Review of Sleep Disorders: Their Impact on Public Health

IN THE RECENTLY PUBLISHED BOOK, SLEEP DISORDERS: THEIR IMPACT ON PUBLIC HEALTH,¹ THE EDITORS (DAMIEN LÉGER AND SR PANDI-PERUMAL) SEEK “TO provide a comprehensive and up-to-date coverage of specialized topics on sleep and public health” (p xii). They accomplish that goal quite nicely in an informative and interesting volume consisting of 16 chapters with authors from North America and Europe. The international flavor is a particular strength of the book, and it ensures that the data presented and the public health issues discussed are not centric to either the United States or Western Europe. Another strength of the book is that most chapters provide overviews and definitions of terminology and concepts from the sleep field and, to a lesser extent, from the public health field. In this way, the book can be useful for professionals from either field who want to understand better the intersection of the two. The potential crossover appeal of the book is perhaps its greatest asset. Sleep researchers will gain more appreciation for the public health and economic impacts of sleep, sleep loss, and sleep disorders. Public health professionals, in turn, can learn more about how sleep related issues affect the societal conditions and individual disorders they study.

While the editors do not explicitly divide the book into sections, the chapters fall into six groups. First, the opening chapters provide an introduction to population based approaches to understanding sleep as well as an overview of the types of concepts and questions addressed in the remainder of the book. The next three chapters bring a developmental perspective to understanding how sleep and sleep problems affect physical and psychological health, as well as performance. The third area covered includes environmental effects on sleep quantity and quality. These two chapters are very interesting and review a set of studies not often discussed in the sleep field. However, they are light on public health implications of these data, and they contain some inconsistencies. Those issues notwithstanding, they are informative, well-written chapters. The fourth group of chapters covers occupational and legal issues related to sleep, sleepiness, and sleep disorders. The chapters on sleep and shift work and on sleepiness and accidents, are probably most prototypical of what people think about when they consider the public health impact of sleep disorders. These chapters contain valuable data on prevalence rates of sleep problems, performance levels and accident rates related to sleepiness, and solid reviews of the economic impact of these issues. There are four chapters on sleep disorders that provide a wealth of data regarding prevalence rates, economic and quality of life effects, and potential economic savings from treatments. Some of these chapters have significant overlap in content, but that is not necessarily a bad thing. Finally, there are two chapters that cover the interface of sleep and medical disorders: sleep and pain, and sleep apnea and stroke. As with the previous several chapters, these two provide information not only on the interaction of sleep with the medical conditions, but on the impact of that interaction for both the individual and society.

This book is a fascinating and educational look at the intersection of sleep and public health. It provides a plethora of data that investigators will want to use to help illustrate the significance of their work in a climate where more and more emphasis is placed on translational and applicable research. The book could serve as a text in public health schools, as it provides an example of how a given area (sleep, broadly defined) can have significant and varied influences on public health. It is a book that every policy maker should read.