Insomnia as a Social Construct...

jrlewis's picture

Senior Seminar in Biology and Society
October 20, 2009
Julia Lewis

I would like to explore the role of society in current understandings of insomnia as a disease, symptom, or social construct.  To that end, I chose a broad range of readings including cultural, medical, and scientific perspectives on insomnia and sleep.  Hopefully these readings will help inform a conversation about the significance of sleep and its absence in human beings.

(Please download the full text pdfs of the articles)

role of sleep

http://www.nytimes.com/2009/09/01/health/01mind.html?scp=1&sq=insomnia&st=cse

narcolepsy

http://www.nytimes.com/2007/10/23/science/23narc.html?ref=science

neuro-imaging evidence of insomnia

http://ajp.psychiatryonline.org/cgi/content/full/161/11/2126

insomnia following tramatic brain injury

http://neuro.psychiatryonline.org/cgi/content/full/11/4/504

study of insomnia in Japanese factory workers

http://www3.interscience.wiley.com/cgi-bin/fulltext/120846067/HTMLSTART

drug treatments for substance abusing insomniacs

http://www.psychiatrictimes.com/display/article/10168/54141

acupuncture as a treatment for insomnia

http://www3.interscience.wiley.com/journal/119965794/abstract

problems with the sleep/insomnia paradigm

http://www3.interscience.wiley.com/journal/119160134/abstract

insomnia and culture

http://www3.interscience.wiley.com/journal/119965790/abstract
 

Comments

Lisa B.'s picture

Factors Influencing Sleep Disturbance in Women

 

A study on sleep disturbance reported that women had a higher rate of insomnia than men (Breslau et al. 1996).  If these results were verified in future studies, then what are some unique factors that contribute to the greater occurrence of women with sleeping disorders? Are hormonal or genetic factors the only explanation, or could certain personality characteristics of women influence sleep patterns?   

 

Anna Dela Cruz's picture

I, for one, think that

I, for one, think that lifestyle and environment have as much influence on sleep patterns as biological factors (i.e. hormones and genes as mentioned). I didn't read the aforementioned study but I'm curious to know if the women participants had been experiencing significant stresses in their lives at the time such as motherhood and work-related issues that might contribute to a higher rate in sleep disturbances compared to men. I'm not a mother myself, but I know that my own mother has often stayed awake at night worrying about me. A little anecdote to share: one night a she had a dream that I had gotten tattoos left her with such an unsettling feeling that she got out of bed, walked into my room, and checked my skin as I slept.

I also think that sleep patterns are malleable. Speaking as a notorious procrastinator and hence a veteran all-nighter, I have experienced insomnia after a few nights of forcing myself not to sleep.  

Paul Grobstein's picture

sleep variations, science, and norms: could we do better?

Lots of interesting conversation, both about sleep and sleep patterns, as well as about more general issues that arise from thinking about that as a specific case of categories and research directions.

Re sleep itself, the relevant article I mentioned is Awakening to Sleep.  Among other things, the article describes a study by Thomas Wehr ...

 

in the night and once in the early morning, Wehr's volunteers woke out of REM sleep, which is strongly associated with dreaming, into a period of quiet wakefulness quite distinct from daytime wakefulness ...'  'It is tempting to speculate,'' Wehr writes, ''that in prehistoric times this arrangement provided a channel of communication between dreams and waking life that has gradually been closed off as humans have compressed and consolidated their sleep. If so, then this alteration might provide a physiological explanation for the observation that modern humans seem to have lost touch with the wellspring of myths and fantasies.''

 

It is well worth thinking more about the issue of whether contemporary understandings of sleep, scientific and otherwise, reflect primarily contemporary observations, and that there may well be contemporary cultural factors that significantly influence those observations in ways that may obscure a clearer understanding of sleep.

This is, of course, a more general issue about science and research, as are other issues that came up in our conversation.  Is there a "norm" sleep pattern that all people should exhibit, with all other sleep patterns then being seen as "disturbances," ie as openings for therapeutic intervention?  Is it useful to think of "disturbed" sleep patterns as either "primary" or "secondary," ie to distinguish between sleep "abnormalities" due to alterations in the mechanisms regulating sleep regulation itself as opposed to alterations in other things that in turn affect sleep patterns?

Like much of the rest of culture, science tends to presume that there are "norms" and all deviations from the norm are "disturbances."  And knowledge can certainly advance with such presumptions. Perhaps though its time to reflect on the recurring pattern of discovering that "norms" are a human construction, and that over time one discovers that it is not norms but variability that is the rule? (sex/gender, healthy versus cancerous, healthy versus infected).  Do we actually need to presume the value of "generalizations" to do science?  Is it essential to science to try and get reliable rather than "noisy" results?  Might we instead do equally well advancing understanding by starting with variation?  The issue is particularly important since the generalizations science starts with often become (or reify) cultural norms and, in so doing, may make perfectly "healthy" individuals unhealthy.   A "practical" approach may help sometimes but may also often create problems that a more "philosophical" approach might not.    

RachelBrady's picture

<"The issue is particularly

<"The issue is particularly important since the generalizations science starts with often become (or reify) cultural norms and, in so doing, may make perfectly "healthy" individuals unhealthy.">

Couldn’t this ^ be a misuse of scientific findings, extending the results outside of the context, and not necessarily something wrong with generalizing itself?

For some odd reason I'm having a hard time abandoning "generalizations". In practice I frequently work from general in order to get to more complex or specific. Especially when learning science you first deal with how things 'should; behave in ideal conditions, and then look at how they actually behave and ways to account for some variation. I'm not saying that this is in any way a sort of 'golden rule' for science, but I find it so inherent in my natural thought process to function in take sort of progression where I work from general assumptions and asses variation and specification from there. (If the variant don't make sense in terms of the general parameters, I start over from my assumptions)

 

RachelBrady's picture

Generalizing

This idea of generalization being contrary to science has been plaguing me, especially when we have been discussing the use of classification in science. Things in the natural world with similar characteristics are usually grouped and defined into classes. The act of identifying and categorizing similar objects into classes is known as classification. The relationships of classes can be organized into a class hierarchy using generalization and variation concepts. The technique of generalizing is an important technique in handling the infinite variation present in the natural world. This is not to say that generalization is the paramount technique, I think of it more as a starting point in order to facilitate understanding of the relationships and laws in the natural world without having to invent new theories for each variant.

jrlewis's picture

generalizations=stories

I take generalizations to be roughly equivalent to the scientific stories Dr. Grobstein describes and paradigms that Thomas Kuhn characterized.  All three are useful constructs.  The difference I see between them is that generalizations are more stable.  Generalizations are less likely to be revised or changed.  Any effort to modify a generalization to accomodate new data presents a problem for the organizational scheme relaint upon the generalization.  There is a conflict here!  I don't see how generalizations allow for progress.  Stories invite revision and paradigms scientific revolutions. 

jrlewis's picture

example of a secondary sleep disorder...

Sleep disturbance is a common symptom of Parkinson's Disease.  There are many potential explanations for poor sleep quality among these patients.  Problems range from physical discomfort to terrifying hallucinations and nightmares that result in trouble falling asleep and frequent awakenings.  The primary treatment for Parkinson's disease are drugs that increase the brain's levels of dopamine.  This change in neurochemistry has been implicated in troubled sleep patterns.  Depression is also common in these patients and causes sleep distubances.  Therefore, it is unclear whether insomnia is a symptom of Parkinson's Disease, a symptom of a comorbid condition, or side effect of treatment.  What's known is that insomnia significantly decreases patient's adn care givers quality of life. 

For more info see: http://www.springerlink.com/content/331v65185l410261/

jrieders's picture

rats?

http://www.ncbi.nlm.nih.gov/pubmed/19816984?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

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