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Paper short abstract

Our paper discusses the gap between gathering biological data and interpreting it into clinically relevant insights in the case of insomnia, and how hypnotic drugs have stepped in to occupy this gap. We draw on 83 in-depth interviews with individuals in Uruguay who reported sleep difficulties.

Paper long abstract

In this paper, we discuss the role of polisomnography in cases of insomnia disorder from a situated perspective. Polysomnography has been considered the gold standard to assess sleep, however its usefulness in cases of insomnia remains unclear. While some say that it should not be used to diagnose insomnia (e.g. American Academy of Family Physicians, n.d.), others have included it in a clinical trial to evaluate the efficacy of a novel drug for the treatment of insomnia (e.g. Mignot et al., 2022). How has such a contradiction in the medical field been translated into the patients’ experience?

In our fieldwork, carried out in Montevideo (Uruguay), we interviewed a total of 83 people who reported having sleep problems. Only three of the interviewees reported undergoing a polysomnography and none of them reported any benefit from the test or any change in pharmacological treatment influenced by the results. Moreover, in most of the interviewees, insomnia was not diagnosed using any type of technology, and many did not even receive an accurate diagnosis of their sleep problems.

Such a panorama has exposed the gap between gathering biological data and interpreting it into clinically relevant insights. In the case of sleep, considering the widespread prevalence of sleep difficulties and the mainstream medical discourses around sleep as a biological matter, hypnotic drugs have stepped in to occupy this gap as the technoscientific response that displaces the necessity of a formal diagnosis.