material in a public health context to the same extent as do the chapters already mentioned. Nevertheless, each offers some valuable and often fresh insights into the sleep disorders with which they deal.

Thus, the chapter on sleep apnoea and stroke deals with under-recognised and under-researched sleep problems that are risk factors for stroke and relatively common among stroke survivors. These problems often go untreated or are not managed as effectively as they could be. This chapter starts with a relatively brief discussion of the relationship between sleep apnoea and stroke, which is relevant to public health only in that several epidemiological studies are mentioned. This is followed by detailed consideration of the physiological mechanisms of stroke in sleep apnoea and treatment of sleep apnoea, with only a brief reference to public health implications being included in a short summary section at the end. In a similar vein, the chapter on narcolepsy and idiopathic hypersomnia provides a clear and informative description of these disorders and a detailed and insightful consideration of their effects. However, in the most part, this consideration is limited to discussion of their effects at the level of the individual.

Overall, this book provides a novel and a valuable contribution to knowledge. It is largely up-to-date, relevant and accessible to an international audience. It will be of interest and use to those in several areas of public health, including epidemiologists, health program developers and health policy makers. It will also be of value to clinicians and researchers whose work deals with the health effects of sleep, sleep problems and sleep disorders.