CUL260 Health, Bodies, Media

Question:

“Medicalisation is and demedicalization are best understood in terms of coexisting processes. The tension between these processes can lead to unpredictable outcomes.

Critically assess this claim.

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You should refer to a historical or substantial case study of a series of health-related activities or a health promotion campaign in your answers.

Answer:

Introduction

Scholars agree that medicalization is often not an integrated process. They fail to consider the many directions and levels of medicalization.

Most scholars view medicalization as a discrete process, rather than a category.

The threshold at which a process becomes “medicalized” or “demedicalized” is also not identified by scholars (Halfmann (2012).

The scholars are often unable to identify the moments when medicalization and demedicalization occur.

They often fail to see the times when both events are occurring simultaneously (Halfmann (2012)

Moloney and Konrad (2011) claim that insomnia or sleeplessness is an epidemic. This means that there is a growing public health problem.

In this essay, we will discuss how medicalization is and can be used to treat sleep disorders or sleeplessness.

This essay will examine the role of sleeping apps in medicalization and their usefulness in treating sleep disorders.

Because chronic sleep deprivation increases risk for other mental health problems and decreases job productivity, it is essential to analyze this topic.

Analyzing the effects of medicalization and non-medicalization on possible treatments for sleep deprivation can be very important.

Medicalization refers to the use of medical terminology and medical language to describe a problem.

Medicalization is often defined as a sociocultural process that involves the medical professional or results in the expansion of medical treatment.

Moloney Konrad and Zimmer (2011) also highlighted the fact that medicalization is when formerly normal biological behaviors are accepted or described as medical processes.

Although the process’ overall value is neutral, it can have adverse effects on public health.

Medicalization is opposed to demedicalization (Halfmann (2012)).

Williams (2004) stated that sleep was a neglected topic from a sociological perspective.

However, there are past and current references that suggest that sleep is a socio-logical topic in relation to where, how and when a person sleeps.

In light of the spatiotemporal arrangements, the importance of sleep for normal functioning of life drives the significance of the concepts of medicalization and sleeping.

Moloney Konrad and Zimmer (2011) examined the issue of medicalization of sleeplessness. This was done as a public concern. The analysis included sleeplessness complaints, sleeplessness diagnosis, and prescriptions of sedatives and hypnotics during physician’s office visits between 1993 and 2007.

The National Ambulatory Medical Care Survey, a nationally representative survey of US office-based physicians visits by the National Center for Health Statistics was used extensively.

Analysing the results showed a stark disparity between insomnia diagnosis and sleeplessness complaints. This is due to a rapid increase of nonbenzodiazepine sedative hypnotics’ (NBSH) use.

The number of NBSH prescriptions increases 21 times faster than the number of sleeplessness complaints, and 5 times faster than that for insomnia diagnosis.

This means that medical treatment is used to treat the underlying problem without regard for the benefits or severity of the diagnosis.

It would suggest a higher incidence of the discrete illness state if there was a simultaneous increase in diagnosis and treatment.

The age trend is indicative of the medicalization and treatment of sleeplessness.

Younger adults and those in middle age have no changes in their sleeping patterns.

Buffel and Bracke (2018) state that sleep problems can be medicalized if it prevents older adults from engaging with daily living activities. In this case, medication is used to treat the condition.

Non-biological reasons like stress and technology are responsible for an increase in sleeplessness among younger adults and middle-aged people.

This non-biological reason for sleeplessness has been able to help demedicalize the issue.

It has also been used to market sleeping pills (Moloney Konrad and Zimmer, 2011).

Sleeplessness was previously associated with the diagnosis of mental health conditions (Taylor, Konrad & Zimmer, 2013).

An increase in awareness of mental health issues and their co-relation to insomnia led to the topic of sleeplessness being introduced as an unrelated visit.

This promoted the demedicalization sleeplessness (Kompier Taris and Van Veldhoven (2012)

(2012) concluded that NBSHs are more addictive than benzodiazepines but they are more costly.

Huedo Medina et. al.

Huedo Medina et. al. (2012) showed that NBSHs only increase overall sleep time by 12 minutes. It is also associated to side-effects such as sleep eating, short term amnesia and sleep walking.

(2012) stated that NBSH is dangerous for older adults who take multiple medications and have a history or potential for accidental falls.

It was easier to de-medicalize sleeplessness by highlighting the side-effects associated with sleeping pills.

It can be defined as a state of mind that is mainly affected by stress or anxiety.

Sleeping apps and its effects on sleeplessness

The medicalization and treatment of sleep disorders is also possible because of the popularity of smart phone sleeping apps.

(2015) conducted a study to analyze the clinical use of sleeping apps for treating sleep deprivation.

The team selected 22 volunteers without any previous sleep disorder or insomnia diagnosis to undergo an in-laboratory Polysomnography (PSG) and simultaneously use the Sleep app.

Analysis of the study showed that there was no significant relationship between the sleep app parameter and PSG.

The study concluded that the sleep app was not an accurate measure of sleep quality or impending sleep disorders.

Van den Bulck (2015) explained that the seeping app vibrates at the right time. It does not wake the wearer at a set hour, but when the wearer is more in light sleep than deep sleep.

This app claims it will awaken the user in a fresh state of mind, rather than making them feel sleepy.

Van den Bulck (2015) claims that being awakened even during light sleep causes incomplete sleep, which can lead to poor quality sleep. This could also affect the quality of one’s life.

The developers of these apps, who are trying to get the attention of buyers, use the imagination of their customers to design apps that do not have a scientific correlation to the sleep-awake cycles.

Van den Bulck (2015) showed that increasing use of sleep apps leads to the “medicalization” of sleepless people and an increase in sleeplessness pills.

Fleishman (2012) found that the generalization of sleep being unnecessarily “medicalized,” ignores the important consequences of sleep deprivation.

Doctors have the responsibility to correctly diagnose sleep deprivation and give effective medication.

Improvements in Sleep-Pattern

Freeman et. al. reported on improving sleep patterns.

(2015) carried out a clinical study on patients suffering from persistent delusions or hallucinations.

(2015) mostly used cognitive behavioral therapy as non-pharmacological treatments to improve sleep patterns.

An analysis of the data revealed that the non-pharmacological interventions were beneficial for almost 80% of those who received them within 6 months of their completion. No side-effects were known.

This study was able to offer an alternative to pharmacological intervention in improving the insomniac condition.

(2015) agree that healthy sleep hygiene practices, such as moderate to mild physical activity, a healthy diet and the restriction of alcohol and tobacco, can counteract sleep-deterrents like artificial lighting and 24-hour Internet access.

(2012) indicated that proper job sharing, flexibility in work hours, and compliance with the sleep hygiene school curriculum could help reduce the burden of sleeplessness.

Hislop (2003) and Arber (2003) carried out a study to examine the neglected area of sociology and illness, which was sleep deprivation.

The study focused on how medicalization and healthicization help to develop a proper model to manage and understand the effects of sleep disruptions in women.

Analysis of the results showed that prescriptions of sleeping pills remain an indicator for medicalization of sleep, while healthicization was a trend towards healthy lifestyle practices. The same trend is being reflected by an increase in the focus of media, pharmaceuticals and other healthcare services.

Self-directed, personalized activity is an important part of women’s responses to sleep deprivation.

Hislop and Arber(2003) suggested a different model to manage women’s sleep. These included personalized activity, as well other strategies related with healthiciation or medicalization.

The non-pharmacological treatment of insomnia and sleepless nights has promoted the demedicalization.

Although the importance of non-pharmacological interventions for managing sleeplessness is obvious, doctors still prefer sleeping pills. This is due to market pressure, time constraints, and increased rate of consumerism.

Therefore, doctors must be trained and promoted in health promotion to raise awareness about long-term negative effects of sleeping pill use and the importance of behavioural therapies for treating sleeplessness (Kornfield and al. 2015).

This awareness will encourage healthy sleeping patterns and the reduction of dependence on medication.

Conclusion

As you can see, medicalization and demedicalization are two of the most significant social problems. They also have a huge impact on sleeplessness and other conditions such as insomnia.

Although sleep deprivation, or sleeplessness, is a neglected topic from a sociological perspective it can have an enormous impact on daily health and well being.

Due to increased use of sleeping pills such as nonbenzodiazepine sedative hypnotics NBSHs, the medicalization has taken place.

These medications do not have any significant effect on improving a person’s sleep cycle.

However, it can cause long-term side-effects and complications.

Additionally, sleeping apps are responsible for medicalizing sleep.

Similar to sleeping pills, using the apps via smart phone for sleep has no effect on the sleep-wake cycles.

Demedecalization of sleepinglessness has been possible due to the increased awareness of metal health problems and the association between stress and anxiety.

Even though the harmful effects of sleeping pills are well-known, doctors still feel pressured to prescribe them.

It is important to educate and inform the public so that non-pharmacological treatments can be used to promote sleep.

The non-pharmacological interventions are healthy eating, moderate exercise, and less consumption of alcohol or tobacco.

References

Is there a clinical use for smartphone sleep apps

Comparison of a smartphone app for sleep cycle detection with polysomnography.

Journal of Clinical Sleep Medicine, 11(7): 709-715.

Medicalization of Sleep Problems in an Ageing Population: A Longitudinal Cross–National Study of Medication Use in Sleep Problems among Older European Adults.

Journal of Aging and Health, 30(5), 816-838.

Insomnia may require medicalization.

A prospective, pilot-controlled, assessor-blind study evaluating the efficacy of cognitive behavioral therapy for sleep improvement in patients suffering from persistent delusions or hallucinations (BEST).

The Lancet Psychiatry. 2(11), 975-983.

Recognizing medicalization, demedicalization: discourses and practices.

Sociology of illness & health, 25(7), 815-837.

A meta-analysis of data submitted at the Food and Drug Administration reveals that non-benzodiazepine, non-benzodiazepine, hypnotics are effective in treating adult insomnia.

The role of sleep hygiene and public health promotion: An analysis of empirical evidence.

Tossing, turning-insomnia, and occupational stress.

Scandinavian journal of health, environment, and work, 238-246.

Trends in prescription drug advertisement exposure, 2003-2011

American journal for preventive medicine, 48(5) 575-579.

The medicalization and treatment of sleeplessness: a public concern.

American journal for public health, 101(8). 1429-1433.

An epidemiology of insomnia among college students: Relationship with mental health, life quality, and substance use problems.

Behavior therapy 44(3), 339-348.

Apps for sleep and the quantified person: blessing or curse.

Journal of sleep research, 24(2) 121-123.

Hislop and Arber: A rejoinder.

Sociology of Health & Illness, 26(4), 453-459.

An effective and feasible mind-body stress relief in the workplace: A randomized controlled study.

Journal of occupational psychological health, 17(2), 246.