0730 - Medicalisation of Sleep and Wakefulness - RM

Question 1

What are the 5 elements of the medicalisation process (key concept for exam)

Answer 1

1. Biologically plausible explanation for the illness (believable that it would have physiological health effects)
2. Something that speaks to a current preoccupation in society - people view it as important
3. There is an ‘authority’ within medicine to deal with it - e.g. respiratory physicians dealing with sleep disorders.
4. There is a method of diagnosis - e.g. a diagnostic sleep clinic.
5. There is an acceptable treatment.

Question 2

In sociological theory, medicalisation is often constructed as being disempowering for patients? When (and why) might patients regard medicalisation as empowering?

Answer 2

In a delegitimised illness. A good example of medicalisation as empowering process is the medicalisation of fatigue into chronic fatigue syndrome (or other fatiguing illesses). Patients who felt their legitimacy as ill people questioned, found that the diagnosis of CFS reinforced the legitimacy of their illness. Medicalisation can be empowering because it gives patients the licence to be sick/adopt the sick role – so it’s particularly useful when the symptoms are disabling and common.

Question 3

Why is sleep apnoea considered (at this stage) a partially medicalised condition?

Answer 3

Sleep apnoea is incompletely medicalised because the current treatment (CPAP machines which are noisy and cumbersome) is often not acceptable to patients.

Question 4

What’s the connection between SIDS and sleep apnoea?

Answer 4

SIDS helped redefine sleep as a period of danger – potentially life-threatening. Sleep had previously been regarded as a time of replenishment or revelation, but not a state in which one could mysteriously die. The recasting of sleep as dangerous was revisited a decade later when sleep apnoea became a widely-used diagnosis. The popular understanding of SIDS as arbitrary reconnected the ideas of sleep and danger for sufferers of sleep apnoea.

Question 5

Outline the arguments for and against the pharmaceutical enhancement of wakefulness.

Answer 5

FOR:

Enhances cognitive capacity in the weary so useful for sleep-deprived persons (military personnel, students)

Enables us to double our effective living time

Makes society more effective in a global economy (can keep industry working efficiently through the night; you can communicate with colleagues in different time zones without one of you feeling like you have been hammered with a saucepan)

AGAINST

We are uncertain of the long-term consequences are of chronic sleep ablation (sleep, for example, is the time of many neurophysiological events, like secretion of growth hormone)

Potential risk of losing leisure time

There may be a social or economic compulsion to take wakefulness enhancers for industry to be competitive