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"...explains sleep fundamentals and what happens to the body, mentally & physically, when sleep deprivation occurs...includes chapters on sleep disorders & tips about establishing a 'sleep-smart' lifestyle."
I was extremely fortunate to be joined by my friend and colleague in sleep medicine at Stanford, the late Dr. Gèrman Nino-Murcia. To establish a baseline, we first reviewed the records of approximately 750 patients; as expected, sleep disorder diagnoses were absent. After the baseline review, Dr. Nino-Murcia and I conducted training sessions for all interested health professionals. The Walla Walla primary care physicians then began diagnosing and treating sleep disorders patients. All the cases were discussed in detail in weekly telephone conferences held with Dr. Nino-Murcia and me. Then, as the Walla Walla physicians acquired more and more expertise, only complicated and difficult cases were discussed.
Since it was the first time anything like it had been attempted, the Walla Walla Project began slowly. However, from today's perspective, the results of this project have been astounding. The Walla Walla physicians were amazed by the large number of patients they found to have serious sleep disorders. All of these patients had been seen at the clinic on multiple occasions previously, yet their sleep disorders were not recognized until the Walla Walla Project was well under way. The physicians participating in the project have since acquired the skills and experience to manage any sleep disorder entirely on their own. Three Walla Walla physicians have learned to score and interpret sleep tests. Four Walla Walla primary care physician, Dr. Richard Simon, is now a diplomate of the American Board of Sleep Medicine, and with several colleagues, has founded a fully accredited sleep disorders center. In a most touching gesture, this excellent clinical resource was christenedas the Kathryn Severyns Dement Sleep Diso
I am excited and gratified that sleep has now entered the mainstream of Walla Walla society as a fully qualified member of the basic triumvirate of health: good nutrition, physical fitness, healthy sleep. A sleep curriculum is being prepared for Walla Walla's two middle schools and high schools. Material covering the nature of sleep, sleep deprivation, biological rhythms, and the essentials of healthy sleep is being introduced in its three small colleges.
In addition to our work in Walla Walla, we are working nearby in Moscow, Idaho, where we have evaluated every patient in a single primary care practice, with startling results. No patient in the practice had received a specific sleep disorders diagnosis as of the end of 1996. But when we evaluated this patient population, we found that more than half of them presented obvious symptoms of one or more sleep disorders. Given these results, and assuming that the Moscow doctors are representative of those in the rest of the nation, it is clear that primary care physicians are missing important diagnoses and must fully integrate sleep medicine into the general practice of medicines.
There is one thing I must make absolutely sure that everyone understands. Primary care physicians are absolutely not responsible for the neglect of sleep disorders in America today. They are as much the victims of the lack of medical school teaching as everyone else. In my opinion, the tiny band of primary care physicians who have already tackled the sleep disorders problem head-on are heroes worthy of the highest accolades.
In Walla Walla as I write, about 2,000 seriously ill citizens have been diagnosed and treated, first at the Walla Walla clinic and in the past two years at the Kathryn Severyns Dement Sleep Disorders Center. The results of the Walla Walla project have been a mind-boggling revelation. In those suspected of having apnea, 80 percent of the sleep tests have revealed far-advanced illness. This means that these patients became ill decades ago, and as the years passed, they simply got sicker and sicker. The 80 percent figure is likely the same as would be found in other communities but such an effective sleep disorder and awareness program has not been done beyond Walla Walla.
Several thousand Walla Walla citizens have already received or will soon receive clinical salvation through treatment, and the potential for salvation elsewhere is awesome. An example: One of Dick Simon's many patients was an overweight 60-year-old who was overwhelmingly fatigued. The only thing he could do was sit around all day long, frequently dozing off in his chair. He was also in far advanced congestive heart failure. The slow failure of his heart muscle caused massive tissue swelling called edema. He could not walk one block without becoming very short of breath. When he lay down, the pressure of tissue and body fluids on the heart and lungs also made it hard to breathe. He had been hospitalized many times. The heart failure was assumed to be secondary to high blood pressure, which did not respond to treatment.
In less than a minute, Dick recognized his true condition, obstructive sleep apnea. The man's sleep test revealed a very high level of severity. He stopped breathing nearly 100 times every hour. After several weeks of treatment, this patient was reborn. He can breathe when lying down, he can walk many blocks without shortness of breath, his edema is gone, and he feels great. Of the eight medications he was taking for his heart, blood pressure, and fluid retention, he now takes only two. And each night his sleep is deep, healthy, and restorative.
After all the research I've done on sleep problems over the past four decades, my most significant finding is that ignorance is the worst sleep disorder of them all. People lack the most basic information about how to manage their sleep, leading to a huge amount of unnecessary suffering. My goal for this book is not to tell everyone about all the exciting discoveries in sleep science and sleep medicine--outstanding researchers and clinicians have filled volumes with that information. Rather, my goal is to give people the fundamental knowledge they need to change the way they sleep and live. What I am trying to do is akin to teaching the alphabet of sleep so that people can start learning to read. We are not healthy unless our sleep is healthy, and we cannot make our sleep healthy unless we become thoroughly aware of both its peril and its promise.
For nearly half a century, a huge reservoir of knowledge about sleep, sleep deprivation, and sleep disorders has been building up behind a dam of pervasive lack of awareness and unresponsive bureaucracies. We don't know how many preventable tragedies are occurring right now, today, this very instant. It is time to blow up the dam. The gentler approach of convincing authorities to lower the floodgates has not worked. Therefore, I hope and pray that this book will allow sleep knowledge to flow to the millions of people whose lives it can change--and save.
Posted September 4, 2000
The information contained was helpful in repairing my health. The Promise of Sleep represents more than a title it is a condition. The name clearly states what every person should promise himself or herself: sleep. Every person who plans to live a healthy life should read this book.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted December 17, 1999
Dr. Dement is a skilled, articulate researcher and professor who engages any reader--from college students to grandparents--as he explores sleep (his area of profound expertise).Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.