MEDICATED SLEEP AND WAKEFULNESS: A Social Scien3fic Inves3ga3on of Stakeholder Interests, Policies and Prac3ces
NEIL is a 25 year old MEDICAL STUDENT. His ethnic background is White Bri3sh. “Studying doesn’t affect my sleeping pa5erns at the moment. I’ve learned that if I try and work against when I’m >red then I don’t get the best outcomes. Obviously there are deadlines where you have to ignore that feeling of 3redness. I think that’s jus3fiable for the short term but not for the longer term. Before exams I can never sleep. That’s just something I’ve got used to. I don’t do all-­‐nighters, but obviously, when I’m a junior doctor I will have to do them. I have no choice in that; it’s just part of the package. I think sleep is very important. I am fine as long as I’ve had 6.5 – 7 hours sleep but I know when I’m >red. I can s>ll func>on to a certain level but my mood and my interpreta>on of things will change. Sleep seems to enable your brain to func>on at its op>mum level and it seems to have such a connec>on with energy and drive as well. I’ll have less energy and mo>va>on. It seems to all be connected. The first thing I think, if I’m >red is, “I’ll go to bed early tonight” but it never happens. Within a couple of hours I forget that I’m >red and that’s where that sleep debt can build up. I don’t take naps. I don’t have >me to and I don't think I would even if I had >me because I would probably be doing other things. Before I studied medicine I used to have insomnia, about three nights a week. I was working away from home and I wouldn’t be able to switch off. I would sleep three or four hours a night, then catch up when I got home. I experimented with quite a few different ways of trying to get to sleep. Neil has tried lots of different ways to manage sleep and wakefulness. He knows people who have taken Ritalin as a study drug. He is against lifestyle uses of prescrip>on medica>on on health grounds. I’ve tried an3histamines that are packaged as sleeping aids. Also the Nytol herbal ones, and Melatonin, which I got from the Internet because you can’t get it in the UK. I didn't really feel that a GP would be able to do much to help because I felt that a lot of it was a behavioural based thing so, psychological. I was confident that I could deal with that myself. In terms of wakefulness, I will resort to energy drinks on an excep3on. Most of the 3me I’ll have coffee because I prefer it and it’s got less sugar, so I think it’s healthier for you. I tried Yarba Mate tea bags last year and they were so much more powerful than coffee. I ended up having heart palpita>ons and I couldn’t sleep for two days -­‐ I soon stopped taking them. I wouldn’t recommend that to anyone! I was awake but I was so irritable and hypersensi>ve; it wasn’t a produc>ve state to be in at all. I took an>histamines as a way of counterac>ng the Yarba Mate and I ended up sleeping for 16 hours and missing a whole morning’s worth of lectures because it was just going from up to a down. I know people who have taken Ritalin to stay awake longer and study in the run up to exams and I can’t think of anything worse, maybe due to my experience of insomnia in the past and having to stay up all night. I would rather sleep, to be honest. There is always another day to do whatever you’ve got to do, why do it through the night as well? I think people have more problems than they have benefits from taking these things. They're more likely to jeopardise things than the benefit that you can derive from working steadily and surely over the semester. It doesn’t get me angry in terms of I feel cheated, or anything like that, it just makes me concerned for them because they are poten>ally messing with their own brain. I would suggest that if you don't need to use drugs in terms of prescribed medica3on then don’t use them because everything has a side effect at the end of the day. My concern, in current society, is that wakefulness drugs would be very highly abused because everything is much more 24/7 than it used to be. There are so many reasons why you would want to think that sleep is the last of your priori>es. I think you would have more people choosing to take them that don’t actually need them, using them to facilitate their lifestyle. From a health perspec>ve, I think that can have bad long-­‐ term implica>ons. Sleep is good for you, rest is good for you. I don't think we need these drugs to stay awake more; that’s a direc>on for society that we don't need to take.” Project Team: Professor Jonathan Gabe, Royal Holloway, University of London Professor Simon Williams, University of Warwick Professor John Abraham, King’s College, London Dr. Catherine Coveney, University of Warwick/ University of Sussex Research funded by The Economic and Social Research Council UK