Selling slumber: American neoliberalism and the medicalization of sleeplessness

Sleeplessness is an ancient and cross-cultural phenomenon that is socially structured and restructured against a backdrop of ideology and inequality. In an effort to make sense of sleeplessness, some scholars have invoked the medicalization framework, which highlights consumerism, managed care, biotechnology, and physicians as key “engines” that foster the transformation of this formerly “normal” condition to one that people view as a medical problem. However, this burgeoning literature has not answered the call of medical sociologists to situate the medicalization process in a political economic context. In this article, we employ the case study of sleeplessness and the creation of the “Sleep Industrial Complex” to expand the medicalization framework and illustrate how American neoliberalism creates an ideal environment for the primary engines of medicalization. We identify three critical features of American neoliberalism—enhancement culture, commodification of health, and a “productivity imperative”—that act in concert with the driving engines to foster an environment wherein medicalization not only survives but also thrives.