Sleep apnoea update

Sleep disorders are among the most prevalent problems in the Australian community, and compact, reliable sources of information on this topic are hard to find. There are good, large specialist textbooks on sleep medicine but no suitable short texts aimed at non-specialists. This book says that this is its market.

Breathing disorders in sleep is, to a sleep specialist, a marvellous book and most sleep specialists will want it (although they might baulk at paying 70 cents a page). The authors are the leading lights in research into sleep-disordered breathing in both North America and the United Kingdom. Several chapters contain valuable new data, some previously unpublished results, and new presentations recalculated from the authors' raw data. Everywhere there are keen insights, some clinical and practical, some theoretical.

The book's focus is narrower than its title implies — it is really about adult obstructive sleep apnoea. There are a few pages each on sleep apnoea in children, sleep in chronic obstructive airways disease and chest wall and neuromuscular disease, but specialists expecting a comprehensive reference on breathing during sleep will be disappointed.

But is this the book non-specialists have been looking for? No! It looks like a book for non-specialists. A lot of attention has been paid to layout, and there are frequent “key points” boxes. Non-specialists could learn a lot by browsing through these key points boxes, and a good student text on obstructive sleep apnoea could be created from them. However, the book is essentially a collection of research reviews, which are excellent, but of little help to the non-specialist. For example, a reader wanting to know whether obstructive sleep apnoea causes vascular disease will find several detailed discussions of the evidence, but conflicting conclusions reached in different chapters.

A lot of knowledge is assumed, and in some cases information is presented in such a technical way that most readers will be unable to make use of it. Clinicians who are used to systematic reviews and to thinking in terms of “absolute risk difference” and “number needed to treat” will be dissatisfied — by the management chapters in particular.

Those interested in this book or in the politics of book pricing may like to note that amazon.com sells it new for US$99 or used for US$79, which (even with the shipping cost of US$7) makes it much cheaper than buying locally.

Leslie G OlsonDepartment of Respiratory and Sleep Medicine John Hunter Hospital, Newcastle, NSW