Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-10T21:02:31.792Z Has data issue: false hasContentIssue false
  • English
  • Français

Pharmaceuticalisation and the social management of sleep in old age

Published online by Cambridge University Press:  06 March 2017

ELSA PEGADO ,
NOÉMIA LOPES  and
JOANA ZÓZIMO
ELSA PEGADO*
Affiliation:
Egas Moniz, Centro de Investigação Interdisciplinar (CiiEM), Caparica, Portugal. Centro de Investigação e Estudos de Sociologia (CIES-IUL/ISCTE), Lisbon, Portugal.
NOÉMIA LOPES
Affiliation:
Egas Moniz, Centro de Investigação Interdisciplinar (CiiEM), Caparica, Portugal. Centro de Investigação e Estudos de Sociologia (CIES-IUL/ISCTE), Lisbon, Portugal.
JOANA ZÓZIMO
Affiliation:
Egas Moniz, Centro de Investigação Interdisciplinar (CiiEM), Caparica, Portugal. Centro de Estudos Sociais (CES-UC), Coimbra, Portugal.
*
Address for correspondence: Elsa Pegado, Egas Moniz, Centro de Investigação Interdisciplinar (CiiEM), Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal E-mail: elsa.pegado@iscte.pt
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper discusses sleep as a social phenomenon, analysing it in the older population within the frame of a growing pharmaceuticalisation of conditions associated with old age. Two analytical dimensions are privileged: one pertains to patterns of sleep in old age, showing these patterns to be socially differentiated; while another has to do with the subjective experience of sleep, particularly in terms of the social meanings attributed to sleep as well as the strategies employed to manage it. These strategies may be therapeutic or non-therapeutic, as an expression of different rationales favouring or resisting the pharmaceuticalisation of sleep. This analysis is empirically based on data from a research project on the consumption of psychopharmaceuticals among the older population, in an urban context in Portugal. The research methodology followed a mixed-methods approach: a survey was deployed to a sample of individuals aged 65 years and over (N = 414); and life history interviews were conducted with a number of respondents (N = 30) from the previous survey. Both techniques included individuals with physical and cognitive autonomy, living at home or in institutional settings. The results reveal a considerable social adherence to the use of pharmaceuticals to manage sleep problems, although consumption practices are socially differentiated in terms of gender, age and living contexts. They also reveal the use of non-therapeutic strategies, stemming from a resistance to the pharmaceuticalisation of sleep.

Keywords

older populationpharmaceuticalisationsleep patternssleep management
Type
Article
Information
Ageing & Society , Volume 38 , Issue 8 , August 2018 , pp. 1645 - 1666
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arber, S., Hislop, J., Bote, M. and Meadows, R. 2007. Gender roles and women's sleep in mid and later life: a quantitative approach. Sociological Research Online, 12, 5. Available online at http://www.socresonline.org.uk/12/5/3.html [Accessed 2 December 2015].CrossRefGoogle Scholar
Collin, J. 2003. Médicament et vieillesse: trois cas de figure. Anthropologie et Sociétés, 27, 2, 119–38.Google Scholar
Conrad, P. 1992. Medicalisation and social control. Annual Review of Sociology, 18, 209–32.Google Scholar
Coveney, C. M. 2014. Managing sleep and wakefulness in a 24-hour world. Sociology of Health & Illness, 36, 1, 123–36.Google Scholar
Elias, T. and Lowton, K. 2014. Do those over 80 years of age seek more or less medical help? A qualitative study of health and illness beliefs and behaviour of the oldest old. Sociology of Health & Illness, 36, 7, 970–85.Google Scholar
Flick, U., Garms-Homolová, V. and Röhnsch, G. 2012. ‘And mostly they have a need for sleeping pills’: physicians’ views on treatment of sleep disorders with drugs in nursing homes. Journal of Aging Studies, 26, 4, 484–94.CrossRefGoogle ScholarPubMed
Gabe, J., Coveney, C. M. and Williams, S. J. 2015. Prescriptions and proscriptions: moralising sleep medicines. Sociology of Health & Illness, 38, 4, 627–44.CrossRefGoogle ScholarPubMed
Henry, D., Knutson, K. L. and Orzech, K. M. 2013. Introduction. Sleep, culture and health: reflections on the other third of life. Social Science & Medicine, 79, 1–6.Google Scholar
Hislop, J. and Arber, S. 2003 a. Sleepers wake! The gendered nature of sleep disruption among mid-life women. Sociology, 37, 4, 695–711.CrossRefGoogle Scholar
Hislop, J. and Arber, S. 2003 b. Understanding women's sleep management: beyond medicalization-healthicization? Sociology of Health and Illness, 25, 7, 815–37.Google Scholar
Infarmed 2014. Psicofármacos: evolução do consumo em Portugal continental (2000–2012) [Psychopharmaceuticals: Evolution of Consumption in Mainland Portugal (2000–2012)]. Available online at http://www.infarmed.pt/documents/15786/17838/psicofarmacos_relatorio2013+(1).pdf/3e52568f-7f90-47c8-9903-d128395c73e5 [Accessed 2 May 2016].Google Scholar
Instituto Nacional de Estatística 2012. Mais de um milhão e duzentos mil idosos vivem sós ou em companhia de outros idosos [Over One Million Two Hundred Thousand Elders Live Alone or in the Company of Other Elders]. Available online at https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_destaques&DESTAQUESdest_boui=134582847&DESTAQUESmodo=2 [Accessed 27 April 2016].Google Scholar
Jick, T. D. 1979. Mixing qualitative and quantitative methods: triangulation in action. Administrative Science Quarterly, 24, 4, 602–11.Google Scholar
Lassere, A., Younés, N., Blanchon, T., Cantegreil-Kallen, I., Passerieux, C., Thomas, G., Chan-Chee, C. and Hanslik, T. 2010. Psychotropic drug use among older people in general practice: discrepancies between opinion and practice. British Journal of General Practice, 60, 573, 156–62.Google Scholar
Lopes, N. (ed.). 2010. Medicamentos e Pluralismo Terapêutico: Práticas e Lógicas Sociais em Mudança [Medicines and Therapeutic Pluralism: Social Practices and Logics in Change]. Afrontamento, Porto, Portugal.Google Scholar
Lopes, N., Clamote, T., Raposo, H., Pegado, E. and Rodrigues, C. 2012. O natural e o farmacológico: padrões de consumo terapêutico na população portuguesa [The natural and the pharmacological: patterns of therapeutic consumption in the Portuguese population]. Saúde & Tecnologia, 8, 5–17.Google Scholar
Lopes, N., Clamote, T., Raposo, H., Pegado, E. and Rodrigues, C. 2015. Medications, youth therapeutic cultures and performance consumptions: a sociological approach. Health, 19, 4, 430–48.Google Scholar
Luff, R., Ellmers, T., Eyers, I., Cope, E. and Arber, S. 2011. Time spent in bed at night by care homes residents. Ageing & Society, 31, 7, 1229–50.Google Scholar
Mauritti, R. 2004. Padrões de vida na velhice [Life patterns in old age]. Análise Social, XXXIX, 171, 339–63.Google Scholar
Meadows, R. 2005. The negotiated night: an embodied conceptual framework for the sociological study of sleep. The Sociological Review, 53, 2, 240–54.CrossRefGoogle Scholar
Pegado, E. 2010. Consumos terapêuticos e investimentos de saúde [Therapeutic consumptions and health investments]. In Lopes, N. (ed.), Medicamentos e Pluralismo Terapêutico: Práticas e Lógicas Sociais em Mudança. Afrontamento, Porto, Portugal, 223–66.Google Scholar
Pound, P., Britten, N., Morgan, M., Yardley, L., Pope, C., Daker-White, G. and Campbell, R. 2005. Resisting medicines: a synthesis of qualitative studies of medicine taking. Social Science & Medicine, 61, 1, 133–55.CrossRefGoogle ScholarPubMed
Raposo, H. 2010. Consumos terapêuticos, percepção e gestão do risco [Therapeutic consumptions, risk perception and management]. In Lopes, N. (ed.), Medicamentos e Pluralismo Terapêutico: Práticas e Lógicas Sociais em Mudança. Afrontamento, Porto, Portugal, 159–222.Google Scholar
Rodrigues, C. 2010. Consumos terapêuticos: notas e reflexões metodológicas [Therapeutic consumptions: methodological notes and reflections]. In Lopes, N. (ed.), Medicamentos e Pluralismo Terapêutico: Práticas e Lógicas Sociais em Mudança. Afrontamento, Porto, Portugal, 267–82.Google Scholar
Taylor, B. 1993. Unconsciousness and society: the sociology of sleep. International Journal of Politics, Culture and Society, 6, 3, 463–71.Google Scholar
Venn, S. and Arber, S. 2011. Daytime sleep and active ageing in later life. Ageing & Society, 31, 2, 197–216.Google Scholar
Venn, S. and Arber, S. 2012. Understanding older peoples’ decisions about the use of sleeping medication: issues of control and autonomy. Sociology of Health & Illness, 34, 8, 1215–29.Google Scholar
Venn, S., Meadows, R. and Arber, S. 2013. Gender differences in approaches to self-management of poor sleep in later life. Social Science & Medicine, 79, 1, 117–23.Google Scholar
Williams, S. J. 2002. Sleep and health: sociological reflections on the dormant society. Health, 6, 2, 173–200.Google Scholar
Williams, S. J. 2004. Beyond medicalization-healthicization? A rejoinder to Hislop and Arber. Sociology of Health & Illness, 26, 4, 453–59.Google Scholar
Williams, S. J. 2011. The Politics of Sleep: Governing (Un)consciousness in the Late Modern Age. Palgrave Macmillan, New York.Google Scholar
Williams, S. J. and Bendelow, G. 1998. The Lived Body: Sociological Themes, Embodied Issues. Routledge, London.Google Scholar
Williams, S. J., Coveney, C. and Gabe, J. 2013. Medicalisation or customisation? Sleep, enterprise and enhancement in the 24/7 society. Social Science & Medicine, 79, 40–7.CrossRefGoogle ScholarPubMed
Williams, S. J., Seale, C., Boden, S., Lowe, P. and Steinberg, D. 2008. Waking up to sleepiness: Modafinil, the media and the pharmaceuticalisation of everyday/night life. Sociology of Health & Illness, 30, 6, 839–55.Google Scholar
Wolf-Meyer, M. 2008. Sleep, signification and the abstract body of allopathic medicine. Body and Society, 14, 4, 93–114.Google Scholar