Media Review: The Nocturnal Brain—Nightmares, Neuroscience, and the Secret World of Sleep by Guy Leschziner

I haven’t read this book yet, but the review here seems really fascinating. In the spirit of Oliver Sacks, who I have read extensively over the years, this book offers a look at the unique aspects of the nocturnal experience. The review compelled me to order it, so perhaps I’ll write a riff about it once I get it and read. I get these great resources every week in my American Academy of Sleep Medicine notices. Some of this stuff is so out there – amazing what some people experience, and sometimes have to endure.


The Nocturnal Brain: Nightmares, Neuroscience, and the Secret World of Sleep by Guy Leschziner is a compilation of clinical vignettes, akin to Oliver Sacks’s memorable work The Man Who Mistook His Wife for a Hat. As a neurologist and sleep physician, Dr. Leschziner describes extreme cases that he has cataloged during his career at the Sleep Disorders Centre at Guy’s Hospital and at London Bridge Hospital. Each case is presented alongside the clinical, pathophysiological, and historical basis for the respective sleep disorders—like Eugene Aserinsky’s serendipitous (and humorously self-deprecating) role in the discovery of rapid eye movement sleep—in addition to the cultural context in which the patient lived, such as the man who was convicted for crimes later attributed to a diagnosis of sexsomnia or the young woman of Ugandan descent whose sleep paralysis was thought by some to be linked directly to black magic “juju.” This collection portrays patients and their loved ones in a very real and tangible style. It is evident in this well-written, yet easy-to-read, collection that Dr. Leschziner’s patients divulged their stories in order to help introduce to the reader these common (and not-so-common) conditions. Dr. Leschziner’s pleasant writing style notably sheds light on the real human experience endured as a result of their diagnoses.

An endearing aspect of this work is the way that Dr. Leschziner writes his prose – almost as if it is a conversation, relaying an interesting case to a colleague. He does not deliver the patient’s story in the dry way of a case report presented in a journal or textbook. Instead, he skillfully writes in a manner that intermingles history, culture, ethics, sociology, and law, and elucidates various facets of the patient as a person, and not just a clinical diagnosis. Background descriptions, such as the Korean War–era survival tactics for POWs to cope with extreme abuse in the form of sleep deprivation and the analogy of the incubus and horse in Henry Fuseli’s famous 1782 painting, The Nightmare , make the portrayals of the patients quite genuine, as if they are sitting in your clinic waiting room. In this way, The Nocturnal Brain is written not just for the clinician but for anyone interested in the humanistic side of medicine.

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