Editors' Introduction: Gender, Sleep and the Life Course

by Sara Arber, Jenny Hislop and Simon Williams
University of Surrey; Keele University; University of Warwick

Sociological Research Online 12(5)19
<http://www.socresonline.org.uk/12/5/19.html>
doi:10.5153/sro.1628

Received: 28 Sep 2007     Accepted: 28 Sep 2007    Published: 30 Sep 2007


Introduction

1.1 We spend approximately a third of our lives asleep, and getting sufficient sleep is fundamental to most aspects of our waking lives. Yet surprisingly, despite the increased interest of sociologists in researching everyday lives, there has been little interest in studying sleep as part of everyday/night life. Consideration of how sleeping lives differ for children, young people, parents, and older people, remains relatively unexplored. Moreover, we know little about how sleeping in family contexts, sleeping alone, in institutional settings or on the streets impacts on sleep quality.

1.2 Sleep is embedded in the social context of everyday life. It often takes place in a shared sleeping context, for example, partners sleeping in the same bed or room, and for older people shared sleeping in a residential or other type of institutional context. Sleep provides a window onto understanding how gender is played out in relationships between partners, parental-child relationships, and other caring relationships.

1.3 Apart from sleep providing a lens through which gender roles and other power relationships within families or institutional settings are brought into sharp relief, sleep also has societal importance. In our 24/7 society, the night-time may not be a silent expanse but be populated or be interrupted by mobile phone communications (especially among children and young people), use of the internet/TV, as well as paid work (through shift-work and 'taking-home' work performed at night). Families and individuals are embedded within neighbourhood social environments, which may disrupt sleep in myriad ways, whether through noisy neighbours, car alarms, or traffic noise. These night-time environmental disturbances may themselves by socially patterned.

1.4 Many years of research by sleep scientists have pointed to the links between sleep, health and well-being. Sleep, these findings suggest, is crucial to cognitive functioning and memory consolidation. Lack of sleep, in turn, has been linked with higher levels of mortality, reduced liver and immune system functioning, and increased risk of obesity and diabetes. Sleep disruption and lack of sleep is also a major cause of road and work-related accidents. These findings, facts and figures are regularly voiced, in professional and popular culture, as cause for concern. Sleepiness, as such, is now construed as an 'at risk' state, with significant costs and consequences for personal and public health, safety and well-being. At one and the same time, many millions of sleeping tablets are prescribed each year (particularly for older people) for those in search of a 'good' nights sleep. Wakefulness promoting drugs are also now available for those experiencing 'excessive' levels of sleepiness. These links between sleep and health then may provide another spur for sociologists to turn their gaze to sociological understandings of sleep and its connections to broader sociological debates on health, medicine and society.

1.5 This special section of Sociological Research Online has its origins in papers presented to an ESRC seminar series on 'Sleep and Society' (2004-06, <http://www.warwick.ac.uk/go/sleepandsociety >) co-organised by Simon Williams and Sara Arber. Papers were selected which focused on gender and sleep, and addressed how the social context and social meanings of sleep change across the life course. Apart from the first theoretical article on families, intimacy and sleep by Jan Pahl and the review article on children and sleep by Luci Wiggs, the articles are all based on empirical research.

1.6 Because of the lack of familiarity of many sociologists with the field of sleep, this Introduction provides a brief overview of key developments within the sociology of sleep, before outlining each article in the special section.

The development of a Sociology of Sleep

2.1 Sleep is a physiological process which has spawned a vast research literature on physiological issues, for example, relating to sleep stages and REM/NREM sleep. Much of this research has been based on laboratory studies of sleep using EEG brain recordings to measure the depth and duration of sleep, as well as laboratory-based sleep deprivation experiments. Sleep medicine has also identified and studied an increasing array of diagnosed sleep disorders, such as sleep apnoea, narcolepsy and restless leg syndrome.

2.2 While sociologists cannot deny the physiological basis of sleep nor the medical/biological research by sleep scientists, sleep provides a fertile ground for sociologists to address very different issues. A key early work on sociological aspects of sleep was Aubert and White (1959), who built on anthropological work which identified the diverse arrangements for sleep in different cultures. They highlight the cultural variation in sleep patterns, rituals and rules for sleeping, and emphasise the ways in which sleep is interconnected to different societal institutions, status and power.

2.3 Schwartz (1970) develops these issues further, focusing on the notion of sleep as a 'periodic remission' from the conscious waking demands of society, the societal 'need' to protect individuals while they are asleep and how social arrangements have been institutionalised to 'protect' the sleeping environment of individuals. In doing so, he introduces the idea of the role of the sleeper and the rights as well as the obligations of the sleeper. Taylor (1993), in a later paper, develops the sociologically useful notion of 'doing' sleeping (i.e. the meanings, methods, motives and management of sleeping). He also introduces the concept of observed sleep which has particular relevance in relation to children's sleep and sleep in residential or other institutional settings, where the sleeper may not have the rights of privacy.

2.4 These early theoretical contributions have subsequently been taken forward and developed over the past 10 years by Williams, including further work on the sociological nature and status of the sleep role (Williams 2001, 2005, Williams and Bendelow 1998), the social etiquette of sleep (Williams 2007a), the bodily and embodied dimensions of sleep (Williams 2005) and, most recently, the relationship between sleep, vulnerability and human rights (Williams 2007b), including the hidden injuries of sleep deprivation in situations of domestic violence (Lowe et al. 2007). Profitable links have also been forged here, returning to the point raised above about sleep and health, to current debates in medical sociology on the healthicisation and medicalisation of sleep (Williams 2002, 2004, 2005; Hislop and Arber 2003c, 2004), including related work on the role of the media (Seale et al. 2007, Williams et al. In Press a, Kroll-Smith 2003), the role of the pharmaceutical industry (Williams et al., In Press b) and the role of medico-managerial imperatives in relation to sleep and the self-help sphere (Brown 2004).

2.5 These developments in turn mesh with other recent work on the governance of sleepiness in contemporary society (Kroll-Smith and Gunter 2005), the relationship between sleep, work-time and work-ethics (Boden et al. 2008, In Press), the social significance of the workplace nap (Baxter and Kroll-Smith 2005) and the commercialisation and commodification of sleep in consumer culture (Williams 2005, Williams and Boden 2004). Further work has also been developed on embodiment as a proposed integrating framework for the sociological study of sleep. Meadows (2005), for example, drawing on Watson's (2000) previous work on male bodies, has delineated four distinct modes of embodiment (namely, visceral, experiential, normative and pragmatic) which he argues are fruitful for understanding and exploring sleep as a negotiated act, particularly in the context of coupledom and family life.

2.6 The gendered aspects of sleep and sleeping have received particular attention through recent innovative research conducted by the Surrey Sociology of Sleep group (cf. Hislop and Arber 2003a, 2003b, 2003c, 2006; Venn et al. forthcoming) (www.sociologyofsleep.surrey.ac.uk/). This body of research has examined the meanings of sleep and the everyday world of sleep among women and couples, showing how a close analysis of sleep provides a window onto gender roles and gender inequalities within families.

2.7 This corpus of work has produced insights into how sleep is socially patterned and the impact of social context on women's and couple's sleep. In particular it illustrates how women's gender role as care-taker of family well-being, both for her partner and children, subsumes her own sleep needs as being of lesser importance than the welfare and sleep needs of other family members. Venn et al. (forthcoming) introduce the concept of the Fourth Shift, to highlight the ways in which women continue to undertake caring roles throughout the night. These night-time roles are not restricted to the direct provision of care, such as attending to the physical needs of children during the night, but also relate to women's engagement in the emotional labour of worrying about and anticipating the night-time needs of family members.

2.8 As well as using traditional qualitative methodologies (focus groups, in-depth interviews), this research has pioneered new qualitative tools to study the individual's experience of sleep, which may be considered a 'non-conscious' activity, e.g. through audio sleep diaries (Hislop et al. 2005), in which participants record their own narratives of the night soon after waking each morning. Also, given the shared nature of many sleeping environments, Venn et al. (forthcoming) illustrate the particular value of interviewing couples together, so that each partner can provide accounts of the other's sleep, while also interviewing each partner separately about their own and their partner's sleep. The individual interviews allow each partner to voice issues about the other's sleep and anxieties related to the sleeping environment that would not be voiced in a shared couple interview. These dual couple and separate individual interviews provide insights into power and inequalities within the couple relationship by highlighting whether certain issues are spoken of in each context and the different ways they are articulated with/without the presence of the partner (see also Venn in this section).

2.9 As a physiological process, sleep to some extent is unknown and unknowable to the sleeper, prompting the Surrey Sociology of Sleep group to conduct inter-disciplinary research on sleep, integrating the collection of qualitative data, with actigraphy and other physiological measures. Actigraphy involves participants wearing an actigraph, which is a watch-like device, that measures movement on a minute-by-minute basis, e.g. for a period of 7 (or 14) days. The actigraphy record can be related to data from audio-sleep diaries to indicate the nature and extent of sleep disturbance for each partner during the night (Meadows et al. 2005). Among couples, audio sleep diary data from both partners for the same night reveals the different ways in which that night was experienced by each partner, such as the influence of disruptions from children or a partner snoring. Alongside this, the actigraphy records provide measures of waking periods for each partner during the night, as well as cross-validation of the audio diary accounts with the 'objective' actigraphic record.

2.10 The study of sleep by sociologists provides a rich resource for revealing understandings about gender roles and relationships and power dynamics, while also providing a springboard for the development of new methodologies to study sleep and a site for addressing the challenges of integrating data from multi-disciplinary approaches.

Content of special section

3.1 The special section focuses on sleep in relation to gender and the life course. Gender is important to address for two broad reasons. First, studies routinely find that women report poorer sleep quality than men (Zhang and Wing 2006). The dominant explanation put forward by sleep scientists is one of biological or physiological sex differences, purported to relate to innate physiological differences between men and women (Manber and Armitage, 1999), or women's hormone levels, particularly oestrogen (Dzaja et al. 2005; Chen et al. 2005). Psychological explanations for women's poorer sleep are also prevalent (Lindberg et al. 1997). However, few scientific studies of sex differences in sleep consider sociological explanations. Chen et al. (2005: 488) conclude that 'In contrast with explanations emphasising sex differences in biology and prior psychiatric illnesses, the sociological perspective has not been well investigated in the existing literature.' Sociologists can therefore contribute to understanding gender differences in reported sleep problems. Secondly, and perhaps more importantly, sociological research on sleep can reveal hidden and implicit gender norms and bases of gender inequalities within society.

3.2 There are also two broad rationales for taking a life course approach when examining gender and sleep. First, ample physiological research shows how sleep duration, sleeping patterns and stages of sleep vary with ageing. Amount of sleep during any 24 hour period is greatest for babies and young children, as discussed by Wiggs (in this special section). In contrast, among older people increasing age is associated with progressive deterioration in the structure, 24-hour distribution, and quality of sleep (Morgan 1998; Dement and Vaughan 2000). Second, an examination of sleep across the life course throws into sharp relief issues of power and control at different stages of life: in childhood, youth, working life, and in later life. In each case, the sleeping contexts differ in terms of control and privacy, especially in later life which may involve a move to a residential care setting with sleep under more direct surveillance. Gender and the life course need to be seen as inextricably linked (Arber et al. 2003). In later life, for example, the majority of older people who enter institutional sleeping contexts in care homes are women, and therefore older women are more likely to experience the disadvantages associated with these changes in living circumstances.

3.3 Following the first article by Pahl, the articles in the special section are broadly ordered according to stages of the life course. Since most sleep takes place in the context of family life and intimate relationships, Pahl reviews sociological approaches to the study of intimacy and family life to provide a theoretical framework within which sociological data about sleep can be located. She builds on Morgan's (2001) distinctions between the 'three economies' of family life: the political economy, the moral economy, and the emotional economy, to suggest a theoretical framework for empirical research on sleep.

3.4 Among children, sleep is often an area of contest (or conflict). Children who do not obtain sufficient night-time sleep are increasingly being constructed as a social or educational 'problem'. At the same time the child's bedroom has become the site of activity, involving TV, computer games, internet and mobile communication, with social connectivity for young people translating into night-time sleep disruption, often hidden from parent's gaze.

3.5 The first of the three articles on children, by Wiggs, examines young children's sleep. She contrasts the ways in which child sleeplessness can be conceptualised as a 'biologically-defined sleeplessness' or alternatively as a 'socially-defined sleeplessness' when a child's sleep pattern is defined by parents or others as deviating from the 'desired sleep pattern'. This leads to debate about the socially constructed nature of judgements that constitute a 'desired sleep pattern', and therefore the contested nature of whether or not children are getting enough sleep.

3.6 Williams et al, drawing on their recent empirical research, explore the embodiment and embedment of sleeping in children's everyday/night lives, including the roles, routines and rituals involved in going to bed/going to sleep, issues associated with bedrooms and privacy, and relations between dormancy and domicile. They also provide a series of further reflections on the mutually informing relations between the sociology of sleep and the sociology of childhood, and the theoretical, methodological and ethical challenges which researching (children's) sleep poses. Children's sleep they argue, extending recent developments in childhood studies, is best understood in hybrid, 'impure', networked terms: a complex assemblage involving many different factors and elements.

3.7 The following article by Moran-Ellis and Venn draws on accounts of children and young people to explore how the temporal, spatial and interactional dimensions of routine sleep create a definable night-world for children. This arena of action is marked out materially and socially, and is qualitatively different from the night-time activities of adults. Issues of privacy, self-determination, and control over material space emerge as key for participants, particularly in relation to the construction of intergenerational and sibling relationships, coupled with opportunities for self-hood.

3.8 Four articles focus on gender and sleep, particularly how partners are the gatekeepers to the sleep resource for women, the negotiation of sleeping arrangements among couples, and normative assumptions regarding sleeping in the 'marital bed'.

3.9 In the first of these articles, Hislop explores the intimate space of the bedroom, highlighting the tensions inherent as couples negotiate their respective sleep preferences and biological need for sleep within the context of shared space. She argues that the negotiation of space within the double bed reflects and reinforces the gendered roles, identities and power dynamics inherent in the couple relationship and in society in general. In examining why couples choose to sleep together, despite the potential for sleep disruption, the article reveals the strong underlying togetherness culture in society and the stigmatisation of behaviour which challenges this norm.

3.10 Continuing this theme of the negotiation of sleep among couples, Venn focuses on the gendered nature and implications of snoring. She shows how the gendered nature of snoring is problematic for women in three ways. First, women who snore are embarrassed and stigmatised by this 'unfeminine' action. Second, women's embarrassment is compounded by the ways in which their partner shares information about their snoring outside the privacy of the relationship. Third, women attempt to develop strategies to cope with the disruptive effects of their husband's snoring - developing complex yet subtle strategies to try to stop their partner snoring while not waking him up, but these prioritise their husband's sleep over their own.

3.11 Lowe et al. focus on couples and sleep through an analysis of newspaper coverage of stories about sleep and sleeping arrangements. These are shown to re(produce) heteronormativity through focusing on the (heterosexual) 'marital bed' with the 'marital bed' constructed as both the physical and symbolic centre of successful heterosexual relationships. The focus on the 'marital bed' helps to exclude non-heterosexuals from the idea of intimate sleeping relationships, effectively silencing their experiences of sleep and sleeping arrangements.

3.12 Few social surveys collect data on sleep, hampering analysis of large scale representative samples to examine sleep. The only quantitative article in the special section, by Arber et al., uses the UK Women's Sleep Survey 2003 to analyse how three central aspects of women's roles impact on their sleep quality. Women's sleep is adversely affected by the night-time behaviours of their partner, particularly snoring, by the night-time actions of children, particularly children coming home late at night, and by night-time worries and concerns, many of which relate to worries about their family. In addition, disadvantaged socio-economic status, particularly low educational qualifications, and poor health status are implicated in women's poor sleep quality.

3.13 Most empirical research on gender and sleep has been based in the UK. In contrast, Bianchera and Arber examine sleep among midlife and older women in Italy, which represents a family welfare context with very limited state welfare support to care for children or frail older relatives. This qualitative research shows how family structure, gender role expectations and caring roles impact on women's sleep at different points in their life course. Undertaking intensive care work is shown to decrease women's sleep quality, especially care for frail older relatives when women lack support from other informal carers. The article proposes a typology of the ways in which four different aspects of care-giving can affect the quality of care-givers sleep.

3.14 The final three articles examine sleep in later life, focusing particularly on the implications of changing sleeping contexts through moves to sheltered housing (Fairhurst), residential care (Davis et al.) and among people with dementia (Martin and Bartlett). Many researchers have previously been blind to the presence of data about sleep in their research illustrating the taken for grantedness of sleep. Fairhurst demonstrates the value of re-analysing data collected in a previous study. She examines the extent to which 'sleep' and sleeping practices were part of the discourse of older people considering a move to sheltered housing or planners who design sheltered housing. This re-analysis provides insights into the 'doing' of sleep in later life, especially where, when and how sleeping practices occur. The article considers the methodological implications of re-analysing research materials for emerging sociological topics, such as sleep.

3.15 Many older people report poor quality sleep, and Davis et al. use data from older women living in Australian residential care to examine how older women construct themselves as either 'good' or 'poor' sleepers. They show the lack of congruence between quantitative measures of sleep behaviour, which are the gold standard of scientific sleep research, and self categorizations as 'good' or 'poor' sleepers. In-depth interviews with women investigate the processes by which self-categorizations emerge. These women, through processes of social comparison with the sleep of other older people, construct ideas about 'normal' sleep, and its normative definition, rather than the sleep phenomena experienced.

3.16 The final article by Martin and Bartlett examines experiences of sleep among people with dementia and the perceptions of family carers and care staff in different care settings. The discourses of older people with dementia emphasised the vulnerabilities associated with sleep, and meanings associated with the experiential dimensions of sleep that were closely connected to their social identities and roles. In contrast, the discourses of the care staff focused on the organisation of sleep, particularly the temporal management of sleep, and issues of safety, surveillance and privacy. These different perspectives denote varying positions and concerns in relation to sleep between waking conscious actors and dormant bodies, thereby highlighting the social significance of power relations and vulnerabilities within the context of care for older people with dementia.

3.17 Viewed as a whole then, this special section, and the broader emerging sociological literature on sleep and sleeping of which it is a part, suggest a rich and vibrant research agenda on the social dimensions and the social significance of sleep. Whether a primary topic of research, or a new way into existing sociological topics and concerns, sleep sheds valuable new light on the world around us, helping us to see things differently. This special section, we suggest, is an exemplar of that promise and potential.


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