Elsevier

Social Science & Medicine

Volume 79, February 2013, Pages 40-47
Social Science & Medicine

Medicalisation or customisation? Sleep, enterprise and enhancement in the 24/7 society

https://doi.org/10.1016/j.socscimed.2012.07.017Get rights and content

Abstract

This paper extends and problematises recent sociological research on the medicalisation of sleep, focussing on trends and transformations in the prospective ‘customisation’ of sleep in the 24/7 society. What exactly does customisation mean in this context; how does it relate to the medicalisation of sleep; and how salient or significant are these trends to date in the 24/7 society? These are the key questions this paper seeks to address, taking workplace napping and wakefulness promoting drugs amongst the ‘healthy’ as our comparative case studies. Both we argue, despite their apparent differences and embryonic status to date, provide alternative routes to broadly similar ends. Namely they customise our sleep patterns and practices to fit around the escalating temporal demands of daily life, thereby helping remedy the increasing misalignment between biological and social time. Each, moreover, seeks to improve or optimise safety, productivity and performance in late modern society, where alertness is prized, sleepiness is problematised and vigilance is valorised. The paper concludes with some further reflections on these matters, including relations between the biomedicalisation and the customisation of sleep and a research agenda on the biopolitics of sleep and wakefulness.

Highlights

► Napping and wakefulness promoting drugs provide alternate ways of customizing sleep to meet demands of daily life. ► Each strategy seeks to improve or optimise safety, productivity and performance in the 24/7 society. ► Further research is needed on how sleep medicine affects the way we relate to our bodies.

Introduction

A key strand of recent sociological scholarship on sleep concerns the degree to which it provides another prime example of the medicalisation of society. For all its promise as a rich vein of sociological research, further pertinent questions arise here regarding other forms of sleep ‘management’ in late modern society, which potentially problematise or qualify arguments about the medicalisation of sleep and suggest the need for further elucidation and conceptual clarification.

It is in this context therefore, as a small contribution to this broader enterprise, that this paper is located. In particular we ask whether there are any significant signs that sleep is being ‘customised’ in the so-called 24/7 society and, if so, in what ways and to what degree? We also seek to reflect on where this leaves us in terms of current debates on the medicalisation of sleep and associated research agendas in this newly emerging field of sociological inquiry. More specifically we ask, taking workplace napping and wakefulness promoting drugs amongst the ‘healthy’ as our two case studies, what comparisons and contrasts may be drawn between these two prospective sleep management strategies in late modern society; how salient and significant are they to date and where, precisely, do they fit in relation to these current debates on the medicalisation of sleep and society?

The paper builds in new ways on both our own previous sociological work on the medicalisation and politics of sleep (Williams, 2011, 2005; Williams, Seale, Boden, Lowe, & Steinberg, 2008) and other recent research on medico-managerial agendas regarding sleep (Brown, 2004; Hancock, Williams, & Boden, 2009) and the changing fate and fortunes of practices like the workplace nap in a global context (Baxter & Kroll-Smith, 2005). Whilst important work has also recently been done on sleeping cultures in Asia and the West, both past and present (cf. Brunt & Steger, 2008; Steger, 2003), the main focus in this paper, given our concerns and expertise, is primarily on the latter, particularly the North American and Northern European context in this latest phase of so-called ‘late’, ‘fast’, ‘flexible’ or ‘post-Fordist’ capitalism (Harvey, 1989).

Our ‘data’ come in a variety of forms, including both existing relevant studies and other documentary sources bearing on these themes. Due to the limited nature of the data that are at our disposal, however, our discussion of the workplace nap focuses mainly on ‘upstream’ issues whereas our discussion of wakefulness promoting drugs also draws on data from interviews and surveys about the prospective use and meaning of such drugs in everyday life (i.e. more ‘downstream’ issues). As for the ‘novelty’ of the trends we document, on the one hand of course they may legitimately be considered part and parcel of a long history of attempts to manage or modify our sleep, with or without the aid of drugs. On the other hand, we suggest they signal significant, if embryonic, attempts to optimise or perhaps eventually optionalise sleep in late modern society.

All this however begs prior questions regarding the very ‘problematisation’ of sleep today, including medicalising trends and associated issues to do with framing sleep through the health, risk and lifestyles nexus. We start, therefore, with a brief sketch of these trends as a backdrop to the themes and issues that follow in the main part of the paper, where workplace napping and wakefulness promoting drugs are compared and contrasted.

Section snippets

Problematisation/medicalisation? Sleep, health and risk

Professional and public concern is increasingly voiced about the relentless nature of life today where sleep is all too frequently sacrificed in favour of other demands, desires or dictates. Sleep problems, it is claimed, are endemic in contemporary society given the transition to a 24/7 global age and the advent of an on-line digital culture to keep us from our beds, or leave us tossing and turning in them, in a wired-awake world of work and worries. It is not our intention to rehearse these

Transformation and optimisation? Sleep, safety and performance

Our contention is that sleep today is not simply being medicalised but customised in various ways that problematise existing notions of normality and abnormality, health and illness. Customisation, for our purposes, denotes the ways in which sleep is being reframed or reconfigured in order to improve, enhance or optimise not simply health but safety, productivity and performance in late modern society.1

Conclusion

In this paper, we have argued that sleep is not simply being problematised or medicalised through expert-led discourses and debates on the risks of poor sleep for society. Instead it is being ‘customised’ in the post-Fordist Western world in ways that potentially at least, both now and in the near future, take us beyond existing notions of normality and abnormality, health and illness, to wider questions of safety, productivity and performance, if not enhancement and optimisation.

Both workplace

Acknowledgements

The authors should like to thank Stefan Timmermans and two anonymous reviewers for their helpful comments on an earlier draft of this paper.

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