“Teaching the World to Sleep” was written on the back of a presentation delivered to a group of around 120 psychologists, psychotherapists, counsellors and others in London in December 2014. This presentation had been delivered many times over the previous decade, mostly to healthcare professionals and, on occasion, to members of the public and other interested parties. At the event in London in December 2014 there was, sitting in the audience, an associate editor from Karnac. After the event Rod Tweedy, editor-in-chief at Karnac, contacted me and suggested that I might consider translating the presentation that his associate had heard into a book. I roughed-out an outline for the book and, in due course, contracts were signed and the work was commissioned by Karnac in February 2015. Writing took one-year and the final manuscript went to publication in November 2016.
I suppose it is worthy here to describe the motivation of the work that I (and now we) at Sleep Unlimited do, and how the book is a key element in that, in order to provide some context to its inception, its structure and our wishes for its future, now that it has gone to press. The motivation is simple, there is a huge need for this in the world; the structure, designed on the back of presentations and workshops that have been delivered hundreds of times to a range of audiences, has been developed and refined over the course of a decade or more; and our wishes for the future of it are hopefully not too grandiose.
There are a multitude of people in the world who struggle with sleep. This struggle impacts negatively on them, those around them, and causes much expense in terms of poor productivity, low motivation, as well as (sometimes very costly) mistakes and accidents. There are also a multitude of healthcare professionals who lack the experience and training to manage the sleeping problems that they so often see in their clients, with very few training courses paying any attention to the field of behavioural sleep medicine. This is an intense source of frustration for me personally, as we have very well-defined, evidence-based treatment options, that can be highly effective for most people who do not sleep well. These are made unavailable to those who need them due to a lack of education and experience in our trusted treating healthcare professionals. Instead people usually either: 1) suffer in silence, or 2) receive a prescription of hypnotic medication. The latter not being licenced for use beyond a few months, yet the average amount of time that people consume these medications for is around seven years! The drugs themselves only contain the problem, they do not ‘cure’ a sleeping problem, as, when people come off the drugs, their sleep problems almost always return. Couple this with the toxic and addictive nature of them it is little surprise that people who start taking them remain taking them, and then progress onto stronger (and so more toxic) drugs when their original prescription fails to have the desired effects. Recent work in the USA has indicated a four-fold increase in mortality as a result of long-term hypnotic drug consumption. These drugs are no good, they don’t solve the problem and they tend to kill people more quickly than those people who do not take them. Additionally, we have the issue of ‘hangover’ effects when people remain ‘dosed’ in the morning and daytime following consumption of the hypnotic drug the previous evening. This has negative consequences for their functioning, their mood, and places them at a heightened risk of accidents the next day.
The effectiveness of the psychological and behavioural interventions for managing, and treating, or ‘curing’ a sleep problem are well-documented and the frustration for me lies in the lack of knowledge and experience of our healthcare professionals in delivering this knowledge to those who need it. That is the motivation for this book: to alleviate distress, improve quality of life, and to reduce accidents, poor performance, poor health and premature death.
Structurally the book follows the refined talks, workshops, seminars and presentations that we have been delivering for over a decade now, and has been written to target healthcare professionals, people with sleeping problems, and informed and interested lay-readers. The content all hangs on the ‘science of sleep,’ which forms the first chapter of the book. This first chapter should be of interest to, and of use for, all. The second, and third chapters focus on the various types of sleeping problem that abound, and their assessment, before the range of treatment options are described in chapter four. These chapters are aimed more at the population of healthcare professionals, but will be of interest to the lay-reader as well. Chapter five describes the first 2nd generation cognitive and behavioural intervention for insomnia, which will have utility for both the person with a sleeping problem and the professionals who meet people with sleeping problems in their day-to-day clinical work. Chapter six then explains how these interventions can be tailored and adapted for specific populations (e.g. children, older people, carers, and those who are living with complex conditions such as chronic pain, Multiple Sclerosis, chronic fatigue, fibromyalgia, dementia, brain injury etc.) This book then concludes with a final chapter on both historical and contemporaneous theories about the purpose of dreams and dreaming, and how ‘dream-work’ has been, and can be, applied in a therapeutic setting.
We are fortunate that the material presented in the book is not rocket-science. Just as with the presentations that we deliver, it doesn’t really matter what level of education the reader (or person in the audience) has had, most get it, and get it very easily as the material is all very ‘common sensible.’ Any high-school graduate would be able to follow and understand the material presented in its pages, but the super-intelligent, highly-qualified medical types will also find this useful, as they will almost certainly have missed much of this material in their training. So we consider ourselves very lucky in the broad appeal of the subject matter as it has relevance for everyone, at all ages and at all levels of education and experience. So much of this is ‘new’ to the audiences that we speak to, yet should be common knowledge to all. If it were (and this book’s mission is precisely that: to make this knowledge available to all), then we would see a much happier, healthier, safer and more productive planet. Please read this book and spread the word to your families, friends, colleagues and anyone who you know who is struggling with their sleep. Thank-you.
“Teaching the World to Sleep,” Karnac, London, 2016
By Dr David Lee
BSc PhD CertEd AFBPsS CPsychol CSci
Clinical Director at Sleep Unlimited Ltd.