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.
Meadows RAL (2008) The rights and duties of the sleeper, Virtual Mentor (American Medical Association Journal of Ethics) (10) pp. 585-588
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.
Meadows RAL (2007) Risk, In: Flood M, Gardiner K, Pease B, Pringle K (eds.), Routledge international encyclopaedia of men and masculinities Routledge
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.
Arber S, Meadows R, Venn S (2012) Sleep and Society, In: Morin CM, Espie CA (eds.), The Oxford Handbook of Sleep and Sleep Disorders 11 pp. 223-247
Oxford University Press
This chapter demonstrates how sleep is inextricably linked to ?society?. Part 1 illustrates how sleep and its disorders are historically and culturally divergent and that ?where?, ?why? and ?how? we sleep differ depending on the society in which we live. Part 2 focuses in more detail on the ?private? nature of Western sleep. Sleep is affected by the social context where it occurs, and is thus influenced by household composition, power, gender, social roles and life course position. Finally, we examine sleep in care-giving and institutional contexts, where sleep is not only ?observed?, but may be disturbed by those undertaking care or surveillance at night. Sleep is also socially patterned with the socially disadvantaged most likely to report sleep problems.
Meadows RAL (2012) Denying death's counterfeit?: the sociological aspects of sleep, In: Green A (eds.), Sleep: multi-professional approaches Jessica Kingsley
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.
Meadows RAL (2007) Epistemology, In: Flood M, Gardiner K, Pease B, Pringle K (eds.), Routledge International Encyclopaedia of men and masculinities Routledge
Meadows RAL (2008) Older men's sleep: function and 'narratives of decline', Generations 32 (1) pp. 28-31
Williams SJ, Coveney C, Meadows RAL (2015) ?M-apping? Sleep? Trends and Transformations in the Digital Age., Sociology of Health and Illness: a journal of medical sociology 37 (7) pp. 1039-1054
This article critically explores recent trends and transformations in the monitoring and management of sleep in the digital age, taking as its focus the advent of new digital technologies to trace and track the 'sleep of ourselves' far away from the conventional sleep laboratory or clinic. Our argument is situated dually in the history of sleep science and medicine on the one hand, and the rise of new digital forms of so-called self-tracking and mobile health (m-Health) on the other hand. While the recent history of sleep science and medicine may rightly we suggest, in Kroker's terms, be characterised as a concern with the 'sleep of others', a new chapter in this story may well be dawning through the advent of these smart new mobile tools and technologies for mapping, or 'm-apping' as we term it, the 'sleep of ourselves' in the digital age. The problems and prospects this holds are then critically considered - through the interrelated themes of selfhood, sociality and governance - and some preliminary conclusions ventured in this new digital domain.
Meadows RAL (2014) Review of "Late Capitalism and the ends of sleep", Work, Employment and Society 28 (5) pp. 838-839
Meadows Robert, Williams S, Gabe J, Coveney C (2010) The Sociology of sleep, In: Cappuccio F, Miller M, Lockley S (eds.), Sleep, Health and Society: From Aetiology to Public Health (13) 13 pp. 275-299
Oxford University Press
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.
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.
Boyle J, Meadows RAL, Degia A, Hindmarch A (2004) Impairment of driving ability: The assessment of the pharmacodynamics of psychoactive compounds, Neuropsychiatrie 18 (3-4) pp. 86-99
Boyle J, Ridout F, Meadows RAL, Johnsen S, Hindmarch I (2005) Suppression of the histamine-induced wheal and flare response by fexofenadine HCI 60mg twice daily, loratadine 10mg once daily and placebo on healthy Japanese volunteers, Current Medical Research and Opinion 21 (9) pp. 1495-1503
Arber S, Bote M, Meadows RAL (2009) Understanding how socio-economic status, gender and marital status influence self-reported sleep problems in Britain, Social Science and Medicine 68 pp. 281-289
Degia A, Meadows RAL, Johnsen S, Hindmarch I, Boyle J (2005) Development of a portable psychometric testing device for use in the field: an alcohol investigation, Perceptual and Motor Skills 101 (2) pp. 383-392
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.
Meadows RAL, Arber S (2015) Marital status, relationship distress and self-rated health: what role for ?sleep problems??, Journal of Health and Social Behavior 56 (3) pp. 341-355
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.
Arber S, Meadows R (2011) Social and health patterning of sleep quality and duration, In: McFall S, Garrington N (eds.), Understanding Society: Early findings from the first wave of the UK?s Household Survey Institute for Social Research.
Degia A, Meadows RAL, Johnsen S, Dixon P, Hindmarch I, Boyle J (2006) Investigation into the suitability of a portable psychometric device to be used in the field: an illicit drugs field investigation, Journal of clinical forensic medicine 13 (5) pp. 242-246
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.
Meadows RAL, Stanley N, Venn S, Hislop J, Arber S (2005) Completely unattended home sleep recordings, Sleep 28 (4) pp. 526-526
Cooper G, Meadows RAL (2015) Conceptualising Social Life, In: Stoneman P, Gilbert N (eds.), Researching Social Life Sage
Luff R, Meadows R, Eyers I, Cope E, Arber S (2009) REST-ACTIVITY FRAGMENTATION IN OLDER PEOPLE LIVING IN CARE HOMES, GERONTOLOGIST 49 pp. 206-207 GERONTOLOGICAL SOC AMER
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.
Sleep disturbances are a common problem among institutionalised older people. Studies have shown that this population experiences prolonged sleep latency, increased fragmentation and wake after sleep onset, more disturbed circadian rhythms and night-day reversal. However, studies have not examined the extent to which this is because of individual factors known to influence sleep (such as age) or because of the institutional environment. This paper compares actigraphic data collected for 14 days from 122 non demented institutional care residents (across 10 care facilities) with 52 community dwelling poor sleepers aged over 65. Four dependent variables are analysed: i) the ?interdaily stability? (IS); ii) the ?intradaily variability? (IV); iii) the relative amplitude (RA) of the activity rhythm; and iv) the mean level of activity during the 24 hour day. Data are analysed using a fixed effects, single level, model (using MLwiN). This model enables comparisons between community and institutional care groups to be made whilst conditioning out possible ?individual? effects of ?age?, ?gender?, ?level of dependency?, ?level of incontinence care?, and ?number of regular daily/prescribed medications?. After controlling for the effects of a range of individual level factors, and after controlling for unequal variance across groups (heteroscedascity), there is little difference between community dwelling older adults and institutional care residents in IS score; suggesting that the stability of day to day patterns (such as bed times, get up times, lunch times etc) is similar within these two resident groups. However, institutional care residents do experience more fragmented rest/wake patterns (having significantly higher IV scores and significantly lower mean activity values). Our findings strongly suggest that the institutional care environment itself has a negative association with older people?s rest/wake patterns; although longitudinal studies are required to fully understand any causal relationships.
Meadows RAL (2016) The importance of viewing sleep as a 'practice', Addiction 11 (6) pp. 1094-1095
There is now a growing body of work which highlights how sleep can affect addiction/dependence and vice versa. Irwin and colleagues add further, valuable, detail to this. Individuals can have very different concepts of sleep depending on their experiences and circumstances and these need to be taken into account in future research and treatment discussions.
Ridout F, Meadows RAL, Johnsen S, Hindmarch I (2003) A placebo controlled investigation into the effects of paroxetine and mirtazapine on measures relating to car driving performance, Human psychopharmacology: Clinical & Experimental 18 (4) pp. 261-269
Ridout F, Shamsi Z, Meadows RAL, Johnsen S, Hindmarch (2003) A single-centre, randomized, double-blind, placebo-controlled, cross-over investigation of the effects of fexofenadine hydrochloride 180mg alone and with alcohol, with hydroxyzine hydrochloride 50mg as positive internal control, on aspects of cognitive and psychomotor function related to driving a car, Clinical Therapeutics 25 (5) pp. 1518-1538
This paper 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.
Arber SL, Fenn K, Meadows R (2014) Subjective financial well-being, income and health inequalities in mid and later life in Britain, Social Science and Medicine 100 pp. 12-20 Elsevier
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.
Davidson K, Meadows R (2010) Older men?s health: the role of marital status and masculinities, In: Gough B, Robertson S (eds.), Men, masculinities and health: critical perspectives Palgrave
Meadows RAL, Davidson K (2006) Maintaining manliness in later life: Hegemonic masculinities and emphasized femininities, In: Calasanti T, Slevin K (eds.), Age matters: Realigning feminist thinking Routledge
Meadows RAL (2014) Review of Sociologies of Interaction, Sociology
Arber S, Hislop J, Bote M, Meadows RAL (2007) Gender roles and women?s sleep in mid and later life: A quantitative approach, Sociological Research Online
Hindmarch I, Johnsen S, Meadows RAL, Kirkpatrick T, Shamsi Z (2001) The acute and sub-chronic effects of levocetirizine, cetirizine, loratedine, promethazine and placebo on cognitive function, psychomotor performance and weal and flare., Current medical research and opinion 17 (4) pp. 241-255
Meadows RAL (2005) The negotiated night: An embodied conceptual framework for the sociological study of sleep, The Sociological Review 53 (2) pp. 240-254
Meadows RAL, Venn S, Hislop J, Stanley N, Arber S (2005) Investigating couples? sleep: An evaluation of actigraphic analysis techniques, Journal of Sleep Research 14 (4) pp. 377-386
Meadows RAL (2014) Disease, In: Kimmel M, Kennedy A, Milrod C (eds.), Cultural Encyclopedia of the Penis pp. 1-2
Rowman and Littlefield
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.
To develop a patient reported outcome measure to assess sleep amongst people experiencing problems with alcohol or other drugs.
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).
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.
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.
Children with Cerebral Palsy (CP) account for the largest group of children with a physical disability in the UK. Despite evidence that sleeplessness occurs commonly in children with CP, there is little in-depth research on their sleep. Previous research has relied on the viewpoints of parents, mainly mothers. No research has explored sleep from multiple family members? perspectives within the same family. This study explores the meanings, organisation and practice of sleep for children with CP, their siblings and their parents.
This qualitative study of 10 families involves 10 children with CP (aged 6-13 years), 7 siblings (from 5 families) and 17 parents. Influenced by existing literature on involving disabled children in research, qualitative semi-structured interviews are supplemented by data from children?s self-directed photography and sleep questionnaires, 2 week sleep diaries and actigraphy for all participants.
Findings emphasise the importance of the social and family context of sleep. For children, the bedtime routine was significant with reference to their practice of sleep and differences were highlighted dependent on age and severity of CP. Night-time interactions with parents were important for children with severe CP experiencing sleeplessness. For some children, the use and location of their bedrooms enabled the attainment of privacy and autonomy. However, differences, regarding these factors, were found between children with severe CP and those without. Night-time parental monitoring of children with severe CP was common but methods differed depending on a number of intersecting factors including severity of the child?s CP, location of bedrooms and co-existing health issues. Different methods of monitoring had varying degrees of impact on parents? sleep and on privacy for the child with CP. Co-sleeping was engaged in by a small number of parents with their disabled child at specific times and used as a strategy to protect the sleep of family members.
Meadows Robert, Williams S, Gabe J, Coveney C, Arber Sara (2018) The Sociology of Sleep, In: Cappuccio F, Miller M, Lockley S, Rajaratnam S (eds.), Sleep, Health and Society: From Aetiology to Public Health pp. 171-178
Oxford University Press
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: 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.
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.
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.
This is a qualitative inquiry informed by in-depth interviews carried out with 27 parents of children treated with PBT.
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.
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.