The Slumbering Masses: Sleep, Medicine, and Modern American Life

4. Desiring a Good Night’s Sleep: Order and Disorder in Everyday Life

99 4 .................. Desiring a Good Night’s Sleep Order and Disorder in Everyday Life In this chapter, I change my focus to examine the lives of individuals and families as they are affected by disorderly sleep. I move from the disciplinary and institutional logics of sleep science and medicine and attend the forms of life that they produce, largely in the lives of individuals who see themselves in need of medical intervention. I am interested in the lives that individuals form for themselves and the effect they have on those around them. In order to establish their everyday lives as orderly, individuals integrate new pharmaceuticals, prosthetics, and behaviors into their self-care. These intimacies, these alliances with new objects, form emergent desires. In some cases, these therapeutic intimacies are intolerable for individuals, who struggle to shape their everyday lives through varying means, sometimes opting out of medical treatment altogether. But there are similarities across individuals diagnosed with the same disorder, both in treatments available to them and in the consequences of finding nonmedical alternatives to managing their everyday lives. In relation to these similarities, I structure this chapter nosologically, by medical definitions of disorder. In so doing, I bring together cases of individuals and families who share symptoms but who resolve their disorders differently from one another. In some cases, their choices involve medical treatment. In other cases, individuals find nonmedical means to allay their sleep disorders. I draw on cases similar to these throughout the rest of Part II, examining how Desiring a Good Night’s Sleep 100 individuals with similar sleep disorders and their families form and are formed by the institutions they encounter, in particularly American ways, through their emergent relations with therapies, institutions, and the desire for sleep. Early twenty-first-century American society has been marked with an intensified interest in sleep as an explanatory device for health and its impediments, a trend that differs substantially from medical discourses of the 1990s, in which sleep was largely ignored. This change has been brought about, in no small part, through direct-to-consumer advertising of sleep-inducing medications, now annually a multibillion dollar industry , as well as through the efforts of various individuals and institutions to popularize sleep. My interest in this chapter, in tracking this shift during the 1990s and the early 2000s, is to attend primarily to the alterations in treatment regimes, namely, the intensification of pharmaceutical therapies for health problems, and to elaborate what might be particular to this seemingly emergent pharmaceutical aspect of integral medicine’s further development. “Pharmaceutical personhood” has become an ever more naturalized form of life in contemporary American society and in modern life more generally. Beyond the reliance upon medications as a means of alleviation—which is new only in the sense of its intensi fication, inasmuch as medications and medicinal supplements have a protracted history—my interests are specifically in the “time–discipline” of pharmaceuticals, the ways that the use of pharmaceuticals produces particular kinds of spatiotemporal predispositions, desires, and intimacies and how these form and are formed by American everyday life. I see in pharmaceuticals and pharmaceutical use a reliance upon repetition, the formation of everyday rhythms that reinstate themselves through desirous means. Simultaneously, pharmaceutical regimes are also constituted by ideas about the everyday, about rhythm and spatiotemporal order. Contemporary pharmaceutical use depends upon a mode of enframing that produces the spatiotemporality of the everyday inasmuch as it mitigates disorder through the formation of normative orders of desire and intimacy. In the early twenty-first century, American everyday life is tied to ideas of the therapeutic, emblematized in the repetitive use of pharmaceuticals. When a particular everyday rhythm is so vital, its disordering can have profound effects for individuals, their families, 101 Desiring a Good Night’s Sleep and society more generally, and order can be reasserted by turning to the powers of medicine. “We Don’t Get Enough Sleep” Marcus and Laura Burton were professional, upper-middle-class, white Americans from the suburbs of Minneapolis and, at the time of their interview, were in their early fifties. They had been together since their early twenties, having met as undergraduates while at a university in the Midwest. They were not unique in their sleep problems; in fact, neither was recognized as having a nosologically defined sleep disorder in the strict sense, other than...