Professor Robert Meadows
Rob joined the University of Surrey in 1999 to work at the Human Psychopharmacology Research Unit, Medical Research Centre (HPRU/MRC), having previously gained degrees in Law, Sociology and Social Anthropology (LLB: Keele) and Socio-Legal studies (MA: Sheffield). From 1999 to 2003 he held numerous research positions within the HPRU/MRC, (including Programmer/Analyst, Acting Head of Data Management) worked as part of a small Home Office funded team, and spent time visiting two Japanese Universities. In October 2003, Rob joined the sociology department as Research Fellow and co-investigator on an ESRC funded project, before becoming (2006-2008) a senior researcher and part of the core management team on a large-scale, cross-council, project. During this period Rob was also a part-time PhD student (2002-2008), Associate Lecturer/tutor (2002-2007) and a part-time (20%) lecturer (2007-2008) in the sociology department. He took up a full-time lectureship in August 2008, was promoted to senior lecturer in April 2013, Reader in 2017 and Professor in 2021.
Rob is currently Unit of Assessment Lead (REF) for the Department and is part of the team which looks after the day courses. Rob is on the editorial board of Sociological Research Online, is a member of the UKRI Future Leaders Peer Review College, sits on NIHR panels and is co-recorder of the Sociology and Social Policy Section of the British Science Association. He also currently acts as External Examiner at Portsmouth University.
Previous internal service roles include Deputy Director of Research (impact), Programme Director for Sociology Programmes, Senior Placement Tutor, Department Lead Academic Integrity Officer, Department Examinations Officer, Departmental International Liaison Officer, Member of the Faculty Ethics Committee. External roles have included PhD proposal reviewer for the Government of Ireland, Invited Member of Validation Panel (Brunel MSc in Public Health), External expert for the Open University (Health, Wellbeing and Aging), External subject expert for BSc and MSc programme validation Kingston University, External examiner Kingston University Undergraduate Sociology programmes, External examiner Kingston University MSc Life Planning and Retirement programme.
In the media
My research largely operates at the nexus of sleep, technology and recovery. My research has been supported by the ESRC (x2), the British Academy (x3), Wellcome Trust and Foundation for the Sociology of Health and Illness. I have also been an investigator on 7 internal awards and other contracts. I am currently working on :
(i) 'Making sleep';
My research on sleep takes a broad focus and speaks to diverse literatures - including health and illness, mental health, family, gender, STS and the sociology of the body – as well as tending to trouble disciplinary boundaries. I have been invited to talk about my work on sociological aspects of sleep in several countries (Japan, Turkey) and numerous UK Universities (for example Cambridge, Oxford, Chester). I am (co)author of 5 papers reprinted in a recent international volume on critical concepts in sleep. I was also part of the team which developed the Substance Use Sleep Scale (here). This has now been incorporated in the SURE Recovery app (see here). Current work focuses on public health and sleep and includes a forthcoming conference on 'Making sleep: new agendas for a new public health' - as well as a forthcoming co-authored book titled 'Technosleep'.
(ii) 'Making recovery'
Artificial intelligence (AI) is said to be ‘transforming mental health’. AI based technologies and technique are now considered to have uses in almost every domain of mental health care: including decision making, assessment and healthcare management. What remains underexplored is whether/how mental health recovery is situated within these discussions and practices. Projects include a British Academy funded study looking at chatbots and mental health recovery.
AI based chatbots are increasingly being used in the mental health field yet very little attention is being paid to how they relate to the concept of mental health recovery. The proposed study therefore asks: To what extent are chatbots both shaped by, and shaping, the concept of mental health recovery?
Sleep is a site and source of ethics, from long-standing proverbs of the ‘early to bed early to rise …’kind to contemporary moralising regarding sleep medicines. Recent developments in digital and social media add further dynamics to these matters given their Janus-faced relations with sleep. On the one hand, social media are said to disturb sleep; with recent research, for example, suggesting that increased dependency on social network sites is associated with decreased sleep quality. On the other hand, sleep experts are using the same media to develop novel methods for investigating sleep; with researchers, for example, building a ‘digital phenotype’ of insomnia using microblogging (Twitter) data. Further complexities arise when new technologies are considered – such as Somnometer, Fitbit etc - which feed sleep data directly to users and encourage sharing to traditional forms of social media. We undertook a programme of work provided (i) an innovative methodology which is reflective of its own role with regard to ethical issues; (ii) a multidisciplinary network which includes social scientists, biomedical sleep experts, designers and methodologists; and (iii) scoping data from designers/sleep experts involved in design and from a large sample of users/non-users/prospective users.
This Symposium gathered together academics and postgraduate research students who have theoretical and empirical interest in ‘recovery’ in the context of mental health, physical illness or injury and addiction. Despite prima facie cross-over there has been little dialogue about recovery between these domains and the conceptual models of recovery they are building do not necessarily speak to each other. Within the field of mental health, Watson (2012) has identified a need for sociologists to develop a better understanding of recovery in the context of contemporary service provision, in particular the co-existence between policy framing of recovery as experienced by service users and biomedical and clinical conceptualisation of recovery as outcome. In contrast to mental health, recovery from acute physical illness or serious injury is relatively under-researched and under-theorised notwithstanding Frank’s (1995) seminal work on narratives of serious illness and extensive research on experiences of chronic illness. The concept of ‘survivorship’ has been found to be problematic from the perspective of cancer patients (Khan et al 2012) and findings from the recent ESRC-funded project Getting Back to Normal? (Thomas and Earthy) demonstrated the complexity of the social processes surrounding transition from an acute phase of illness and treatment to a more stable situation, whether that constitutes full or partial recovery. In 2007, White argued that the addiction field had failed to achieve consensus on a definition of “recovery” and that this had undermined clinical research, clinical practice and confused communications amongst clients, professionals, the public and policymakers.
The study used longitudinal dyadic data analysis to explore (i) the dynamics of gender identity within heterosexual couples over time; (ii) how gender dynamics within couples over time are associated with reports of sleep. Results were used to engage with ideas surrounding how traditional masculinities are constructed in relation to ‘emphasized feminities’ and how they are constructed in the areas of face-to-face interactions over time. The findings also enabled us to engage with recent sociological literature which suggests that ‘sleep’ is a gendered arena.
The project also enabled Meadows to be mentored by Professor Amanda Sacker (Director of the International Centre for Life-Course Studies, UCL). Prof. Sacker has extensive expertise in family demography and statistical methods. Meadows also spent time at Michigan State University developed his knowledge of dyadic data analysis techniques
Research by Neale and Nettleton into the everyday lives of recovering heroin users found sleep to be an important issue for those seeking to overcome addiction. Although there is a biomedical literature on substance misuse and sleep, there is virtually no sociological research on sleep during rehabilitation. Working with Meadows, a sociologist of sleep, the team explored how sleep is experienced, interpreted and managed by recovering users in residential treatment settings. A novel conceptual model which situates sleep, drug misuse and recovery as embodied social actions that are embedded within social contexts was developed. Thirty individuals wore an actiwatch (an established tool for measuring sleep/wake cycles) for one week; they were then interviewed to gather data on their perceptions of their night/day experiences. These subjective data matched, by objective measures of sleep, facilitated comparison between perceptions of sleeping patterns and actual patterns of sleeping.
More information can be found in this paper which considers the rationale for, design and outputs of a project, based at the University of Surrey UK and funded by the Economic and Social Research Council (ESRC), which sought to integrate aspects of teaching substantive and Quantitative Methods (QM) teaching across first year sociology undergraduate programmes using a blended approach. The paper considers the nature of concerns regarding teaching QM within social science undergraduate programmes. It goes on to describe the rationale for this project, its design and its primary outputs. We consider a range of data related to student attitudes towards studying QM at university as well as their perspectives on the project and the implications for practice.
The research examined social factors influencing the quality of sleep and sleep negotiation between working age men and women at varying stages of the lifecourse. It used a multi-method approach, which included the integration of social scientific and physiological data:
- Qualitative interviews with 40 couples, to obtain information as to their described sleep reality and to understand how this differs from their normative views on sleep.
- Individual qualitative audio recorded sleep diaries for a period of one week (x80), to provide qualitative data on each partners sleep behaviour.
- Quantitative actigraphy data for a period of one week (x80).
I currently lead on Drugs & Society, Sociology of Health and Illness and Sociology of Mental Health. For many years, I also taught theory modules across the undergraduate programmes and have also taught on a range of research methods modules.
In 2012, colleagues and I were awarded a grant from the ESRC to explore innovative ways to integrate quantitative methods into the FHEQ 4 curriculum. Findings from this pedagogical research were presented and published in 2014 (Bullock et al 2014). Other outputs include: http://www.discoverquants.surrey.ac.uk/ In 2020 I was awarded a teaching innovation grant titled: "teaching the sociology of mental health amidst an unfolding 'crisis'".
PhD students (Awarded)
- Theresa Ellmers A qualitative study of sleep and the night-time in care homes for older people
- Alex Cuncev Homelessness (co-supervisor)
- Basem Zuhur-Adi Education/Critical Realism
- Richard Green Masculinities and Prostate Cancer
- Jessica Underhill Household sleep and cerebral palsy
- Nadia Haerizadeh-Yazdi Parenting a Child Recipient of Proton-Beam Therapy
In Progress includes Lorraine Locke, Nicola Spencer-Godfrey, Megan Georgiou and Frances Sanders
This paper takes a critical look at the role of chronobiology in society today, with particular reference to its entanglements with health and medicine and whether or not this amounts to the (bio)medicalisation of our circadian rhythms. What we have here, we show, is a complex unfolding storyline, within and beyond medicine. On the one hand, the promises and problems of these circadian, infradian and ultradian rhythms for our health and wellbeing are now increasingly emphasised. On the other hand, a variety of new rhythmic interventions and forms of governance are now emerging within and beyond medicine, from chronotherapies and chronopharmacology to biocompatible school and work schedules, and from chronodiets to the optimisation of all we do according to our ‘chronotypes’. Conceptualising these developments, we suggest, challenges us to think within and beyond medicalisation to wider processes of biomedicalisation and the biopolitics of our body clocks: a vital new strand of chronopolitics today indeed which implicates us all in sickness and in health as the very embodiment of these rhythms of life itself. The paper concludes with a call for further research on these complex unfolding relations between chronobiology, health and society in these desynchronised times of ours.
The United Kingdom Government are planning to issue guidance on sleep duration. Whilst sleep is clearly important for health, offering such guidance is not the answer. Within this commentary we put forward three arguments to support this claim: (i) sleep is liminal and beyond the limits of voluntary agency; (ii) sleep is linked to structural inequality; and (iii) sleep is multiple. The first two points are now well established. However, the third encourages a considerable break from established thinking. Recent research has highlighted that we need to move away from viewing sleep as a singular, objectively defined phenomenon, and instead position it as many different practices woven together. Sleep is situated, contingent and is enacted in multiple ways. Public health would be better served by a ground-up approach which explores good and poor sleep across these three axes: liminality, social position and ontology.
In this paper we seek to understand the influence of gender on the different approaches to managing poor sleep by older men and women through the conceptual framework of existing theoretical debates on medicalization, healthicization and 'personalization'. In-depth interviews undertaken between January and July 2008 with 62 people aged 65-95 who were experiencing poor sleep, revealed that the majority of older men and women resisted the medicalization of poor sleep, as they perceived sleep problems in later life were an inevitable consequence of ageing. However, older men and women engaged differently with the healthicization of poor sleep, with women far more likely than men to explore a range of alternative sleep remedies, such as herbal supplements, and were also much more likely than men to engage in behavioural practices to promote good sleep, and to avoid practices which prevented sleep. Women situated 'sleep' alongside more abstract discussions of 'diet' and health behaviours and drew on the discourses of the media, friends, family and their own experiences to create 'personalized' strategies, drawn from a paradigm of healthicization. Men, however, solely relied on the 'body' to indicate when sleep was needed and gauged their sleep needs largely by how they felt, and were able to function the following day. © 2012 Elsevier Ltd.
This article illustrates the ways that sociological research can inform an understanding of sleep. We emphasise the value of qualitative studies of sleep, by reviewing recent research on the ways that gender and co-sleeping influence sleep, and the influence of caregiving at night on sleep. We then consider large-scale quantitative studies of sleep, drawing on data from the UK Understanding Society 2009 survey (n=14,746). We show how providing care to an elderly or disabled relative in the home is linked to reported sleep problems which is only marginally attenuated following adjustment for disadvantaged socio-economic characteristics and poor health.
Everyday social order is said to be based on appropriate bodily conduct. The emphasis on day raises at least two questions for the sociological study of sleep: the first concerns the existence of a ‘sleep habitus’ and whether sleeping bodies can ever be ‘unruly’. The second involves the possibilities for breaching or mediating any such ‘sleep habitus’. What we suggest here is that any ‘sleep habitus’ does appear to be limited. If a sleeper is considered to be ‘unconscious’, in a private space, and in an intimate relationship with his or her audience, bodies appear free to do anything without invoking the need for embarrassment. However, at the same time, couples do suggest that sleeping bodies can feel embarrassed, and thus can experience failed ‘impression management’. Gender and length of relationship appear important factors here. For example, as a relationship becomes ‘routinized’ couples learn to ‘fit together’, and to ‘mutually adapt’. Although, this fitting together negates the requirement for ‘private’ embarrassment, it may actually increase the likelihood that the private is ‘leaked’ into the public domain and thus, augment the possibilities for ‘reputational’ embarrassment.
Within western societies it is commonplace for couples to share a bed. Yet there has been remarkably little research carried out on couples’ sleep. This paper draws upon actigraphy, audio diary and questionnaire data from both partners in 36 heterosexual couples (age 20-59) and aims to quantify the extent to which it is important to take the dyadic nature of sleep-wake cycles into account. It achieves this through two interrelated aims: (i) to use Hierarchical Linear Models to measure dyadic interdependence in actigraphically recorded variables; and (ii) to investigate how much of this dyadic interdependence truly results from couple dynamics. The variables with the most significant couple interdependency were ‘Actual bed time’, ‘Sleep latency’, ‘Light/Dark ratio’ and ‘Wake bouts’. The paper concludes by suggesting that interdependence may be the defining feature of couples’ sleep and that we need to employ analytic approaches which both acknowledge this and which are sensitive to the possibilities that not all aspects of sleep will behave in the same way.
Recent literature has highlighted the sociological significance of sleep and has suggested that sleep offers a ‘window’ onto the gendered nature of our lives. Yet within this body of work men's sleep has been largely ignored. This paper seeks to rectify this omission and situates itself at the intersection between literature on the sociological aspects of sleep and social-constructionist-orientated writings on men's health. It draws upon qualitative data from 40 men to investigate male understandings of, and attitudes towards, sleep. At first glance, it could be suggested that men have little regard for sleep, and are prone to taking risks with their dormancy. Viewed in this way sleep becomes an instrument used in the negotiation of status and power and intrinsically bound up with the demonstration of masculinities. Yet, men's relationship with sleep is more complex than this. Amongst other things, the men within the present study were embroiled in a function/non-function dichotomy. Sleep was seen as needed for the praxis of ‘father’, ‘worker’, ‘husband’ and ‘mate’ but was also considered as something which should not get in the way of performing these roles.
Sleep, which is vital for health and wellbeing, is influenced by a complex array of (neuro)biological and social factors. Previous research has suggested that these factors vary across the life course, as well as being affected by transitions, such as parenthood, care-giving and widowhood. This research has also suggested that many of these transitions have a greater affect on women’s sleep. Yet much of this research has focused on women and one-sided reports of partner behaviours. This paper draws on data from Wave 1 of the Understanding Society Survey to examine gender differences in sleep maintenance within younger and older heterosexual couples. Data were collected in 2009 from a representative sample of households in Britain with a response rate of 59%. Sleep maintenance, namely waking on 3 or more nights per week, was included in a self-completion module. A series of logistic regression models are run using sleep maintenance as a dependent variable; i) a two level model for couples where the male is aged 50 or less (n=2452 couples); ii) a two level model for older couples where the male is aged above 50 (n=1972 couples); iii) bivariate models which allow for odds to be calculated separately for male and female partners. Results from the couple level models illustrate how both younger and older women have increased odds of difficulties with sleep maintenance (as compared to their male partners). Poor sleep maintenance is also associated with poor health, own unemployment, dissatisfaction with income, having had a previous cohabiting relationship and having younger children for both men and women. Reports by the husband of frequency of coughing/snoring at night is significantly associated with their wives’ sleep maintenance among younger couples and vice versa; but among older couples there is only a significant association of husband’s snoring on wife’s sleep. Whilst the current analysis is cross-sectional, further understanding of the dynamic relationships of sleep will be revealed through longitudinal analysis as Understanding Society moves through future waves.
The relationship between health and income is well established, but the link between subjective financial wellbeing and self-assessed health has been relatively ignored. This study investigates the relationship between health, subjective financial wellbeing and income in mid-life and later life in Britain. Analysis of the General Household Survey for 2006 examined these relationships at ages 45-64 (n=4639) and 65 and over (n=3104). Logistic regression analysis was used to adjust for income and other socioeconomic factors linked to self-assessed health. Both income and subjective financial wellbeing are independently associated with health in mid-life; those with lower incomes and greater subjective financial difficulties had higher risk of reporting ‘less than good’ health. In contrast in later life, subjective financial wellbeing was associated with health, but the effect of income on health was mediated entirely through subjective financial wellbeing. The poorer health of the divorced/separated was also mediated entirely by differences in subjective financial wellbeing. Research on health inequalities should pay greater attention to the link between subjective financial hardship and ill-health, especially during periods of greater economic difficulties and financial austerity.
This paper analyzes data from a nationally representative survey of adults in the United Kingdom (Understanding Society, N = 37,253) to explore the marital status/health nexus (using categories that include a measure of relationship distress) and to assess the role that sleep problems play as a potential mediator. Findings indicate how it is not just the "form" marital status takes but also the absence or presence of relationship distress that is essential to self-rated health. We demonstrate two further findings that: (1) sleep problems act as a mediator of the link between marital status/relationship distress and self-rated health, most notably for those in cohabiting relationships with medium/high distress or who have a history of relationship loss, and (2) the mediating role of sleep problems differs for divorced men and women.
Over the past decade, sociological studies have convincingly demonstrated that sleep is a socially, culturally and historically variable phenomenon. How we sleep, when we sleep, where we sleep, what meaning and value we accord sleep, let alone with whom we sleep, vary around the world, both past and present, within and between cultures and within different segments of society. This chapter outlines two interrelated strands of recent sociological work; how (i) sleep is a ‘practice’, which is ‘done’ and ‘negotiated’ with others; and (ii) the problems and prospects surrounding the medicalisation of sleep. The concluding section summarises the importance of sociological studies of sleep for public health.
Background: Artificial intelligence (AI) is said to be “transforming mental health”. AI-based technologies and technique are now considered to have uses in almost every domain of mental health care: including decision-making, assessment and healthcare management. What remains underexplored is whether/how mental health recovery is situated within these discussions and practices. Method: Taking conversational agents as our point of departure, we explore the ways official online materials explain and make sense of chatbots, their imagined functionality and value for (potential) users. We focus on three chatbots for mental health: Woebot, Wysa and Tess. Findings: “Recovery” is largely missing as an overt focus across materials. However, analysis does reveal themes that speak to the struggles over practice, expertise and evidence that the concept of recovery articulates. We discuss these under the headings “troubled clinical responsibility”, “extended virtue of (technological) self-care” and “altered ontologies and psychopathologies of time”. Conclusions: Ultimately, we argue that alongside more traditional forms of recovery, chatbots may be shaped by, and shaping, an increasingly individualised form of a “personal recovery imperative”.
Background: Sleep problems are common amongst people who use alcohol and other drugs, but treatment options are limited. This paper explores how people in residential treatment for alcohol and other drug problems perceived and described ‘non-problematic’ sleep to provide insights that might inform sleep interventions for this population. Methods: Qualitative interviews were conducted with 28 residents (19 women, 9 men; ages 24-83 years) in two residential drug and alcohol treatment centres in England during 2014/15. Interviews were audio-recorded, transcribed, and coded. Accounts of non-problematic sleep were then analysed inductively. Results: Non-problematic sleep comprised three linked components: i. personal sleep patterns and routines; ii. sleep perceptions; and iii. sleep metacognitions. Some participants reported they slept well; others described their sleep as problematic but improving. Participants believed that sleep improved naturally with residential treatment and abstinence, but perceptions of ‘good’ sleep varied greatly. Participants used a range of metacognitive strategies (e.g. downgrading the importance of sleep; adapting their sleeping patterns; and focusing on sleep quality alongside sleep quantity) to manage sleep problems and render them non-problematic. Conclusions: Metacognitive strategies that focus on changing perceptions of sleep can potentially inform sleep interventions for people with a history of alcohol and other drug use.
Study Objectives: To develop a patient reported outcome measure to assess sleep amongst people experiencing problems with alcohol or other drugs. Methods: Item development included secondary analyses of qualitative interviews with drug/alcohol users in residential treatment, a review of validated sleep measures, focus groups with drug/alcohol users in residential treatment, and feedback from drug/alcohol users recruited from community and residential settings. An initial version of the measure was completed by 549 current and former drug/alcohol users (442 in person [IP] and 107 online [OL]). Analyses comprised classical test theory methods, exploratory and confirmatory factor analysis, measurement invariance assessment, and item response theory (IRT). Results: The initial measure (30 items) had good content and face validity, and was named the Substance Use Sleep Scale (SUSS) by addiction service users. After 7 items were removed due to low item-factor loadings, 2 factors were retained and labelled: ‘Mind and Body Sleep Problems’ (14 items) and ‘Substance Related Sleep Problems’ (9 items). Measurement invariance was confirmed with respect to gender, age, and administration format. IRT (information) and classical test theory (internal consistency, stability) indicated measure reliability. Standard parametric and non-parametric techniques supported convergent and discriminant validity. Conclusions: SUSS is an easy-to-complete patient reported outcome measure of sleep for people with drug/alcohol problems. It can be used by those concerned about their own sleep, and by treatment providers and researchers seeking to better understand, assess, and potentially treat sleep difficulties amongst this population. Further validity testing with larger and more diverse samples is now required.
Sleep, until recently, has been a neglected topic or issue within sociology and the social sciences and humanities in general. At first glance this may seem unsurprising given the predominant waking assumptions, concerns or preoccupations of these disciplines. Further reflection, however, reveals the shortcomings of any such neglect or dismissal of sleep as a topic worthy of sociological attention. Sleep is a socially, culturally and historically variable phenomenon. How we sleep, when we sleep, where we sleep, what meaning and value we accord sleep, let alone with whom we sleep, are all important topics of sociological investigation which do not simply vary around the world, both past and present, but within different segments of society and within and between cultures. The nature, quantity and quality of sleep, moreover, is clearly important both for the individual and society in terms of health and safety, productivity and performance, quality of life and well-being. In part a response to this past neglect, and in part a response to broader social trends and transformations regarding sleep, sociologists and others in the social sciences and humanities are now turning their attention to what might broadly be termed the ‘sleep and society’ agenda (Williams 2005; Williams 2008). Sleep, in this respect, is not simply a rich and fascinating sociological topic in its own right, but a valuable new window or way of approaching a range of existing sociological research agendas on issues as diverse as work, health, gender, ageing and family life. This work in turn opens up significant new opportunities to explore the dynamic interrelations between social and biological factors regarding sleep and sleep disruption across the life course. In these and many other ways then, a sociological approach to sleep is not simply long overdue, but a timely and valuable complement to work in related fields of inquiry such as sleep epidemiology and public health which, in similar fashion, take us far beyond the sleep laboratory or sleep clinic to broader issues concerning sleep, health and society. It is therefore to a further consideration and elaboration of this newly emerging sleep and society agenda within sociology that we now turn in this chapter. We outline several strands of recent sociological work - starting with some preliminary points regarding the very conceptualisation and measurement of ‘sleep’ as a methodological backdrop to the sociological themes and issues that follow.
Background: Alcohol and other drug use is associated with poor sleep quality and quantity, but there is limited qualitative research exploring substance users’ experiences of sleep and few psychosocial sleep interventions for them. Aim: To inform the development of psychosocial interventions to improve sleep amongst people reporting drug/alcohol problems. Method: Qualitative data were collected during a sleep survey. Of the 549 drug/alcohol users completing the survey, 188 (34%) provided additional information about their sleep using a free text box. Responses were analysed via Iterative Categorization. Findings were reviewed with reference to the Behaviour Change Wheel (BCW). Results: All data were categorized inductively under five headings: i. sleep quality; ii. nature of sleep problems; iii. sleep and substances; iv. factors improving sleep quality; v. factors undermining sleep quality. Substance use undermined sleep, but poor sleep often persisted after substance use had ceased. Sleep problems were diverse; as were the causes of, and strategies for dealing with, those problems. Causes and strategies had biological, psychological, social, and environmental roots. Conclusions: The BCW facilitated the identification of intervention components that might improve the sleep of people who use substances. These components relate to education, training, enablement, modelling, service provision, guidelines and environment.
Introduction: Proton Beam Therapy (PBT) is often described as an advanced mode of radiotherapy. Whilst PBT offers an equivalent chance of cure to conventional radiotherapy, it is said to offer a theoretical reduction in long term side effects. NHS patients have had access to PBT since 2008 and approximately 65% of the 1144 approved referrals have been for paediatric cases. Yet, there is little research on how parents in these paediatric cases perceive their child’s PBT and the information sources they encounter. Methods: This is a qualitative inquiry informed by in-depth interviews carried out with 27 parents of children treated with PBT. Results: Parents primarily frame PBT as a form of radiation but one which is better than alternatives. Whilst medical professionals do play a role, wider sources of information – such as other families and the internet – are important to both initial decision-making and treatment/recovery experiences. Conclusion: Parents are faced with the challenge of a ‘fragmented expertise’ which comes with the ‘novelty’ of the radiation therapy, the ‘rare’ nature of the tumours and the remote location of clinical specialists. Implications for Practice: This article will prove useful for practitioners dealing with parents and care givers of children undergoing proton therapy, and is especially valuable and timely for practitioners based in the newly installed proton centres in the UK. Two high energy proton centres are expected to become fully operational in the UK by the end of 2020. Understanding parents’ experiences and perspectives can help avoid undue anxiety and lead to service improvements and overall satisfaction.
There is evidence that poor sleep mitigates recovery from substance dependence and increases risk of relapse. However, to date research literature is located within biomedical, clinical and psychological paradigms. To complement the extant work, this article offers a sociological exploration of sleep in the context of recovery from dependence on alcohol and/or other drugs. Drawing on qualitative data generated through interviews with 28 men and women living in residential rehabilitation settings in England, we provide a detailed exploration of sleep practices focussing on how these are enacted throughout the night. We offer the concept of sleepfulness to suggest that sleep should not be understood simply as being other than awake; rather it involves a myriad of associations between diverse actants - human and non human – that come to ‘fill up’, enable and assemble sleep. Together these empirical insights and conceptualisations disturb the ontology of sleep and point to the fulsome dimensions of the category.
This paper reports on a study of sleep amongst men and women who are living in residential rehabilitation centres in the UK and who are receiving support for their recovery from addiction to alcohol and other forms of substance use. Conceptually and methodologically, the paper draws on the work of the French sociologist Lefebvre and, in particular, his rhythmanalysis. We argue that this approach offers a useful way of exploring sleep in terms of biological, experiential, temporal, spatial and social rhythms. It also has the potential to facilitate interdisciplinary dialogue. Empirical data comprising qualitative interviews with 28 individuals, sleep diaries, and actigraphy reports (which measure movement as a proxy for sleep) are examined in combination to generate insights into the challenges associated with sleep in recovery from substance misuse. We examine how sleep in recovery involves an alignment of the spatiotemporal rhythms of rehabilitation and the multiple embodied rhythms of individuals. Institutionalised routines reproduce and impose ideas of day/night sleep cycles which are presumed to accord with ‘natural’ circadian rhythms. Although study participants very much want to achieve these ‘natural hegemonies’ of sleep, alignment of individual and institutional rhythms is difficult to achieve. We develop the notion of ‘sleep waves’ as an analytic to capture the multifaceted elements of sleep and to argue that sleep waves recur but are also shaped by complex networks of rhythms, rituals and routines. Sleep waves can become relatively stabilised in rehabilitation settings, but the anticipation of moving on disturbs rhythms and generates anxieties which can affect recovery.