As noted by Meredith Wadman in her review of Matthew Wolf-Meyer's book on US sleep medicine, The Slumbering Masses (Nature 490, 173–174; 2012), the sweeping generalization that sleep is unnecessarily “medicalized” ignores the drastic consequences of insufficient sleep. Sleep-medicine physicians, like all doctors, have an ethical responsibility to diagnose patients who have a suspected health disorder and to provide them with the most effective treatment.

Chronic sleep deprivation increases the risk of illness and accidents and curtails productivity. Insomnia, the most common complaint, is also associated with a host of morbidities, including psychiatric disorders such as severe depression and the associated risk of suicide. Left untreated, insomnia will seriously damage an individual's health and quality of life.

Sleep medications approved by the US Food and Drug Administration can safely provide relief from insomnia when used properly under the supervision of a physician. Clinical guidelines from my institution, the American Academy of Sleep Medicine, recommend that sedative-hypnotic drugs should be supplemented with behavioural and cognitive therapies, that the lowest effective dose should be prescribed and that medication should be tapered when conditions allow.