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Medicalisation, pharmaceuticalisation, or both? Exploring the medical management of sleeplessness as insomnia

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journal contribution
posted on 17.10.2018 by Katie Coveney, Simon J. Williams, Jonathan Gabe
In this paper we examine the medical management of sleeplessness as ‘insomnia’, through the eyes of general practitioners (GPs) and sleep experts in Britain. Three key themes were evident in the data. These related to (i) institutional issues around advocacy and training in sleep medicine (ii) conceptual issues in the diagnosis of insomnia (iii) and how these played out in terms of treatment issues. As a result, the bulk of medical management occurred at the primary rather than secondary care level. These issues are then reflected on in terms of the light they shed on relations between the medicalisation and the pharmaceuticalisation of sleeplessness as insomnia. Sleeplessness, we suggest, is only partially and problematically medicalised as insomnia to date at the conceptual, institutional and interactional levels owing to the foregoing factors. Much of this moreover, on closer inspection, is arguably better captured through recourse to pharmaceuticalisation, including countervailing moves and downward regulatory pressures which suggest a possible degree of depharmaceuticalisation in future, at least as far prescription hypnotics are concerned. Pharmaceuticalisation therefore, we conclude, has distinct analytical value in directing our attention, in this particular case, to important dynamics occurring within if not beyond the medicalisation of sleeplessness as insomnia.

Funding

This study was funded by the UK Economic and Social Research Council (ES/H028870/1).

History

School

  • Social Sciences

Department

  • Communication, Media, Social and Policy Studies

Published in

Sociology of Health and Illness

Citation

COVENEY, C.M., WILLIAMS, S.J. and GABE, J., 2019. Medicalisation, pharmaceuticalisation, or both? Exploring the medical management of sleeplessness as insomnia. Sociology of Health and Illness, 41(2), pp. 266-284.

Publisher

John Wiley & Sons Ltd on behalf of Foundation for SHIL © The Authors

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/ by/4.0/

Acceptance date

17/07/2018

Publication date

2019

Notes

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution andreproduction in any medium, provided the original work is properly cited.

ISSN

0141-9889

eISSN

1467-9566

Language

en

Licence

Exports