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Book Review   |    
Forensic Aspects of Sleep
Stephen Noffsinger, M.D.
Psychiatric Services 1998; doi:
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edited by Colin Shapiro and Alexander McCall Smith; New York City, John Wiley & Sons, 1997, 208 pages, $69.95

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Forensic Aspects of Sleep is a comprehensive look at the legal ramifications of sleep disorders, encompassing both the criminal and the civil aspects of the law. The editors make a convincing argument in the book's introduction that due to the considerable recent progress in our understanding of sleep and its disorders, as well as increased attention by the courts, this topic is worthy of our attention.

The book is written on a level easily comprehended by the physician with even a passing knowledge of sleep physiology. An introductory chapter is entirely devoted to an overview of sleep physiology and sleep disorders, with subsequent chapters also giving the reader basic knowledge about sleep medicine. The various sleep disorders and their diagnostic criteria are presented early in the book.

One of the book's highlights is an in-depth analysis of sleep disorders and their relationship in the law to insanity. The authors do not assume the reader has extensive knowledge about forensic psychiatry, and they provide a good introduction to the basics of criminal law and insanity before delving into the specifics of sleep disorders and insanity. An analysis of the relevant case law in this area is provided; however, the contributors choose—not surprising, given that they are primarily Canadian—to review Canadian and English case law and forego case law from the United States. I found this to be a pleasant surprise, as U.S. case law can be easily obtained from other sources by readers with a special interest in it.

The chapter devoted to the civil liability issues arising out of sleep deprivation and sleep disorders is comprehensive and instructive. Of particular interest to the clinical psychiatrist is the section dealing with the civil liability of the psychiatrist whose sleep-disordered patient harms a third party as the result of his sleep disorder—for example, the narcoleptic patient who falls asleep while driving and causes an accident. Other topics covered include what appear to be new research findings about men who sexually assault sleeping victims, chronobiologic aspects of alertness, and pharmacological aspects of drowsiness.

The material is presented in an organized fashion and is very readable. The various chapters are of sufficient depth to be informative, but not exhaustive. In the final analysis, the editors have put together an organized and complete book that is not only interesting but also easy to read.

Dr. Noffsinger is director of forensic psychiatry for the Northcoast Behavioral Healthcare System in Northfield, Ohio, and assistant professor of psychiatry at Case Western Reserve University School of Medicine.

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