Wednesday, January 26, 2011

Research Junkie (be prepared, this is a long one!)

I have been wanting to write a post for some time now to give an update on a previous post, all about my New Year's resolution to encourage A. to sleep (or at least sleep better than she does). I've been avoiding it because I'm a little tired of discussing this issue. Our trouble with sleep has been a problem since A was born, save for a couple of glorious weeks around 2 months of age when she decided to sleep through the night. So my hubby and I have talked this subject to death, and then some. However, the issue has come up again in our lives, and I feel the need to spill it all out onto virtual paper.

I am a research junkie (hence why I now work in health research), and so of course, I have scoured the internet for information related to babies/children and sleep. There is TONS of stuff out there, ranging from personal opinion to evidence-based research. You could drive yourself nuts trying to cover it all. As a researcher, I tend to rely on better quality material, as people with "opinions" haven't been in my house at 3am with my screaming daughter.

One very interesting paper is by C.M. Worthman and M.K. Melby, and is titled "Toward a Comparative Developmental Ecology of Human Sleep." Ecology is the branch of sociology that studies the relationships between human groups and their physical/social environments. Worthman and Melby attempt to gain insights into sleep regulation from an ecological and anthropological viewpoint. Before you start to nod off or find something else to do, keep reading! This is really interesting stuff, I promise.

According to these two women, we know absolutely NOTHING about human sleep, with some work on SIDS being the exception. Any Western studies that have been done don't adequately represent the range of human sleep ecologies - meaning, we don't know anything about the variety of sleep conditions amongst various cultures around the world (in particular, traditional cultures). The authors argue that Western sleep habits are grounded in our cultural environments; essentially, our sleep patterns, the proximity to others, bedtimes and wake times, and sleeping locations are all social, learned behaviours. The way we sleep is not natural, but social.

As Westerners, we have a sleep model that is binary - in our view, we're either asleep or we're awake. There is no continuum of sleep. But in other cultures, much emphasis is placed on the importance of many sleep/wake states, including daydreaming, dozing and napping. This allows individuals to gain many hours of various states of sleep throughout the day. Western society is very much concerned with an unbroken period of sleep that we think should occur at one point in the day (usually at night). Many of us frown upon napping, dozing or being "semi-alert." To us, this is an unproductive use of our time. Hence, the 7 or 8 hours of sleep we try to get at night becomes very important if we must function well during the rest of the day.

In other more traditional societies, solitary sleep is not the norm (the Balinese become very fearful about sleeping alone, as they believe they are more at risk of encountering evil spirits). In a review of 127 cultural groups from around the world, it was found that 79% of these societies had children who normally slept in the same room as their parents, with 44% of these sharing the same bed (Barry and Paxson, 1971). Furthermore, many of these sleeping environments are "open concept" where other members of the home or village come and go at will. Men (and sometimes women) will engage in nighttime rituals and practices that allow them to sleep for only short periods at a time. Music may be played at different times of the night, and the need for warmth requires some individuals to be up and down tending to the fire. This differs quite a bit from the sequestered, quiet and controlled environments in which we sleep.

Here in Canada most children have bedtimes and naptimes. Parents are anxious about setting these routines, as a lot of children have no interest in going to bed by the clock. In traditional cultures, children's bedtimes are not rigid. They will sometimes retire to sleeping areas with their mothers, but often fall asleep in someone's arms during family gatherings. Infants are carried almost full-time in a sling or sack, and thus fall sleep whenever they are tired (there are no distinct "nap times").

What I find fascinating about all of this is that Western sleep ecology is distinctive from so many other cultures - we are the anomaly in the world of sleep. Worthman and Melby make the suggestion that the particularities of Western sleep ecologies may contribute to the patterns and prevalence of sleep disorders. This makes sense to me - so many in our population are perpetually tired and sleep deprived, and many struggle with real sleep disorders such as insomnia. All of my time spent researching the phenomenom of sleep has led me to strongly believe that we have created our own sleeping problems - by trying to manipulate sleep, it has increasingly started to elude us.

And perhaps most relevant (to this post at least!) is that our culture seems to be most concerned with how our babies and children sleep:

"In those societies with a strong Euro-American influence, the moment of birth is commonly viewed as the beginning of autonomy for a baby who is no longer connected to the mother. Early independence is a developmental goal to be achieved rapidly by infants, particularly at night." (Ball, 2007)

This viewpoint is a recent one and developed less then two centuries ago, when increasing wealth for the middle and working classes led to changes in living conditions (separate sleeping and eating space, and then separate bedrooms). This was coupled with the popularity of behaviourist childrearing strategies - doctors (all men), who emphasized the self reliance of children, the withholding of affection by parents, and solitary infant sleep. Whether we like it or not, this influence still lives within us, and within our mothers and grandmothers.

So what does all this reading and research mean for my family? On one hand, I find it instinctual to have my daughter sleep with us and tend to her needs at night. This feels normal to me, and my daughter seems happiest with this arrangement. On the other hand, I live in a society where I must get all of my sleep at night so that I can function throughout the day. Plus, I have been conditioned to believe that sleep should be controlled and solitary. (On a side note, as a feminist, I find it frustrating that this has been indoctrinated into my life by a bunch of men who claimed to be experts in the care of babies and children. What might have happened if a bunch of mothers wrote the books on childrearing in the early twentieth century? We might be in a very different place)

I struggle with being woken up at night because I am unable to see the benefit of various wake-sleep states (and there is also not much space in my life for naps). So back to the conflict - do I do something to change my daughter's habits (and therefore go along with our Westernized ecology of sleep - I hate conforming!!) or do I learn to "go with the flow" and arrange my life in a way so this works?

There are probably more questions than answers at this moment, but I'll keep on readin' and maybe one day will be all the more wiser for it. Oh yes, and as for that update! A was doing really well with our "Operation A-to-sleep" plan until she got her shots, followed by a bout with the flu. We are back to where we started....

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