At the Edge of Sleep: Insomnia in Hong Kong

睡眠是每人的基本需求，但我們並非每晚都能安睡。本研究借助近年興起的睡眠人類學領域，檢視失眠所反映的香港社會文化。香港不時被形容為「失眠都市」。根據政府統計，香港大概20%人口經歷頻密失眠。本論文提出兩條主要問題。第一，失眠發生的時候人們如何處理？他們的選擇和實踐反映失眠在香港有着什麼地位？基於這兩條問題，本研究分別探討香港市民失眠的日常經歷，以及睡眠醫學對失眠的處理。本研究的田野調查為期五個月。當中主要包括兩部分：在公立醫院睡眠科診所進行參與觀察，以及詳細訪問經歷失眠的市民。另外，為更深入瞭解受訪者的睡眠環境，本研究亦有加入家訪和攝影的田野元素。在香港，失眠遊走於日常困擾和疾病之間，然而前者更明顯。相比接受醫學治療，受訪者認為個人調整更為重要。失眠的處理方法亦挑戰我們對「治療」的固有觀念。在睡眠科診所，規管作息習慣比藥物治療更受醫護人員重視。失眠人士亦會自行嘗試各種外行方法。他們的嘗試包含務實和創意，並產生一個重視紓緩睡眠障礙多於瞭解真正原因的治療拼湊。本文的總結將會討論如何透過「匠」反思睡眠的本質，以及重新界定睡眠和失眠之間的關係。透過失眠的視點，本文為睡眠，醫療化，臨床實踐，和日常生活的人類學研究提供新的見解。Everyone sleeps, but our sleep is not always smooth. Joining the bourgeoning field of anthropology of sleep, this research targets at insomnia in Hong Kong. Hong Kong is often portrayed as a ‘sleepless city’ and according to official statistics, around 20% of the population experience frequent insomnia. This thesis then asks two main questions: what do people in Hong Kong do when insomnia happens? And what do their choices and practices tell us about the current status of insomnia in Hong Kong? To answer these questions from a broader view, this research delved into the everyday experiences of insomnia, as well as the management of insomnia in the field of sleep medicine. Ethnographic fieldwork of this research lasted for 5 months and it consisted of two main techniques—participant observation at the sleep clinic in a public hospital, and semi-structured interviews with people who experience insomnia. Home visits and photography were also employed to better understand participants’ sleep environments. This thesis has found that insomnia in Hong Kong sits at the edge between an “illness” to be treated in the clinic and an everyday distress to be adjusted to, with the latter being more prominent. Due to insomnia’s ambiguous status in the science of sleep, clinical management challenges our conventional understanding of ‘treatment,’ as practitioners prioritize regulation of sleep habits over pharmacotherapy. Meanwhile, those who experience insomnia continuously experiment with various ‘lay’ practices. Their effort involves pragmatism and creativity, and it gives rise to the bricolage of treatments that emphasizes solving more than knowing the true cause(s) of the sleep disturbance. This thesis concludes by considering sleep as craft, which opens up a new way to relate to sleep and to the loss of it. Through the lens of insomnia, this thesis offers original insights into the anthropological study of sleep, medicalization, clinical practices as well as everyday life.Tong, Dik Wai David.Thesis M.Phil. Chinese University of Hong Kong 2016.Includes bibliographical references (leaves ).Abstracts also in Chinese.Title from PDF title page (viewed on …).Detailed summary in vernacular field only