In a recent article in the Journal of Public Health (“Who Has Time to Sleep?”) one co-author demonstrated that “high-risk sleep durations (short sleeping and long sleeping) are positively associated with sociodemographic categories associated with poorer health.” Hale’s paper has generally been read with the understanding that “poorer health” is an undesirable objective and that the conclusions of such research are obvious: public policies that encourage populations to practice effective sleep hygiene ought to be encouraged. (The National Sleep Foundation, for instance, offers a set of sleep hygiene tips that derive directly from the observation that better sleep habits are correlated with better health. ) But this is not necessarily the only implication of such research. It could instead be argued that sleep patterns reveal a necessary connection with other important normative variables, like opportunities to freely will and fulfill life projects.
In this paper we will claim that individual subjects do not have so much control over sleep that it is aptly characterized as a personal choice; and that normative implications related to public health and sleep hygiene do not necessarily follow from current findings. It should be true of any empirical study that normative implications do not necessarily follow, but we think that many public health sleep recommendations falsely infer these implications from a flawed explanatory account of the decision to sleep: the consumer choice view. This view, which we criticize here, proposes that sleep duration and sleep quality be understood as one choice among many.
Our strategy will be the following. First we will give a brief overview of the treatment of sleep by empirical researchers, and turn specifically to a linear model of sleep that has been dominant in the past. In this case, Hale (2005) presents innovative methodologies that fly in the face of earlier linear models of the relationship between sleep and sociodemographic variables. We understand models of sleep to be primarily descriptive and to fall into at least two categories: the linear and the curvilinear. Our concerns in this paper, however, relate to explanatory accounts, or views, of what is happening in such models. We will therefore discuss what we will call the “choice view” (or “consumer choice view”) of sleep, which proposes that one can choose to sleep; versus the “autonomy view” of sleep, which proposes that sleep tracks autonomy. It will be our position that while the descriptive linear model of sleep does lend itself to the explanatory choice view, the descriptive curvilinear model of sleep challenges the choice view. Instead, the results of the curvilinear model can better be explained by the autonomy view.
It is our primary purpose to argue that although the choice view may be the simplest way to conceive of sleep, it is neither the view that best explains the data, nor the view that best suits a robust picture of the decision to sleep. Following Norman Malcolm, our presupposition will be that sleep cannot adequately be understood as a “choice” because the subject retires, so to speak, upon falling asleep. It is far more helpful, therefore, to conceive of decisions to sleep as composed of a set of action parameters that the subject sets for himself by deference to practical reasons. In the much bigger picture, though unfortunately not in this short paper, what we argue is that the parameters of sleep-time should be construed as more-or-less flexible options over which one can exercise autonomous control. These parameters constitute the extent of the choice to sleep, and these parameters are frequently shaped by external considerations tied to fulfillment of life projects.