To return to the opening theme of this book, it is indefensible that sleep and its disorders feature so little in medical and other professional education and that, as a result, the standard of clinical practice is inevitably less than it ought to be. The need to correct the situation is obvious.

In fact, the need for educational improvement starts with the general public. As part of general health education it should be made clear that sleep disorders of all types are potentially harmful and that professional help for them should be sought in the expectation that effective treatment is usually possible. In order to meet raised expectations, teaching and training for those providing help will have to improve considerably. This applies to clinicians in family practice, paediatrics and child psychiatry, as well as nursing staff (especially health visitors), psychologists and also those responsible for clinical neurophysiology services. There needs to be a wider appreciation of the broad range of sleep disorders and the many treatment options rather than a preoccupation with the sleepless young child.

Provision of clinical services

Ideally, clinical services would be available at three levels.

1. Many sleep problems could be assessed and treated at the primary care (general-practice) level, especially the common settling and night-waking problems in toddlers (for whom help is already provided by some health visitors) and nocturnal enuresis. Some health visitors have taken the initiative and set up clinics dealing with such problems (Sykes, 1999), but such provision is geographically patchy. Also, it would be appropriate at the primary care level to more consistently include advice on a wider range of sleep disorders such as the more common parasomnias.

2. […]