If ever a book could be called timely, this is it. Sleep disorders
medicine has made rapid advances in recent years. The field has attained
growing respectability, with a textbook recently published, a
congressionally man- dated National Commission on Sleep Disorders
Research, and a growing public awareness of the importance of sleep
disorders. However, this rapid growth has made the discrepancy among
certain components of the field all the more obvious. Thus, we find that
patients who complain of insom- nia are almost never in the majority of
those seen in sleep disorders centers, in spite of the well-known fact
that the prevalence of such individ- uals in our society is by far the
largest. Current articles on insomnia abound, but they tend to be facile
recitations of diagnosis and impractical global recommendations for
treat- ment, without providing the essential details. Indeed, the
clinical profes- sions really do not know what to do about insomnia.
This is reflected in a number of observations I have made in the recent
past. For example, the majority of individuals who complain of insomnia
take alcohol, aspirin, over-the-counter medications, hot baths, and a
host of other nostrums, but rarely seek a physician. In the unlikely
event that a physician is consulted, he is likely to prescribe a sleep
medication but without any particular consistency, or any clear
instructions on its use.