“This is a unique and extraordinary book written by a psychiatrist widely recognised as an international authority on parasomnias in general and random eye movement sleep behaviour disorder (RBD) in particular. Those looking for a comprehensive or conventional textbook on matters ‘‘going bump in the night’’ may be disappointed by the eclectic and extremely personal style of the author. Indeed, it is a little difficult to understand at whom the book is primarily aimed. Published, it seems, using the author’s own resources after 15 years’ gestation, the core of the book consists of numerous case vignettes. Descriptions by subjects and their bed partners cover the full gamut of extraordinary behaviours and experiences that can arise from the state of sleep. Replete with transcripts and literary allusions, reminiscent of Oliver Sachs’s early works, the book would be accessible to the interested lay reader although there is enough referenced detail to keep a sleep specialist happy. The personal involvement of the author in his patients’ ‘‘journeys’’ is palpable, as is his zeal to publicise the often unbelievable range of behaviours that can arise from the hinterland between wake and sleep. Most neurologists will be aware of RBD, its potential violent |
consequences and its tight association with parkinsonian syndromes. Thanks to data from Schenck’s group, it is now appreciated that most of the apparently idiopathic victims will eventually develop an extrapyramidal movement disorder. Fewer clinicians, however, will be familiar with nocturnal sleep eating disorder, sleep driving and other even more complex and occasionally violent behaviours that may originate from the deepest stages of non-REM sleep. Schenck pays considerable attention to the medicolegal or forensic aspects of parasomnias. Several extreme cases are discussed in which violent or sexual assaults have been followed by a successful legal defence on the basis of a ‘‘non-insane automatism’’. Broad guidelines for determining the likelihood of a parasomnia as an explanation for a seemingly criminal act are outlined. This is clearly an extremely delicate area, and neurologists or psychiatrists who may be asked to comment on such cases will almost certainly find the comments, illustrative examples and references in this book helpful.
|
The book might have been better served by a tighter editorial influence. It is a little difficult to navigate around the various chapters, and there is a somewhat rambling, occasionally repetitive narrative to the case histories. However, given that the primary motivation behind the book is to illustrate the extraordinary range of abnormal nocturnal behaviours rather than serve as a simple textbook, this lapse may be forgiven. I suspect that readers without a particular interest in sleep medicine will find the material contained in the book inherently fascinating. Patients with sleep disorder and those trying to manage them will both appreciate and find comfort from the incredible stories related by Schenck. Overall, I think the book is an original and passionate attempt to highlight the mysterious world of parasomnias. Those searching for a detailed neurobiological account of parasomnias may be disappointed, but, given its reasonable price, I would not hesitate in recommending this book to a wide readership.” - DR Reading |