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8 Developmental Cultural Ecology of Sleep Carol M Worthman

Introduction

The scientific community long has viewed sleep as a basic biological function a behavior as natural necessary and universal as eating Accordingly sleep has been studied like other such functions where setshytings and social conditions are treated as moderating factors that influshyence exposure to sleep constraints or disrupters such as discomfort and noise worries or work demands Culture has been disregarded altoshy

gether Only recently has it become clear that sleep like eating is heavily conditioned by culture and that a great deal might be learned about the bases of sleep and sleep disorders through the study of cultural factors

This chapter builds on that insight and explores the role of culture in sleep practices perceptions and problems

The discussion necessarily remains exploratory because the crossshycultural ethnographic and empirical evidence base remains thin Such a curious omission ofthe most prevalent human behavior from anthroposhylogical and ethological inquiry stems partly from a view of behavior as

produced by a conscious agent and ofsleep itself as absent of meaning and cultural constructions except in dreams Thus we find reciprocal gaps in the literature that of culture in sleep science and that ofsleep in

cross-cultural research Together the paucity of data plus the emerging recognition of cultures possible significance offer an exciting opportushynity for sleep science for which conceptual frameworks and hypotheses

worthman
Text Box
In Sleep and Development Familial and Socio-Cultural Considerations M El-Sheikh ed (pp 167-194) 2011 Oxford Oxford University Press

168 Sleep and Development

are needed to map the field of inquiry and inform systematic research

that will fill a real lacuna in current understandings of sleep

The present discussion aims to help bridge that gap from a developshy

mental perspective using the approaches of biocultural anthropology

Commencing with a consideration of adaptive-evolutionary constraints

that have shaped the place of sleep in human development this chapter

outlines a bioecocultural model that provides a framework for integrashy

tion ofculture into the study ofhuman developmentThis model inspired

a study of the comparative developmental ecology of sleep that is then

summarized in terms of initial insights into cultural patterns and variashy

tion in the physical ecology of sleep and the recognition of sleep as a form of social behavior The suggestive findings from this cross-cultural

survey are followed by results from an empirical investigation of the role

of culture in shaping sleep across the life course in a specific society

namely Egypt Study results showed that cultural factors powerfiilly

structured sleep accounting for much of the variance in sleep across the

life courseThis example engages a number ofissues regarding the impact

of culture change and globalization (schooling media family and resishy

dential patterns nutrition) on sleep schedules and consequently on funcshy

tioning and healtb The emerging global literature on these topics is

briefly surveyed

A concluding section deploys psychological anthropology to conshy

sider the role ofcultural models in how sleep is conceptualized and how

such models inform behavior and perception with particular regard to

parental behavior Building on a cultural consensus analysis from our

study ofparenting and development ofchild self-regulation in American

families I delineate two key dimensions in an American cultural model

ofsleep along with the resultant scripts for sleep and parenting practices

Then based on our comparative work contrasting elements in nonshy

Western cultural models ofsleep and their attendant scripts are proposed

A central insight from this perspective is that sleep is embedded in a moral framework that powerfully shapes not only behavior but also evalshy

uations ofsleep as appropriate or disordered Thus the cultural construcshy

tion ofsleep across the life course can also be understood as a project that

directly concerns crucial intangibles such as personhood morality and social relations as well as the urgent practical ones ofhealth subsistence

and survival

De-

Adaptive and Evolutionary Back

The lingeringly mysterious adaptive fa

scope of this chapter (see Worthman 2

tive constraints on human sleep patten

comparative study and raises four poi

range of environments using an array tions to flourish under widely diver

sociality and culture are obligatory to

and integral to development and func

ture shapes human ecology Children a become competent by living in socia

through culture Fourth and related

mental design anticipates reliable inr

ments ofrearing for assembling comp

nervous system (Worthman 2003) Tl Design implications for sleep ir

the daily activities necessary for sum

leable to the range of ecological and inhabit Indeed humans manifest pro

schedules and tolerating sleep restricti culturally prescribed sleep practices r

lenges presented by specific environ

analysis of selected non-Western cul

afternoon napping is not related to h

to the presence of malaria and oth (Barone 2000) Then in line with

sleep should commonly occur in soci

sion of group life Co-sleeping has b

instance all reports in an ethnograph identifIed infants as sleeping in the s

Paxson 1971) Finally dependence ( ing conditions suggests that onto~

shaped by sleeping practices The dt

is regularities in patterning and COl

an important factor in the develoJ

regulation

iuiry and inform systematic research

t understandings of sleep help bridge that gap from a developshy

roaches of biocultural anthropology

1 of adaptive-evolutionary constraints

) in human development this chapter

lat provides a framework for integrashy

nan developmentThis model inspired

pmental ecology of sleep that is then

ights into cultural patterns and variashy

eep and the recognition of sleep as a

estive findings from this cross-cultural

1 an empirical investigation of the role

gt the life course in a specific society

wed that cultural factors powerfully uch of the variance in sleep across the

number ofissues regarding the impact

on (schooling media family and resishy

p schedules and consequently on funcshy

19 global literature on these topics is

S psychological anthropology to conshy

1 how sleep is conceptualized and how

l perception with particular regard to

L cultural consensus analysis from our

~nt ofchild self-regulation in American

ensions in an American cultural model

cripts for sleep and parenting practices

e work contrasting elements in nonshy

and their attendant scripts are proposed

pective is that sleep is embedded in a

shapes not only behavior but also evalshy

disordered Thus the cultural construcshy

can also be understood as a project that

bles such as personhood morality and

ent practical ones ofhealth subsistence

Developmental Cultural Ecology of Sleep 169

Adaptive and Evolutionary Background

The lingeringly mysterious adaptive foundations of sleep lie outside the

scope of this chapter (see Worthman 2008) but a consideration of adapshy

tive constraints on human sleep patterns must be a starting point for any

comparative study and raises four points First humans inhabit a huge

range of environments using an array of cultural and biological adaptashy

tions to flourish under widely diverse ecological conditions Second

sociality and culture are obligatory to humans indispensable for survival

and integral to development and function Third and consequently culshy

ture shapes human ecology Childreg are provisioned learn language and

become competent by living in social groups structured and operating

through culture Fourth and related to cultural dependence developshy

mental design anticipates reliable inputs from the expectable environshy

ments of rearing for assembling complex features such as the immune or

nervous system (Worthman 2003) Thus culture gets under the skin

Design implications for sleep include that it must be fitted into

the daily activities necessary for survival and consequently must be malshy

leable to the range ofecological and cultural circumstances that humans

inhabit Indeed humans manifest prodigious capacity for adjusting sleep

schedules and tolerating sleep restriction (Worthman 2008) Furthermore

culturally prescribed sleep practices may themselves meet adaptive chalshy

lenges presented by specific environments For example cross-cultural

analysis of selected non-Western cultures has found that the practice of

afternoon napping is not related to hot climates or agricultural labor but

to the presence of malaria and other parasitic and infectious diseases

(Barone 2000) Then in line with most of humans primate relatives

sleep should commonly occur in social groups for safety and as an extenshy

sion of group life Co-sleeping has been widespread across societies For

instance all reports in an ethnographic sample of173 traditional societies

identified infants as sleeping in the same bed or room as others (Barry amp

Paxson 1971) Finally dependence of development on input from rearshy

ing conditions suggests that ontogeny of sleep regulation would be

shaped by sleeping practices The developmental ecology of sleep-that

is regularities in patterning and conditions of sleep-may therefore be

an important factor in the development of the systems related to its

regulation

bull 1


The Ecobiocultural Perspective on Human Development

The primary role of culture in shaping rearing environments has

prompted the claim that of all the thing one could do to influence the

development ofan infant the most important would be to decide where

on earth-in what human community-that infant is going to grow up

(Weisner 1996 p 276)A developmental-ecological framework builds on both adaptationist and cultural ecological perspectives and provides a

powerful basis for a fresh approach to sleep The ecobiocultural approach

integrates the pervasive influence of culture on living conditions and

experience with the environmental expectancy of the developing child

(reviewed in Worthman in press) Cultural beliefs values and cognitiveshy

affective orientations directly inform behaviors practices physical conshy

ditions materials and setting that members of the culture produce to

yield the patterned matrix of human ecology The actual conditions

under which children grow up or the developmental niche thereby are

society-specific products of culturally grounded views and practices for

the care and rearing of the young (Super amp Harkness 1986)

The developmental niche ofany society must also work with human

variation and incorporate elasticity responsive to the individual child

Cultural goals and values built in to the niche (eg parent assessments

and responses) engage with the childs endogenous or constitutional

conditions including temperament epigenetics and genetics physical or

functional features capacities and health to both drive and respond to

herhis perceived developmental states and needs toward culturally

desired results Outcomes such as state regulation physical function

and health and cultural competence are formed in this cultured space

Systems that regulate sleep as well as those influenced by sleep patterns

count among these outcomes and thus can be viewed as products of the

developmental niche Such logic argues for the possibly constitutive role

ofculture in sleep behavior and regulation and provides a general frameshy

work for linking distal cultural factors to more proximal accounts such

as Sadeh and Anders transactional model ofinfant sleep problems (Sadeh

amp Anders 1993) Method010gically it follows that ethnography should

play a key role in the study of human development and sleep

The bioecocultural model supports research design by operationalshy

izing culture and its actions in development in terrns of observable

phenomena including the behavior~

ditions that constitute the context

model represents a powerful tool f(

cultures in relation to human develo

ground patterns ofsleep behavior ar

the development not only of sleep

life--emotional social and produc

partThe next section describes a g

sleep and the unexpected insights y

cross-cultural ethnographic study

A Comparative Ecology of SI

The gap between paradigms for lal

and how it is practiced around th(

initial study over a decade ago to

anthropology (Worthman 1999)middot It and variation in sleep behavior

scarcely begun at that time (Reima

Souza Medeiros amp Almirao 1998 r 2000) Although direct comparativ(

were scant the physical and social

in ethnographic and historical acc

1993) Thus we used the ecobiocu

descriptive framework for characte

sleep in diverse societies in rnicroe

ing conditions (eg where when

macro ecological cultural demogra

sleep behavior at any age and phys left column) The framework was 1

inventories from colleagues havir

Bailey Fredrik Barth Magdalena and John Wood) concerning ten

tence strategy and geographic loc

Paraguay to horticulturalists in J Pakistan and Kenya and agricult

middot

ve on Human Development

1 shaping rearing envirorunents has bullthings one could do to influence the It important would be to decide where

lnity-that infant is going to grow up

nental-ecological framework builds on

Cological perspectives and provides a

b to sleepThe ecobiocultural approach e of culture on living conditions and

Ital expectancy of the developing child

I Cultural beliefs values and cognitiveshy

orm behaviors practices physical conshyIat members of the culture produce to

human ecology The actual conditions

or the developmental niche thereby are urally grounded views and practices for

19 (Super amp Harkness 1986) f any society must also work with hu~an icity responsive to the individual child in to the niche (eg parent assessments

tIe childs endogenous or constitutional

lent epigenetics and genetics physical or and health to both drive and respond to

ntal states and needs toward culturally h as state regulation physical function

etence are formed in this cultured space well as those influenced by sleep patterns

and thus can be viewed as products of the

ic argues for the possibly constitutive role

d regulation and provides a general frameshy

ral factors to more proximal accounts such

onal model of infant sleep problems (Sadeh

gically it follows that ethnography should

fhuman development and sleep d supports research design by operationalshy

s in development in terms of observable

Developmental Cultural Ecology ofSleep 171

p~~nomena including the behaviors perceptions relationships and conshydinons that constitute the context of rearing Thus an ecobiocultural

model represents a powerful tool for systematic study of sleep in other

cultures in relation to human development It draws attention to on-theshy

ground patterns ofsleep behavior and exp~rience as important factors in

t~e develo~ment not only ofsleep itself but also of the other aspects of life-emononal social and productive--of which it forms an integral

part The next section describes a general framework for the ecology of

sleep and the unexpected insights yielded from its use in an exploratory


A Comparative Ecology of Sleep

The gap between paradigms for laboratory-based investigation of sleep

and how it is practiced around the world formed the impetus for our

initial study over a decade ago to begin filling this gap from the side of

anthropology (Worthman 1999) Investigation of cross-cultural patterns

and variation in sleep behavior and corresponding physiology had

scarcely begun at that time (Reimao Souza amp Gaudioso 1999 Reimao

Souza Medeiros amp Almirao 1998 reviewed in McKenna 1996 McKenna

2000) Although direct comparative empirical reports on sleep behavior

were scant the physical and social ecology of sleep was more accessible

in ethnographic and historical accounts (Ekirch 2005 McKenna et al

1993) T~us we used the ecobiocultural model to formulate an a priori

descn~nv~ framework for characterizing the developmental ecology of

~leep m ~~erse societies in rnicroecological terms that determine sleepshymg condinons (eg where when how and with whom) along with

macroecological cultural demographic and climatic factors that pattern

sleep behavior at any age and physical or social condition (see Table 81

~eft colu~)The framework was used to elicit structured ethnographic mventones from colleagues having society-specific expertise (Robert

Bailey Fredrik Barth Magdalena Hurtado Bruce Knauft Mel Kanner

and John Wood) concerning ten traditional cultures ranging in subsisshy

tence strategy and geographic location from foragers in Botswana and

Paraguay to horticulturalists in New Guinea and Zaire pastoralists in

Pakistan and Kenya and agriculturalists in Bali This analysis revealed

TABLE 81 Sleep ecology and settings elements and contrasts

Elements of sleep

ecology

Microecology

Proximate physical ecology

Bedding

Presence of fire Sleeping place or

structure

Proximate social ecology

Sleeping arrangements Separation ofsleepshy

wake states Biotic macro- and

micro-ecology Domestic animals

Parasites and nighttime pests

Macropredators

(animal human) Macroecology Labor demands Social activity

Ritual practices BeliefS about sleep and

dreaming Status (social status class

gender)

Life history lifespan processes

Ecology climate

Demography and

settlement patterns

Characteristics of nonshy Western sleep settings Western globalizing

historic

Security

risk from pathogens present absent predators elements enemies

Sensory stimulation sleeping arrangements

co-sleeping body contact thermal properties

use offire noise light

odors bedding

sleep surfaces and

bedding Variability of sensory

properties regulation ofthermal

conditions

disturbance (noise movement light)

moderate-high extensive

extensive heatcold yes

dynamic dimldark present minimal rough

variable

human active

episodic erratic

low-minimal

solitary limited

limited stable no

silent darkdim minimal elaborate smooth padded

stable

climate-control

absentIminiroal

areas ofcommonality along with di

microecology under which people

effects ofsocial cultural and physic

on sleep patterns (Worthman amp M

Unexpectedly the comparativ(

tics of contemporary sleep ecology

Across this small non-Western sam]

itary sleep rare bedtimes fluid and

fire present conditions dim or da

animals and little or no acoustic ar

tiollSAs such sleep settings offered

including security and comfort thr

in time and space and little climate

eties by contrast appear to have r

properties including solitary or lov

bedtimes and wake times with cor

fuse bedding absence of fire darb as physical boundaries to sleep spac

modernized sleep conditions tl

challenging include habitual soli

infancy onward a lie down and d

vals with few brief sleep-wake tr

physical and social cues in sleep set

distinctively modernized habits

dens on the development of sleepshy

contribute to contemporary sleeF

another hypothesis might propose

sustained sensory loads straining sl

mentation and requiring more dis

sitated robust sleep-wake regulatio

Our cross-cultural survey als mental niche for sleep that were co

from prevailing Western practice

rooming In line with the crossshy

1971) virtually all infants and mo

were provided with sleeping parI

sleep was an exception rather tha

ents and contraSts Western Inonshyglobalizing

historic

Western I

IS present absent

ments

don moderate-high low-minimal

ents extensive solitary llimited

extensive limited

heatcold stable

yes no

dynamic silent

dimldark darkdim

present minimal

minimal elaborate

rough smooth padded

lnsory variable stable

mal human active climate-control

e episodic erratic absent minimal

light)


areas ofcommonality along with diversity in the proximal conditions or

microecology under which people sleep and documented the pervasive effects ofsocial cultural and physical ecological factors or macroecology

on sleep patterns (Worthman amp Melby 2002)

Unexpectedly the comparative evidence flagged some characterisshy

tics of contemporary sleep ecology and practices as unusual (Table 81)

Across this small non-Western sample sleep settings were social and solshyitary sleep rare bedtimes fluid and napping common bedding minimal

fire present conditions dim or dark and relatively noisy with people

animals and little or no acoustic and physical barrier to ambient condishy

tions As such sleep settings offered riC and dynamic sensory properties

including security and comfort through social setting fuzzy boundaries

in time and space and little climate controL Postmodern industrial socishyeties by contrast appear to have relatively impoverished stable sensory

properties including solitary or low-contact sleep conditions scheduled

bedtimes and wake times with consolidated sleep padded bed and proshy

fuse bedding absence of fire darkness silence and high acoustic as well

as physical boundaries to sleep spaces Features ofthese much more static modernized sleep conditions that may make sleep regulation more

challenging include habitual solitary sleep or limited cosleep from

infancy onward a lie down and die model of sleep in restricted intershy

vals with few brief sleep-wake transitions and sensory deprivation of physical and social cues in sleep settingsAn untested question is whether

distinctively modernized habits and settings place high sustained burshy

dens on the development ofsleep-wake regulation systems and in turn contribute to contemporary sleep problems and disorders Conversely

another hypothesis might propose that traditional settings placed high sustained sensory loads straining sleep maintenance fostering sleep fragshy

mentation and requiring more distributed and variable sleep that necesshy

sitated robust sleep-wake regulation

Our cross-cultural survey also identified features of the developshymental niche for sleep that were common across the sample but distinctive

from prevailing Western practices First is extensive co-sleeping andshy

rooming In line with the cross-cultural evidence (Barry amp Paxson

1971) virtually all infants and most children in our sample normatively

were provided with sleeping partners from birth onward and solitary sleep was an exception rather than a rule Second as with adults fixed


bedtimes were absent for children daily routines were common but also

highly flexible As with adults sleep commonly occurred as needed

interspersed with ongoing quotidian affairs Thus for example young

children listen observe and may doze during family food preparation

and gossip or during evening parlays or rituals Third and related to the

absence of fixed bedtimes and the ability to accommodate individual

sleep needs around the clock we found no strong sense ofspecific stageshy

graded developmental needs for sleep Most societies surveyed regarded sleep not as a wholly distinct state but as a range of attentional states

situated along a spectrum graduated from here-and-now engagement

through somnolence to lightsleepto profound awaynessDevelopmental

goals commonly concerned socialization for appropriate sleep intensity

along an attentional spectrum for physical or spiritual safety in sleep

Fourth was the common importance of normative and moral frameshy

works that structure sleep For instance concerns for spiritual safety

mandated co-sleeping and socialization for light sleep in some societies including the Papua New Guinean Gebusi and Zairian LeseThese four

features of the developmental niche for sleep reflect cultural influences

grounded in shared models and schemas concerning sleep that will be

discussed in later sections of this chapter

Cultural Patterning of Sleep across the Life Course An Egyptian Case Study

Our initial cross-cultural analysis intrigued the sleep science community

Genni amp OConnor 200S and elicited cogent questions about generalizshy

ability to contemporary urban populations Our survey too had revealed

a need for studies ofsleep in the context ofeveryday activities and social

settings Consequendy we undertook a household-based study among

Egyptian families living at two sites Cairo or a densely setded agrarian

village Egypt holds one of the longest continuous records for urbanized

stratified cosmopolitan livilg has moderate to very high population densities and maintains the historic circum-Mediterranean tradition of

co-sleeping and bimodal sleep Study data included one week of conshytinuous activity records by all household members details of each sleep

event sleep history since birth and eth

(Worthman amp Brown 2007)

Qualitative evidence from intern

a strong customary preference for c as expectable protective comforting

tionships and family life (Worthman reported routine co-sleeping and brea

by co-sleeping in early childhood 1 co-sleeping or co-rooming through n as through adulthood All reported

and most endorsed its virtues even Customary practices of providing sle(

are constrained by rules of sexual prol reliably doing so for adolescents and

lished patterns of co-sleeping and co disrupted during adolescence and um was no age_and_gender-appropriate s1

Family activity records revealed tl of sleep per day but followed a patte

napping and habitual co-sleeping (We norms for sleep and sleeping arrang

pattern and amount across the life c(

hood of co-sleeping and relationship

gender of the sleeper Specifically ke night sleep arousals and total sleep) all ally moderated factors most particula

age and gender Family relationships flt most nighttime sleep events and a

involved co-sleeping Furthermore fe

itary without roommate or bed parm ner appeared to be more regular corr but not co-rooming was associated

night sleep shorter less variable lengl turbance represented by reported aro

Co-sleeping may qualify as the I

shared by partners of all ages and ge

ily routines were common but also p commonly occurred as needed

n affairs Thus for example young

lze during family food preparation or rituals Third and related to the

ability to accommodate individual

nd no strong sense of specific stageshy

p Most societies surveyed regarded but as a range of attentional states

i from here-and-now engagement

rofoundawaynessDevelopmental

~tion for appropriate sleep intensity

physical or spiritual safety in sleep

ce of normative and moral frameshy

tance concerns for spiritual safety ion for light sleep in some societies Gebusi and Zairian LeseThese four

for sleep reflect cultural influences

lemas concerning sleep that will be

lpter

cross the Life Course

rigued the sleep science community

ed cogent questions about generalizshytlations Our survey too had revealed

ltext of everyday activities and social

ok a household-based study among s Cairo or a densely settled agrarian

est continuous records for urbanized moderate to very high population

c circum-Mediterranean tradition of

dy data included one week of conshy

ehold members details of each sleep

Developmental Cultural Ecology of Sleep 17S

event sleep history since birth and ethnographic interviews about sleep (Worthman amp Brown 2007)

Qualitative evidence from interviews and sleep histories endorsed

a strong customary preference for co-sle~ing which was regarded as expectable protective comforting and integral to foundational relashy

tionships and family life (Worthman amp Brown 2007) All participants

reported routine co-sleeping and breastfeeding during infancy followed by co-sleeping in early childhood The great majority also reported

co-sleeping or co-rooming through middle and late childhood as well

as through adulthood All reported napping routinely earlier in life and most endorsed its virtues even if they rarely napped later on

Customary practices of providing sleep partners for persons of all ages

are constrained by rules ofsexual propriety that reduce the feasibility of

reliably doing so for adolescents and single young adults Hence estabshy

lished patterns of co-sleeping and co-rooming were most likely to be

disrupted during adolescence and unmarried young adulthood if there

was no age-and-gender-appropriate sleeping partner available

Family activity records revealed that participants averaged 84 hours of sleep per day but followed a pattern of bimodal sleep with daytime

napping and habitual co-sleeping (Worthman amp Brown 2007) Cultural

norms for sleep and sleeping arrangements strongly determined sleep pattern and amount across the life course such that age gender likelishy

hood of co-sleeping and relationship to co-sleeper varied with age and gender of the sleeper Specifically key features of sleep behavior (onset

night sleep arousals and total sleep) all were strongly predicted by culturshy

ally moderated factors most particularly bed-sharing habits followed by age and gender Family relationships formed the context for sleep Hence most nighttime sleep events and a near majority of afternoon naps

involved co-sleeping Furthermore few sleep events (one-fifth) were solshy

itary without roommate or bed partner In this setting sleep with a partshy

ner appeared to be more regular compact and undisturbed co-sleeping but not co-rooming was associated with earlier less variable onset of

night sleep shorter less variable length of nighttime sleep less sleep disshy

turbance represented by reported arousals and less total sleep per day Co-sleeping may qualify as the most intimate behavior that can be

shared by parmers of all ages and genders While sharing their sleeping

I76 Sleep and Development

hours co-sleepers in close body contact share space air warmth and

time (a third of the day) during a vital chronobiological period Such

shared experience creates a context for mutual regulation that also shapes

the developmental course of systems regulating arousal and affect

(McKenna Mosko Dungy amp McAninch 1990) Based on his experishy

mental preclinical work Hofer (1978) early proposed that relationships

act as regulators that inform development and shape adult function

Subsequent research has borne out this prediction and revolutionized

understandings of the roles of early environment and epigenetics in the

process of development Work among rodents in particular has detailed

the impact of expectable environments of rearing and functioning parshy

ticularly maternal behavior and early postnatal conditions on organizashy

tion of arousal and affect regulation among many other systems (Szyf

McGowan amp Meaney 2008 Weaver 2007) Different developmental

periods thus present particular opportunities and vulnerabilities to conshy

textual cues that drive regulation of systems closely involved in sleep

(McKenna 2000)

In line with such views data from our family study in Egypt indicate

that co-sleeping habits directly influenced sleep budgets and sleep qualshy

ity and that interruption of these habits in adolescence and young adultshy

hood was associated with increased likelihood of sleep dysregulation and

disruption in males and females respectively But the data do not address

the logical questions of whether and how sleeping arrangements and

co-sleeping in particular influence the development ofsystems that regshy

ulate sleep and arousal (Thoman 2006) These compelling issues remain

open to empirical investigation inemerging comparative research on

sleep

Culture and Sleep Recent Directions

Research on sleep and human development in different settings is

expanding in two directionsone being documentation of sleep patterns

and related outcomes in increasing numbers of non-Western settings

another being the emergence ofcomparative cross-national cross-cultural

research The former is particularly valuable for drawing attention to

divergent as well as shared issues across contexts that vary by wealth and

Develo)

technology as well as other cultural factor

needed to characterize relationships of sle

niche to the formation of sleep-wake pat1

Culture Culture Change and Child Sleej

Globalization and the forces of rapid soc

developmental niche in many ways Thes

ules for new forms o(labor introductio

gies altered setdement patterns (particu

and shifts in family and household struc

tions likely has profound effects on sl

research on these concerns remains an

lifestyle furthermore impose different (

tion regulation that raise the stakes for

ing changes in the developmental niche

systems including sleep A major factor driving contempor

and activity is formal education By 20

schooling had progressed to the point

children and 78 of secondary sch

(Watkins 2008)This phenomenon has

(see also Wolfson and Richards chapt

mental factors that pose challenges for

must be present and alert during th(

school start times determine wake tim

will impair school performance For e

fIfth-grade Israeli students compared

to less sleep and greater daytime slee

concentrating regardless of hours slel

Schooling also makes children sede

linked to reduced sleep time and

Cameron Biddle Marshall amp Gorel

turbance in a multiethnic study ofAl

Chan amp Meininger 2002) School

families whose ability to meet tho

parent education and workloads 1


itact share space air warmth and

ital chronobiological period Such r mutual regulation that also shapes

ms regulating arousal and affect

linch 1990) Based on his experishy

~) early proposed that relationships

gtpment and shape adult function

this prediction and revolutionized

environment and epigenetics in the

g rodents in particular has detailed

nts of rearing and functioning parshy

r postnatal conditions on organizashy

i among many other systems (Szyf

ler 200 7) Different developmental

lrtunities and vulnerabilities to conshy

gtf systems closely involved in sleep

m our family study in Egypt indicate

lenced sleep budgets and sleep qualshy

ibits in adolescence and young adultshy

likelihood ofsleep dysregulation and

pectively But the data do not address

Uld how sleeping arrangements and

the development of systems that regshy

~006)These compelling issues remain 1 emerging comparative research on

irections

development in different settings IS

being documentation ofsleep patterns

ng numbers of non-Western settings

gtmparative cross-national cross-cultural

trly valuable for drawing attention to

across contexts that vary by wealth and

technology as well as other cultural factors such as lifestyleThe latter is

needed to characterize relationships ofsleep ecology and developmental

niche to the formation ofsleep-wake patterns and self regulation

Cultue Cultue Change and Child Sleep bull

Globalization and the forces of rapid social change are transforming the

developmental niche in many waysThese include changing daily schedshy

ules for new forms oflabor introduction of mass media and technoloshy

gies altered settlement patterns (particularly urbanization) and housing

and shifts in family and household structure Each of these transformashy

tions likely has profound effects on sleep ecology and behavior but

research on these concerns remains an urgent need These changes in

lifestyle furthermore impose different demands on attention and emoshy

tion regulation that raise the stakes for understanding how correspondshy

ing changes in the developmental niche influences development of these

systems including sleep

A major factor driving contemporary young peoples daily schedules

and activity is formal education By 2006 the global project of universal

schooling had progressed to the point that 88 ofprimary school-aged

children and 78 of secondary school-aged youth were in school

(Watkins 2008)This phenomenon has important consequences for sleep

(see also WolfSon and Richards chapter 12 in this volume for environshy

mental factors that pose challenges for young adolescents sleep) Children

must be present and alert during the school hours which means that

school start times determine wake times while factors that erode alertness

will impair school performance For example an early start (710 AM) for

fifth-grade Israeli students compared to the usual 800 AM was related

to less sleep and greater daytime sleepiness as well as increased difficulty

concentrating regardless of hours slept (Epstein Chillag amp Lavie 1998)

Schooling also makes children sedentary Daytime inactivity has been

linked to reduced sleep time and quality in British youth (Murdey

Cameron Biddle Marshall amp Gorely 2004) and to degree of sleep disshy

turbance in a multiethnic study ofAmerican adolescents (Gupta Mueller

Chan amp Meininger 2002) Schooling places scheduling demands on

families whose ability to meet those demands vary by factors such as

parent education and workloads Thus for instance schoolchildren in


Riyadh Saudi Arabia with less educated mothers had later bedtimes and

less weekday sleep while those with working mothers had more total

sleep (BaHammam Bin Saeed AI-Faris amp Shaikh 2006) The same was true among Portugese schoolchildren who also exhibited a direct relashy

tionship of physical activity with total sleep (padez Mourao Moreira amp

Rosado 2009)

These and other studies document the impact ofmedia use on chilshy

drens activity and sleep budgets Children who watch more television

sleep less than those who watch less Similarly the spread of computer

use among Brazilian adolescents has been related to sleep disruption and

daytime sleepiness (Mesquita amp Reirnao 2007) We observed the same

phenomena in our Egypt study (Worthman amp Brown 2007) Such effects

promise to intensify as access to these media spreads worldwide The

attractions of media are not the only source of time load and schedule

disruption for young people In developing countries childrens domesshy

tic or paid labor is vital for household welfare and adds to the scheduling

burden ofschool Moreover school overcrowding in many regions may

prompt rotating morning and evening shifts that together with parent

labor schedules further complicate timetables and compromise youth

sleep (Radosevic-Vidacek amp Koscec 2004Teixeira Fischer de Andrade

Louzada amp Nagai 2004) Accommodation of shifting sleep schedules

comes at a cost to neurobehavioral functioning in children for instance

Sadeh and colleagues have reported that children could adjust to small reductions or extensions within the range of naturalistic variation but

showed large effects on response times and continuous performance

tasks (Sadeh et al 2003)

Combined these sleep studies also illuminate sources for the global

spread ofobesity not only in adults but increasingly in youth (Darntonshy

Hill Nishida amp James 2004) Reduced sleep has been linked firmly to

greater risk for childhood obesity in diverse populations (Chen Beydoun amp Wang 2008 Hui NelsonYu Li amp Fok 2003) Increased inactivity has

been related to sleep reduction and both in turn are related to schooling and media use Thus calls fOf sleeping longer to combat obesity would

also need to consider schooling demands and media opportunities when

both may be valued by youth as means to build vital skills and social

networks

Develo

Even as obesity spreads malnutrition

affects brain development Nevertheless it

considered The scant evidence on develc

suggests disruption in malnourished infa

neurological development that can be re

bilitation (Shaaban Ei-Sayed NassarAsaa

developing countries who participate in

on top of schooling often are marginal study of nutrition activity and sleep testlaquo

gy-sparing role (Benefice Garnier amp Nc

workloads sleep duration in this sample (

than reported for Western counterparts

level during the day did not predict arne

ished Senegalese girls did sleep longer u

nourished peers Continuing expansiol nutrition enlarges the need for understal

on sleep and its regulation In sum viewed globally schedules

ofchildren increasingly are driven by th

school and influenced by media useTh

tion on sleep remains understudied an(

Cross-cultural Studies

A new generation of empirical crossshy

and aims to characterize sleep pract

development A parallel trend is the settings and behaviors in larger if r

within Western populations as well 1

for delineating actual normative con

characterizing their within-populat research with developmental study (

identification of the predictors of ke~ ior and quality self-regulation and ~ direction include reports documentil

tion for sleep schedule duration difj

ed mothers had later bedtimes and

working mothers had more total

ris amp Shaikh 2006)The same was 1 who also exhibited a direct relashy 1 sleep (padez Mourao Moreira amp

nt the impact ofmedia use on chilshyrildren who watch more television

i Similarly the spread of computer

been related to sleep disruption and

imao 2007) We observed the same thman amp Brown 2007) Such effects

lese media spreads worldwide The

ly source of time load and schedule

elopirlg countries childrens domesshy

ld welfare and adds to the scheduling

overcrowding in many regions may

ring shifts that together with parent

~ timetables and compromise youth

c 2004Teixeira Fischer de Andrade

nodation of shifting sleep schedules

functioning irl children for instance

d that children could adjust to small

le range of naturalistic variation but

times and continuous performance

i also illuminate sources for the global

s but increasirlgly in youth (Darntonshy

duced sleep has been linked firmly to n diverse populations (ChenBeydoun

I amp Fok 2003) Increased inactivity has Id both irl turn are related to schooling

eping longer to combat obesity would emands and media opportunities when

s means to build vital skills and social


Even as obesity spreads malnutrition still afRicts many and directly

affects brain development Nevertheless its relationship to sleep is rarely

considered The scant evidence on development of sleep-wake patterns

suggests disruption in malnourished infants which may reflect delayed

neurological development that can be reffiidiated by nutritional rehashy

bilitation (Shaaban Ei-Sayed NassarAsaad amp Gomaa 2007) Children irl

developing countries who participate in subsistence and domestic labor

on top of schooling often are marginally nourished A rare empirical

study of nutrition activity and sleep tested whether sleep plays an enershy

gy-sparing role (Benefice Garnier amp Ndiaye 2004) Despite heavy daily

workloads sleep duration in this sample ofSenegalese girls was no greater

than reported for Western counterparts (Benefice et al 2004) Activity

level during the day did not predict amount ofsleep although malnourshy

ished Senegalese girls did sleep longer and more deeply than their better

nourished peers Continuing expansion of inequities in resources and

nutrition enlarges the need for understanding the impact ofmalnutrition

on sleep and its regulation

In sum viewed globally schedules activity levels and sleep budgets

ofchildren increasingly are driven by their workloads for subsistence plus school and influenced by media use The impact ofwidespread malnutrishy

tion on sleep remains understudied and merits attention


A new generation of empirical cross-national research is just emerging

and aims to characterize sleep practices and ecology during human

development A parallel trend is the documentation of everyday sleep

settings and behaviors in larger if not yet population-based samples

within Western populations as welL These studies are valuable not only

for delineating actual normative conditions and practices but also for

characterizing their within-population variability Alliance of such

research with developmental study designs will significantly accelerate

identification of the predictors of key outcomes including sleep behavshy

ior and quality self-regulation and sleep difficulties Early steps in this

direction include reports documenting developmental curves and variashy

tion for sleep schedule duration difficulties and bed sharing in a Swiss


longitudinal study of nearly 500 children ages I month through 10 years

(Iglowstein lenni Molinari amp Largo 2003 lenni Fuhrer Iglowstein

Molinari amp Largo 2005) Population-typical age curves that include

centile distributions of individual variation provide both bases for indishy

vidual assessment and a reality check for the cultural expectations that

inform parental and clinical goals and assessments

More recent studies have begun to solicit details of sleep ecology

(setting arrangements and parent behaviors) using the internet to recruit

larger samples ofparental reports on early sleep Findings from a sample

ofover 5000 parents in the United States and Canada document features

of sleep ecology to age three and their relationship to sleep patterns

including the emergence ofsleep consolidation (Sadeh et al 2009)They

also emphasized dramatic infant variation in sleep duration during the

first year Excluding age parent behaviors (regularity ofbedtime routines

sleep interventions) were the principal factors related to night sleep

duration and quality A limitation of this approach is reliance on parent

perceptions that are filtered by their access to and evaluation of the

relevant informationYet there may be advantages insofar as parent pershy

ceptions such as are reflected in reported sleep problems predict childshy

care and form the developmental niche

The same internet measure was used to sample nearly 30000 parents

of under-3 children in I2 Asian and 5 Western Anglophone countries or

regions This new evidence shows large population differences in sleep

schedules and duration bed- or room-sharing practices and perceived

sleep problems (Mindell Sadeh Wiegand How amp Goh in press) While

it lends empirical support for our earlier ethnographic analysis more

importantly this study lays the fou~dations for identification of populashy

tion differences and similarities in sleep conditions behaviors and outshy

comes For example parent behaviors emerged as the strongest predictors

of nighttime sleep and mediated the relationship of co-sleeping and

co-rooming with reduced sleep duration and quality (Mindell Sadeh

Kohyama amp How in press)

In summary new evidence about sleep ecology in infancy and todshy

dlerhood consistently points to the impact of social actors (parents) on

the development ofsleep patterns and problems Thus the developmental

niche sculpts the systems regulating sleep

Develol

cultural Models of Child Developn Parenting and Sleep

Expanding cross-cultural research probil

practices and outcomes also increases the

tural rationales and meanings that under and behaviors Cultures are distinguished

of behavior and living conditions but

motivate behavior and give meaning to c

that an account of the role of culture ir

sleep would be incomplete without a ( tion or how culture operates in thougr

tural approach suggests that by syst

perceptions and behavior cultural belief

appropriate parenting are powerful det

mental niche in which children grow Ul

as satisfactory or problematic This secti

tural analysis that permits linkage to 1

health

Cultural Models

Culture comprises complex arrays ofd

tices and it is organized by intersectin

provide integrated accounts ofhow d

in it These cognitive cultural resourCf

experience-based properties that gene

to make sense ofexperience address c

amp Quinn 1997) Cultural models act

nize a phenomenological domain (~ basis for thought and action by recr

to the domain mapped by the model structured experience-based sets of

tion (child) or concept (daughter) th

tions and specific exemplars and el

features (Shore 1996) Schemas als


ldren ages I month through 10 years

go 2003 Jenni Fuhrer Iglowstein

ion-typical age curves that include

ariation provide both bases for indishy

ck for the cultural expectations that

nd assessments In to solicit details of sleep ecology

ehaviors) using the internet to recruit

n early sleep Findings from a sample States and Canada document features

j their relationship to sleep patterns

onsolidation (Sadeh et al 2009)middotThey

ariation in sleep duration during the laviors (regularity ofbedtime routines

mcipal factors related to night sleep

of this approach is reliance on parent

their access to and evaluation of the

ly be advantages insofar as parent pershy

eported sleep problems predict child-

niche as used to sample nearly 30000 parents nd SWestern Anglophone countries or

IS large population differences in sleep

room-sharing practices and perceived

Wiegand How amp Goh in press)While

lUr earlier ethnographic analysis more

)undations for identification of populashy

in sleep conditions behaviors and outshy

viors emerged as the strongest predictors

ed the relationship of co-sleeping and

) duration and quality (Mindell Sadeh

about sleep ecology in infancy and todshy

the impact of social actors (parents) on

as and problemsThus the developmental

ting sleep

Cultural Models of Child Development Parenting and Sleep

Expanding cross-cultural research probing associations between sleep

practices and outcomes also increases the ned for inquiry into the culshy

tural rationales and meanings that underlie differences in sleep ecology

and behaviors Cultures are distinguished by not only distinctive patterns

of behavior and living conditions but also the belief and values that

motivate behavior and give meaning to experience From this it follows

that an account of the role of culture in the developmental ecology of

sleep would be incomplete without a consideration of cultural cognishy

tion or how culture operates in thought and emotion The ecobioculshy

tural approach suggests that by systematically infonning caregiver

perceptions and behavior cultural belief about human development and

appropriate parenting are powerful determinants of both the developshy

mental niche in which children grow up and the assessment ofoutcomes

as satisfactory or problematic This section considers an approach to culshy

tural analysis that permits linkage to human behavior experience and

health

Cultural Models

Culture comprises complex arrays ofdistributed belief values and pracshy

tices and it is organized by intersecting cognitive models or schemas that

provide integrated accounts of how the world works and how one lives

in it These cognitive cultural resources have both shared and individual experience-based properties that generate meanings motives and action

to make sense of experience address challenges and pursue goals (Strauss

amp Quinn 1997) Cultural models act as cognitive frameworks that orgashy

nize a phenomenological domain (such as human development) as a

basis for thought and action by recruiting multiple cognitive resources

to the domain mapped by the model (Shore 1996) Schemas in turn are

structured experience-based sets of representations regarding a percepshy

tion (child) or concept (daughter) that include both generalized proposishy

tions and specific exemplars and embodied-affective and motivational

features (Shore 1996) Schemas also concern social phenomena from


roles (father) to persons (dad) to stereotypes (dads) to self (person)

Models and their informing schemas range in particularity from specific

scripts (infant feeding) to foundational schemas (gender) that inform

multiple domains And they are not merely abstractions but also autoshy

matic and visceral

By scaffolding both behavior and interpretation of others behavior

cultural models and schemas move out of the realm of personal experishy

ence to circulate in the world and become tangibly real (Garro 2000)

Cultural cognition also attains moral force through the internalized

values that motivate scripts and the ability to live by shared codes and do

the right thing thereby become crucial to cultural competence and even

to health For example ability to achieve internalized cultural lifestyle

goals has been associated with physical and mental health status in both

Brazilians and rural African Americans (Dressler 2004 Dressler Balieiro

Ribeiro amp Dos Santos 2007)

Cultural Model of Child Development US

Results from our study of middle-class Atlanta families exemplify how

cultural models and scripts work translating a large domain into the

organization of daily life (DeCaro amp Worthman 2007) Parental models

of young child development identified two core needs namely that for

security and safety as well as that for opportunity and growthThe former

requires stability control predictability and support that create a proshy

tected space for development The latter involves enrichment stimulashy

tion exploration and spontaneity for physical and psychosocial growth

Resolution of the tension between these two fundamental needs relied

on parent efforts to strike a balance between them that optimizes the

specific childs development Action schemas for parenting related to

securitysafety included producing a predictable simple schedule with

continuous surveillance by good caregivers Those for opportunity

growth included good schooling extracurricular activities and play

opportunities That for balance included tailoring to individual child

needs and abilities and subordination ofparental priorities and schedules

to childrens needs The moral corollary was that parent stress indexes

effort and compliance with demands of this model and thus signals

parental virtue We found that parents of young children did enact this

Devel

model and related schemas in the orgar

that maternal and family functioning mlt

tion and arousal regulation (DeCaro amp

fmdings explored how cultural models

mas for appropriate parenting systematic

niche and shape child psychobehavioral

Cultural Models ofSleep US

Similarly sleep behavior and settings at

of sleep and schemas for appropriate sle

of development and schemas for par

target of the Adanta family study (DeC sleep was integral to its round-the-cloc

graphic interviews Based on this evi

this discussion a rough cultural mode includes two dimensions restoration

column)The restorative dimension tre

tial and positive function an autonom

escape or withdrawal from daily care a

sensitive to disturbances The dimen

physiologically and socially bounded and sleep should be scheduled fitted i

into a single block in proper settings I

regulation autonomy and indepenc

sloth or disorganization poor sleep

and sleep loss reflects self-control an

relates to the notion that Western

a foundational schema of the self as il

dent (Markus amp Kitayama 1991 C

2002 and comments) The American cultural model

that shape sleep behaviorS and se (DeCaro ampWorthman 2007)middot Conc

1) essential something of which 0

and physical health (though how m

maintenance permissive for deman


stereotypes (dads) to self (person)

lS range in particularity from specific

ional schemas (gender) that inform

t merely abstractions but also autoshy

nd interpretation of others behavior

out of the realm of personal experishy

become tangibly real (Garro 2000)

lOral force through the internalized

ability to live by shared codes and do

lcial to cultural competence and even

achieve internalized cultural lifestyle

sical and mental health status in both cans (Dressler 2004 Dressler Balieiro

nent us

e-class Atlanta families exemplify how

~ translating a large domain into the D amp Worthman 2007)middot Parental models

ltifled two core needs namely that for

or opportunity and growthThe former

tability and support that create a proshy

he latter involves enrichment stimulashy

y for physical and psychosocial growth

en these two fundamental needs relied

ance between them that optimizes the

ction schemas for parenting related to

ing a predictable simple schedule with

od caregivers Those for opportunity

ing extracurricular activities and play

included tailoring to individual child

lation ofparental priorities and schedules corollary was that parent stress indexes

emands of mis model and thus signals

parents of young children did enact this

model and related schemas in the organization of daily fanilly life but

mat maternal and family functioning moderated markers of child emoshy

tion and arousal regulation (DeCaro amp Worthman 2008a 2oo8b) These

fmdings explored how cultural models of child development and scheshy

mas for appropriate parenting systematicallytStructure the developmental

niche and shape child psychobehavioral outcomes


Sinlllarly sleep behavior and settings are grounded in cultural accounts

ofsleep and schemas for appropriate sleep and also intersect with models

of development and schemas for parenting Although not the direct

target of the Atlanta fanilly study (DeCaro amp Worthman 2008a 2008b)

sleep was integral to its round-the-clock activity monitoring and ethnoshy

graphic interviews Based on this evidence for illustrative purposes in

this discussion a rough cultural model of sleep can be delineated that

includes two dimensions restoration and regulation (see Table 82 left

column)The restorative dimension treats sleep as a mysterious but essenshy

tial and positive function an autonomous self-maintenance behavior an

escape or withdrawal from daily care and demands and a vulnerable state

sensitive to disturbances The dimension of regulation casts sleep as a

physiologically and socially bounded state one is either awake or asleep

and sleep should be scheduled fitted into life demands and consolidated

into a single block in proper settings In moral terms sleep expresses selfshy

regulation autonomy and independence sleeping too much reRects

sloth or disorganization poor sleep reRects a failure in self-regulation

and sleep loss reRects self-control and life demands This model of sleep

relates to the notion that Western societies characteristically feature

a foundational schema of the self as independent rather than interdepenshy

dent (Markus amp Kitayama 1991 Oyserman Coon amp Kemmelmeier

2002 and comments)

The American cultural model of sleep interdigitates with schemas

that shape sleep behaviors and settings (Table 82 middle column)

(DeCaro ampWorthman 2007) Concerning restoration sleep is treated as

I) essential something of which one should get enough for mental

and physical health (though how much is enough is uncertain) 2) selfshy

maintenance permissive for demanding space to meet individual sleep


TABLE 82 Cultural model and schemas of sleep in the USAn outline

Components of cultural Action schemas Parenting schemas

model scripts

Restoration

Essential yet mysterious Get enough but Provide adequate protected sleep amount uncertain

Self maintenance Meet inclividual Child sleeps alone maycrash

requirements Withdrawal escape Seek solitary quiet Provide separate sleeping space

separate setting Vulnerable sensitive Minimize external Minimize stimuli disturbance

stimuli Regulation

Distinct bounded Limit to specific time Establishmaintain bedtimes place

Necessarily consolidated Consolidate sleep into Foster single nighttime blocks a block

Subordinate to life Schedule curtail as Structure regular schedule demands needed

Moral frame

Restoration sustaining good sleep = necessity good sleep = good child = good natural involuntary excusative parent

Regulation self right sleep = self right sleep = good child = good regulation autonomy control social fIt parent efficiency

Foundational schema

Independent self Sleep an individual Tough love to master sleep responsibility habits = learn independence

requirements 3) withdrawal involving solitary quiet comfortable and

separate spaces and 4) vulnerable requiring minimization or shielding

from disruptive stimuli The corresponding moral framework posits sleep

as sustaining natural and involuntary Consequendy good sleep is treated

as a positive good because it is necessary and a need for sleep can excuse

taking time out from work and social demands

The regulation aspect of sleep clearly stands in tension to its restorshy

ative aspect Regulation mandates a push to sleep in a single well-timed

nocturnal episode on a bed in a bedroom to subordinate sleep to ongoing

daily demands and thus to curtail it when necessary Moral entailments

Deveilt

include that sleep steals time from life pri

good social adjustment produced by attin

ing life demands combined with the self-(

ingly Thus sleeping too much at ina

inability to sleep through the night may

of physiology and thus as psycholo

Moreover sleep at the wrong time an(

count as real sleep Demands related tc

demonstrated sleep needs illness or inin

an airport) may be invoked to excuse no

damages These tensions become partiet

tion and parenting

Intersecting Models of Sleep and Child

Consideration of cultural models an American normative practices of sleel

infancy and childhood (Table 82 rieuro

sleep directly inform parenting goals

understood to have special sleep nee

curve in sleep-wake regulation it is t

ensure that the child gets proper sleep For proper child development parent

by providing a separate specified bed

from disturbances (noise light heato

of a young childs sleep dysregulation

extended Setting up and furnishing

crucial preparations for parenthood a

to undergo a protracted period ofdisI

the childs early years Concurrendy

well-regulated sleep in their child c

and maintaining bedtimes and regula

soli dated nighttime sleep with approl

cess may require parents to be firn When a baby has repeated problerr

need to show some tough love (St

large on-line survey ofNorthAmer

ofsleep in the US An outline

(s Parenting schemas

but Provid~ adequate protected sleep

ertain Child sleeps alone may crash

s [uiet Provide separate sleeping space

ing nul Minimize stimuli disturbance

fie time Establishmaintain bedtimes

leep into Foster single nighttime blocks

tail as Srrncrure regular schedule

necessiry good sleep = good child == good parent

self right sleep = good child good parent

Tough love to master sleep ividual habits =learn independence iliry

volving solitary quiet comfortable and

)le requiring minimization or shielding

esponding moral framework posits sleep

ltary Consequently good sleep is treated

lecessary and a need for sleep can excuse

ld social demands ~ep clearly stands in tension to its restorshy

es a push to sleep in a single well-tuned

bedroom to subordinate sleep to ongoing

tail it when necessary Moral entailments

Developmental Cultural Ecology of Sleep I8S

include that sleep steals time from life priorities Sleeping right expresses

good social adjustment produced by attitudes and commitment to meetshy

ing life demands combined with the self-control to regulate sleep accordshy

ingly Thus sleeping too much at inappropriate times or places or

inability to sleep through the night may be Viewed as failures of will or

of physiology and thus as psychological or physical dysfunction

Moreover sleep at the wrong time and place or broken sleep may not

count as real sleep Demands related to the restorative aspect such as

demonstrated sleep needs illness or inimical conditions (eg living near

an airport) may be invoked to excuse nonconforming behaviors or claim

damages These tensions become partculady apparent in sleep socializashy

tion and parenting

Intersecting Models ofSleep and Child Development US

Consideration of cultural models and morals provides insight into

American normative practices of sleep socialization and difficulties in

infancy and childhood (Table 82 right column) Prevailing views of

sleep directly inform parenting goals for child sleep The young are

understood to have special sleep needs and undergo a developmental

curve in sleep-wake regulation it is the parents responsibility both to

ensure that the child gets proper sleep and acquires correct sleep habits

For proper child development parents should foster adequate safe sleep

by providing a separate specified bed and sleeping space that is buffered

from disturbances (noise light heatcold) And they should be indulgent

of a young childs sleep dysregulation and periodic crashes when overshy

extended Setting up and furnishing the newborns sleeping space are

crucial preparations for parenthood among Americans who also expect

to undergo a protracted period ofdisrupted sleep-wake schedules during

the childs early years Concurrently parents are expected to inculcate

well-regulated sleep in their child as swiftly as possible by establishing

and maintaining bedtimes and regular daily schedules that promote conshy

solidated nighttime sleep with appropriate amounts ofnappingThe proshy

cess may require parents to be firm as this popular source suggested

When a baby has repeated problems falling asleep Mom and Dad may

need to show some tough love (Staff 2009 p 54) Correspondingly a

large on-line survey ofNorth American parents found that longer more


consolidated infant night sleep at ages 0-3 years was associated with

parental behaviors fostering self-soothing and independence (Sadeh

et al 2oo9)Variation from the ideal cultural model was extensive over

a third ofinfants sleep in their parents room or bed

Within a few months after birth American parents routinely are

asked Is shehe a good babyThe question actually inquires whether

the baby sleeps through the night goes to sleep without a lot of fussing

and crying and is easy to soothe ifshehe wakes up The moral stakes are

clearly expressed good or correct sleep habits manifest good infant

development that results from good parenting The sleep habits and

soothability of the child symbolize both the current quality of the parshy

ent-child relationship and the cumulative quality of care for the childs

appropriate mastery ofself-regulatory skills Good babies have good parshy

ents Given these views and the intense investments of parenting the

moral-in addition to existential--distress that goes with refractory

infant crying bedtime struggles and sleep problems can be personal and

profound (Barr PatersonMacMartin Lehtonen amp Young 2005) Notably

bedtime and sleep problems account for a 20-30 ofpediatric consults

(Moore Meltzer amp MindeD 2008)

In sum cultural models on sleep perceptions practices and settings

are readily tapped as illustrated above for a weD-studied population the

United States Attention to the moral dimensions that motivate such

models furthermore can yield fresh insight into social pressures and

affective loading on what counts as sleep how it should be done and

what can go wrong that influence how people behave and what sleep

problems they experience

Non-Western Cultural Models ofSleep

Our earlier survey of ethnographic accounts for the study of sleep ecolshy

ogy (Worthman and Melby 2002) also provided an overview of diverse

cultural cognitions and practices around sleep Some elements ofcultural

models in non-Western societies overlap with those extant among

Americans but other widespread themes do not These include domishy

nant concerns for danger and for social integration in sleep A correshy

sponding foundational schema is the interdependent self viewed in

Deveh

terms of relationships with others rather 1

(Oyserman et al 2002) From that perspe

social integration and security For heuristic purposes the prevalen1

ofsociability and danger have been outli

contrast with the US cultural model T the boundary ofsleep-wake as rather fuz

alertness and social engagement Sleep 2

determined by relationships and ones p

sleeping is opportunistic and accommc social priorities Overall an emphasis OJ

framed by people also counterbalance

TABLE 83 Other cultural models and schen

Components ofcultural Action schemas

model

Sociability Sleep as needed and fluid unbounded

possible Sleep with proper Social behavior

partuers Coordinate to life Opportunistic

demandsaccommodating Do not sleep alone Anchored by people

Danger Seek sleeping partn Not of this world Observe conditions Risky necessity

for safety Avoid extended Death-like difficult

deep sleep to break Moral logic

right sleep = sociiSociability social life integration = seand status

good sleep sociDanger social or spiritual alignmspiritual conditions safety

Foundational schema The connected self Sleep as social bel

ages 0-3 years was associated with

soothing and independence (Sadeh

eal cultural model was extensive over

ents room or bed birth American parents routinely are

he question actually inquires whether

goes to sleep without a lot of fussing

- shehe wakes upThe moral stakes are

ect sleep habits manifest good infant

~ood parenting The sleep habits and

~e both the current quality of the parshymulative quality of care for the childs

tory skills Good babies have good par-

intense investments of parenting the

al--distress that goes with refractory


terrns of relationships with others rather than of independent autonomy

(Oyserman et al 2002) From that perspective sleep relates intimately to

social integration and security

For heuristic purposes the prevalent (though not universal) themes

ofsociability and danger have been outlined (Table 83 left column) for

contrast with the US cultural model The dimension of sociality poses

the boundary ofsleep-wake as rather fuzzy graded along a continuum in

alertness and social engagement Sleep also constitutes a social behavior

determined by relationships and ones place in society Correspondingly

sleeping is opportunistic and accommodating fItted into daily life and

social priorities Overall an emphasis on sleep as sociable anchored and

framed by people also counterbala~ces the theme of danger and risk

TABLE Other cultural models and schemas for

and sleep problems can be personal and Components of cultural Action schemas Parenting schemas

rtinLehtonen ampYoung 2005) Notably model

)tint for a 20-30 of pediatric consults

8) deep perceptions practices and settings

tbove for a well-studied population the

moral dimensions that motivate such

fresh insight into social pressures and

ts as sleep how it should be done and

lce how people behave and what sleep

ifSleep

hic accounts for the study ofsleep ecolshy

)2) also provided an overview of diverse

s around sleep Some elements ofcultural

ties overlap with those extant among

ad themes do not These include domishy

for social integration in sleep A crreshy

1 is the interdependent self viewed in

Sociability

Fluid unbounded

Social behavior

Opportunistic accommodating

Anchored by people Danger

Not of this world Risky necessity

Death-like difficult to break

Moral logic

Sociability social life and status

Danger social or spiritual conditions

Foundational schema The connected self

Sleep as needed and possible

Sleep with proper partners

Coordinate to life demands

Do not sleep alone

Seek sleeping partners Observe conditions

for safety Avoid extended

deep sleep

right sleep =social integration = security

good sleep = social spiritual alignment safety

Sleep as social behavior

Permit sleep contingent on need

Carry provide sleeping partners

Fit sleep into ongoing activities

Rapid response to fuss cry

Passive surveillance Provide social spiritual security

Expect sleep in high stimulus load

calm adaptable sleep = secure child = good conditions

untroubled sleep safe child = good parent

Accommodate to master fluid sleep = learn interdependence


Many societies ally sleep with altered states unworldly or moribund and

regard it as a dangerous necessity andor spiritual opportunity Deep

sleep risks encounters with incorporeal realms and malign or beneficent

forces as such profound sleep may be difficult to break and require the

presence ofothers for safe return

Action schemas (Table 83 middle column) related to the sociability

component emphasize avoidance of sleeping alone sleeping with proper

partners and flexibility in time and place for sleep Entailments from the

danger component include measures for safety fmding security in sleepshy

ing partners proper conditions and cultivation of moderate sleep depths

with avoidance ofprotracted deep sleep From a moral perspective sleepshy

ing right or properly expresses the social integration that generates

security while a good sleep expresses the social or spiritual alignment

that generates safety It is both boon and existential barometer Priorities

for parenting from such cultural views (Table 83 right column) include

largely on-demand sleep schedules that fit into daily life infant carrying

and provision of sleeping partners and rapid response to fussing and

crying with expected rapid development ofrobust self-soothing Danger

is palliated through passive surveillance from presence of others provishy

sion of social and spiritual security (proper sleep partners amulets) and

sensory loads involved in social sleep

From this generalized non-Western cultural view unfussy adaptshy

able sleep is a hallmark of the secure properly adjusted child while

untroubled sleep reflects safety Each in turn comes from good condishy

tions mediated in part through parents (usually mothers) but also reflecshy

tive ofthe social order The resultanJ well-regulated interdependent child

fits in

This section has hazarded broad generalizations to explore the role

ofcultural models and their related behavioral developmental and moral

agendas in formation of the developmental niche for sleep

Methodologically analysis of these factors can reveal the cultural roots of normal sleep or dysfunction whether perceived or actual With the

exception of co-sleeping if infancy (McKenna 2000) the analysis of

cultural models and moral agendas has been largely absent from sleep

science and medicine But the large roles they play in determining behavshy

ior and health makes them promising targets for systematic study with

real practical value

Develop

Conclusion

This chapter has outlined conceptual aI

steps toward bridging gaps in sleep science

current accounts of sleep function and dy So far results are promising We noW reee

strued as social that it is heavily influenc largely culturally determined and that cuI

sleep behavior settings and sensibilities empirically expand these insights and l

understanding sleep particularly during c

has discussed conceptual and method

Accumulating evidence from our own at

the contexts of sleep are important facto

An ecological approach has proved to 1 sleep patterns and settings their variatic

tions and key variables driving sleep ou

tive can be extended to life course a

comparative study of sleep ecology Recognition ofthe importance ofc

culture matters for sleep The challeng

tractable terms that can be related to

physiology and quality Two framewor~ challenge one being the ecobiocultur

and the other being cultural models a

cognition The ecobiocultural model bull key pathways by which culture infiuen

developmental niche And indeed new

fied a decisive role of parent behavior

ties Such work resonates with discove as was highlighted in our comparativ

recent family study in Egypt How

reflects culturally characteristic social

Equally pressing are wider issues 0

housing and settlement patterns W

and inequity that influence sleep ane

global shifts

i states unworldly or moribund and

andor spiritual opportunity Deep

real realms and malign or beneficent

be difficult to break and require the

dle column) related to the sociability

f sleeping alone sleeping with proper

place for sleep Entailments from the

es for safety finding security in sleep-

l cultivation ofmoderate sleep depths

Jeep From a moral perspective sleepshy

the social integration that generates

~esses the social or spiritual alignment n and existential barometer Priorities

ews (Table 83 right column) include

that fit into daily life infant carrying

s and rapid response to fussing and

pment ofrobust self-soothing Danger

llance from presence of others provishy

y (proper sleep partners amulets) and

~ep

Western cultural view unfussy adapt-

secure properly adjusted child while d dilch in turn comes from goo conshy

lrents (usually mothers) but also refiecshy

mt well-regulated interdependent child

oad generalizations to explore the role

~d behavioral developmental and moral

le developmental niche for sleep

se factors can reveal the cultural roots of

hether perceived or actual With the aney (McKenna 2000) the analysis of

ldas has been largely absent from sleep

ge roles they play in determining be~avshyarising targets for systematic study with


Conclusion

This chapter has outlined conceptual approaches and surveyed flrst

steps toward bridging gaps in sleep science and anthropology that limit

current accounts of sleep function and dysfunction in the real world

So far results are promising We now recognize that sleep can be conshy

strued as social that it is heavily influenced by context that context is

largely culturally determined and that cultural models and morals infuse

sleep behavior settings and sensibilities The present challenge is to

empirically expand these insights and explore their implications for

understanding sleep particularly duripg child development This chapter

has discussed conceptual and methodological tools for that effort

Accumulating evidence from our own and others research suggests that

the contexts of sleep are important factors in sleep behavior and quality

An ecological approach has proved to be a valuable tool for studies of

sleep patterns and settings their variation within and between populashy

tions and key variables driving sleep outcomes The ecological perspecshy

tive can be extended to life course analysis as demonstrated in our

comparative study ofsleep ecology

Recognition of the importance ofcontext has led to another insight

culture matters for sleep The challenge is to operationalize culture in

tractable terms that can be related to outcomes such as sleep behavior

physiology and quality Two frameworks from anthropology address this

challenge one being the ecobiocultural model of human development

and the other being cultural models and schemas that ground cultural

cognition The ecobiocultural model of human development points to

key pathways by which culture influences child outcomes by shaping the

developmental nicheAnd indeed new cross-cultural research has identishy

fled a decisive role of parent behaviors in child sleep and sleep difficulshy

ties Such work resonates with discovery of the social dimension ofsleep

as was highlighted in our comparative study of sleep ecology and more

recent family study in Egypt How where and how well people sleep

reflects culturally characteristic social relationships and views of the self

Equally pressing are wider issues of family and household structure

housing and settlement patterns work and leisure activities nutrition

and inequity that influence sleep and presently are undergoing dramatic

global shifts


Sleep follows cultural models and related schemas about how to

behave how things work and how they go wrong Ai illustrated in the

case of the United States analysis of these frameworks in cultural cognishy

tion is critical for understanding sleep behavior and ecology It also reveals

the moral dimension of sleep accounting for the distress and perceived

dysfunction that erupt when behaviors or outcomes do not conform to

cultural expectations These dynamics are clearly in play in parenting and

child sleep Ai the generalized contrasting models from non-Western

societies illustrate there are different ways to view what sleep is how best

to do it and how these relate to child development and parenting Put

most simply the meanings attached to sleep can prove important for

understanding sleep behavior and distress throughout the life course

In sum although the comparative study ofsleep in human developshy

ment is in its infancy many factors converge to predict its rapid growth

and capacity to yield important insights into sleep and its relationship to

developmental processes Concerns about sleep problems and their psyshy

chobehavioral sequelae alongside globalizing changes that affect sleep

lend practical urgency to a project that promises fully to engage sleep

science with human diversity in everyday social life

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BaroneT L (2000) Is the siesta an adaptation to disease A cross-cultural examshyination Human Nature II233-258

Barr R G Paterson J A MacMartin L M Lehtonen L amp Young S N (2005) Prolonged and unsoothable crying bouts in infants with and withshyout colicJournal oDevelopmental and Behavioral Pediatrics 2614-23

Barry H IlL amp Paxson L M (1971) Infancy and early childhood Crossshycultural codes 2 Ethnology 10 46Cr-so8

Benefice E Garnier 0 amp Ndiaye G M (2004) Nutritional status growth and sleep habits among Sene~ese adolescent girls European Journal of Clinical Nutrition 58 292-30I

Chen x Beydoun M A amp WangY (2008) Is sleep duration associated with childhood obesity A systematic review and meta-analysis Obesity 16

265-274

Develc

Darnton-Hill t Nishida c amp jamesW P1 diet nutrition and the prevention ofchro

101-12I DeCa~]A amp Worthman CM (2007) Cu

young child experience in workingAme

Practice 7 177-203 DeCaro] A amp Worthman C M (2008a) C

cardiovascular regulation at school ent

Human Biology 20 572-583 DeCaro j A amp Worthman C M (200~b)

changing associations between family

Psychobiology 50 183-195 DresslerWW (2004) Culture and the risk (

21-31middot Rib RFDresslerWW Balielro M C euomiddot

consonance and psychological distress tiple cultural domains Culture ~edi~n

EkirchA R (200S) At days close NIght In

Epstein R Chillag N amp Lavie P (1998) daytime functioning of fifth-grade chi

Garro L C (2000) Remembering what 01 pastA comparison ofcultural consens

Ethos 3 27S-3 19middot GuPta N K Mueller W H Ch~

associated with poor sleep quality m a

Biology 14762-768 Hofer M (1978) Hidden regulatory pro

P P G Bateson amp P j Klopfer (Eds

behavior (pp 135-166) Oxford Engl Hui L L Nelson EA SYu L M Li

for childhood overweight in 6-to 7-)

Journal of Obesity 27 14II-1418 Iglowstein Ijenni O G Molinari L

from infancy to adolescence Refe

Pediatrics III 302-30 7 0 G Fuhrer H Z Iglowstein 1j enID middotmiddotf A longitudinal study of bed sharin~ dren in the fmt 10 years of life Ped

jenni 0 G amp OConnor B B (2005) culture and biology PedIatriCS II5

Markus H R amp Kitayarna S (1991) C nition emotion and motivation P

I

and related schemas about how to

they go wrong As illustrated in the

)f these frameworks in cultural cognishyep behavior and ecology It also re~eals )unting for the distress and perceIved

viors or outcomes do not conform to

lics are clearly in play in parenting and

mtrasting models from non-Western

nt ways to view what sleep is how best

child development and parenting Put

led to sleep can prove important for

distress throughout the life course

ative study ofsleep in human developshy

rs converge to predict its rapid growth

lsights into sleep and its relationship to

ns about sleep problems and their psyshy

globalizing changes that affect sleep

ct that promises fully to engage sleep

everyday social life

~aris E amp Shaikh S (2006) Sleep duration Saudi elementary school children Singapore

Idaptation to disease A cross-cultural examshy

-258 artin L M Lehtonen L amp Young S N

lable crying bouts in infants with and withshy

ttal and Behavioral Pediatrics 26 14-2 3 1971) Infancy and early childhood Crossshy

466-508 G M (2004) Nutritional status growth and

e adolescent girls European Journal of Clinical

19Y (2008) Is sleep duration associated with ladc review and meta-analysis Obes(ty 16


Darnton-Hill L Nishida c amp james W P T (2004) A life course approach to

diet nutrition and the prevention ofchronic diseases Public Health Nutrition 7101-12I

DeCaro] A amp Worthman C M (2007) Cultural models parent behavior and young child experience in working American families Parenting Science and Practice 7 177-203 bull

DeCaro] A amp Worthman C M (2008a) Culture and the socialization ofchild cardiovascular regulation at school entry in the US American Journal of Human Biology 20 572-583

DeCaro] A amp Worthman C M (2008b) Return to school accompanied by

changing associations between family ecology and cortisol Developmental Psychobiolcgy 50 183-195

DresslerWW (2004) Culture and the Jisk of disease British Medical Bulletin 69 21-3 I

DresslerWW Balieiro M c Ribeiro R P amp Dos Santos] E (2007) Cultural consonance and psychological distress Examining the associations in mulshytiple cultural domains Culture Mediane and Psychiatry 31 195-224

EkirchA R (2005) At days close Night in times past NewYork Norton

Epstein R Chillag N amp Lavie P (1998) Starting times of school Effects ont

daytime functioning of fifth-grade children in Israel Sleep 21 250-256

Garro L C (2000) Remembering what one knows and the construction of the pastA comparison ofcultural consensus theory and cultural schenla theory

Ethos 3 275-3 19middot GuPta N K Mueller W H Chan W amp Meininger J C (2002) Is obesity

associated with poor sleep quality in adolescents AmericanJournal ofHuman Biology 14762-768

Hofer M (1978) Hidden regulatory processes in early social relationships In P P G Bateson amp P] Klopfer (Eds) Perspectives in ethology ViII 2 Social behavior (pp 135-166) Oxford England Plenum

Hui L L Nelson E A SYu L M Li A M bull amp FokT E (2003) Risk factors for childhood overweight in 6-to 7-y-old Hong Kong children International Journal of Obesity 27 14II-1418

Iglowstein Ljenni 0 G Molinari L amp Largo R H (2003) Sleep duration

from infancy to adolescence Reference values and generational trends Pediatrics III 302-307

jenni 0 G Fuhrer H Z Iglowstein L Molinari L amp Largo R H (2005) A longitudinal study of bed sharing and sleep problems among Swiss chilshy

dren in the fust 10 years oflife Pediatrics II5 233-240

jenni 0 G amp OConnor B B (2005) Childrens sleep An interplay between

culture and biology Pediatrics II5 204-216 Markus H R amp Kitayama S (1991) Culture and the self Implications for cogshy

nition emotion and motivation Psychological Review 98224-253


McKenna]] (1996) Sudden infant death syndrome in cross-cultural perspecshytive Is infant-parent cosleeping protective Annual Review ofAnthropology 25201-216

McKe~a ] ] (2000) Cultural influences on infant and childhood sleep bIology and the science that studies itToward a more inclusive paradigm In G M Loughlin] L Caroll amp c L Marcus (Eds) Sleep and breathing in chiidrenA developmental approach (pp 99-130) New York Marcel Dekker

McKenna] J Mosko S Dungy C amp McAninch] (1990) Sleep and arousal pat~erns of co-sleeping human motherinfant pairs A preliminary physioshylogIcal study with implications for the study of infant death syndrome (SIDS) AmericanJournal ofPhysical Anthropology 83 33 1-347

McKenna] J Thoman E BAnders T SadehA SchechtmanV amp Glotzbach S (1993) Infant-parent co-sleeping in an evolutionary perspective Implications for understanding infant sleep development and the sudden infant death syndrome Sleep 16263-282

Mesquita G amp Reimao R (2007) Nightly use of computer by adolescents Its effect on quality of sleep Arquivos de Neuro-Psiquiatria 65428-432

MindelljA SadehA Kohyama] amp HowT H (in press) Parental behaviors and sleep outcomes in infants and toddlers a cross-cultural comparison Sleep Medicine

MindellJASadehAWiegandB HowT Hamp GohDYT (in press) Crossshycultutal differences in infant and toddler sleep Sleep Medicine

Moore M Meltzer LJ amp MindellJA (2008) Bedtime problems and night wakings in children Primary Care Clinics in Qffice Practice 35 569-581

Murdey L D Cameron N Biddle S J H Marshall S J amp Gorely T (2004) Pubertal development and sedentary behaviour during adolescence Annals ofHuman Biology 31 75-86

Oyserman D Coon H M amp Kemmelmeier M (2002) Rethinking individushyalism and collectivism Evaluation of theoretical assumptions and metashyanalyses Psychological Bulletin 128 3-72

Padez c Mourao L Moreira P amp RosadoV (2009) Long sleep duration and childhood overweight obesity and body fat American Journal of Human Biology 21 371-376

Radosevic-Vidacek B amp KoscecA (2004) Shifworking families Parents workshying schedule and sleep patterns of adolescents attending school in two shifts Revista de Saude pUblica 38 38-46

Reimao R Souza] C amp Gaudioso C E V (1999) Sleep habits in Native Brazilian Bororo children Arquivos de Neuro-Psiquiatria 5714-17

Reimao R SouzaJ c MedeirosM M amp Almirao R I (1998) Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sui Brazil Arquivos de Neuro-Psiquiatria 56 703-707

Sadeh A amp Anders T F (1993) Infant sleep problems Origins assessment interventions Infant Mental Health Journal 14 17-34

Developn

Sadeh A Gruber R amp Raviv A (2003) The extension on school-age children What a d

Deveiopment 74444-455middot SadehA MindellJA Luedtke KWiegand B

in the first 3 years a web-based study Journ Shaaban SY Ei-Sayed H L Nassar M EAs

Sleep-wake cycle disturbances in proteinshynutritional rehabilitation Eastern Mediterran

Shore B (1996) Culture in mind Cognition cui NewYork NY Oxford University Press

Staff (2009 November) The year in health amporr StrauSS c amp Quinn N (1997) A cognitive theor

UK Cambridge University Press Super C M amp Harkness S (1986)The develo)

tion at the interface of child and culture

Development 9 545-569 Szyf M McGowan P amp Meaney MJ (2008)

epigenome Environmental and Molecular MI Teixeira L R Fischer F M de Andrade M M

(2004) Sleep patterns of day-working ev~ of Sao Paulo Brazil Chronobiology Internatl

Thoman E B (2006) Co-sleeping an anci and present and possibilities for the fut

407-417 Watkins K (2008) Education for All Global

Oxford University Press and UNESCO

Weaver1 C (2007) Epigenetic programming macological intervention Nature versUS n

off Epigenetics 2 22-28 WeisnerT S (I 996)Why ethnography should

the study of human development In R

(Eels) Ethnography and human developne

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Worthman C M (2003) Energetics SOCIality tory theory in real life In KWWachter Humanfertility behavior in biodemographic pe DC National Academies Press

Worthman C M (2008) After dark the evo InW RTrevathan E O Smith amp JJ Me and health New perspectives (PPmiddot291-3 13)

Press

syndrome in cross-cultural perspecshyctive Annual Review ofAnthropology

es on infant and childhood sleep

~t Toward a more inclusive paradigm ~ Marcus (Eds) Sleep and breathing in )9-130) NewYork Marcel Dekker

t1cAninch] (1990) Sleep and arousal erlinfant pairsA preliminary physioshy

the study of infant death syndrome

1thropology 83 33 1-347 adehA SchechtmanV amp Glotzbach Ig in an evolutionary perspective

It sleep development and the sudden

-282 ~htly use of computer by adolescents

de Neuro-Psiquiatria 65 428-432 lowT R (in press) Parental behaviors

toddlers a cross-cultural comparison

lT Hamp Goh DYT (in press) Crossshy

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inics in OffUe Practice 35 569-581

R Marshall S] amp GorelyT (2004)

f behaviour during adolescence Annals

meier M (2002) Rethinking individushy

of theoretical assumptions and metashy

-72 sadoV (2009) Long sleep duration and I body fat American Journal of Human

04) Shifworking families Parents workshy

doles cents attending school in two shifts

C E v (1999) Sleep habits in Native

de Neuro-Psiquiatria 5714-17middot M amp Almirao R L (1998) Sleep habits

n in the state of Mato Grosso do Sul

1567deg3-7deg7 mt sleep problems Origins assessment

Journal 14 17-34middot


Sadeh A Gruber R amp Raviv A (2003) The effects of sleep restriction and

extension on school-age children What a difference an hour makes Child

Development 74 444-455middot SadehA Mindell]A Luedtke KWiegand B (2009) Sleep and sleep ecology

in the first 3 years a web-based study Journal f Sleep Research 1860-73middot Shaaban S Y Ei-Sayed H L Nassar M E Asaad T amp Gomaa S M (2007)

Sleep-wake cycle disturbances in protein-energy malnutrition Effect of

nutritional rehabilitation Eastern Mediterranean Health Journal 13633-645

Shore B (1996) Culture in mind Cognition culture and the problem f meaning NewYork NY Oxford University Press

Staff (2009 November)The year in health from a to z Time 174 51-89

Strauss c amp Quinn N (1997) A cognitive theory fcultural meaning Cambridge

UK Cambridge University Press

Super C M amp Harkness S (1986)The developmental nicheA conceptualizashy

tion at the interface of child and culture International Journal f Behavioral Development 9 545-569

Szyf M McGowan P amp Meaney MJ (2008) The social environment and the

epigenome Environmental and Molecular Mutagenesis 49 46--60

Teixeira L R Fischer EM de Andrade M M M Louzada E M amp Nagai R

(2004) Sleep patterns of day-working evening high-schooled adolescents

of Sao Paulo Brazil Chronobiology International 21 239-252

Thoman E B (2006) Co-sleeping an ancient practice Issues of the past

and present and possibilities for the future Sleep Medicine Reviews IO

407-417 Watkins K (2008) Education for All Global Monitoring Report 2009 Oxford


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macological intervention Nature versus nurture Lets call the whole thing

off Epigenetics 2 22-28

WeisnerT S (1996)Why ethnography should be the most important method in

the study of human development In R Jessor A Colby amp R Shweder

(Eds) Ethnography and human development Context and meaning in social inquiry (pp 305-324) ChicagoThe University of Chicago Press

Worthman C M (1999) Comparative ecology ofhuman sleep AmericanJournal f Physical Anthropology Suppl 28 21

Worthman C M (2003) Energetics sociality and human reproduction Life hisshy

tory theory in real life In K W Wachter amp R A Bulatao (Eds) Offspring Humanfertility behavior in biodemographic perspective (pp 289-321 )Washington

DC National Academies Press

Worthman C M (2008) After dark the evolutionary ecology of human sleep

InW RTrevathan E 0 Smith amp ]] McKenna (Eds) Evolutionary medicine and health New perspectives (pp 291-3 I 3) NewYork NY Oxford University Press


Worthrrum C M (in press) The ecology of human development evolving models for cultural psychologyJournal ofCross-Cultural Psychology published on-line 8 April 2010

Worthrrum C M amp Brown RA (2007) Companionable sleep Social regulashytion ofsleep and co-sleeping in Egyptian familiesJournal ofFamily Psychology 21 124-135

Worthman C M bull amp Melby M K (2002)Toward a comparative developmental ecology of human sleep In MA Carskadon (Ed) Adolescent sleep patterns Biological sodal and psychological influences (pp 69-117) New York NY Cambridge University Press

9 Sleep Environments of in Post-Industrial Socie Melissa M Burnham and Erika E Ga

Introduction

The daytime and nighttime sleep

industrialized nations have been t( slightly over four decades (eg bull C

term sleep environment sugges~

subject the sheer variety of sleep families regarding the regularity of

which they are correlated make tt In this chapter we will explicate a ments for children in post-industr

and developmental factors associat

systems perspective it is clear that

circumstances infants and young cl

and extra-individual variables that Developmental Systems The

behaviors cannot be understood w

which that individual is embeddt

person-in-context as the focal u human behavior is only understc

texts within which it occurs T systems and include community and natural environments Anot propositions regarding the trans


are needed to map the field of inquiry and inform systematic research

that will fill a real lacuna in current understandings of sleep

The present discussion aims to help bridge that gap from a developshy

mental perspective using the approaches of biocultural anthropology

Commencing with a consideration of adaptive-evolutionary constraints

that have shaped the place of sleep in human development this chapter

outlines a bioecocultural model that provides a framework for integrashy

tion ofculture into the study ofhuman developmentThis model inspired

a study of the comparative developmental ecology of sleep that is then

summarized in terms of initial insights into cultural patterns and variashy

tion in the physical ecology of sleep and the recognition of sleep as a form of social behavior The suggestive findings from this cross-cultural

survey are followed by results from an empirical investigation of the role

of culture in shaping sleep across the life course in a specific society

namely Egypt Study results showed that cultural factors powerfiilly

structured sleep accounting for much of the variance in sleep across the

life courseThis example engages a number ofissues regarding the impact

of culture change and globalization (schooling media family and resishy

dential patterns nutrition) on sleep schedules and consequently on funcshy

tioning and healtb The emerging global literature on these topics is

briefly surveyed

A concluding section deploys psychological anthropology to conshy

sider the role ofcultural models in how sleep is conceptualized and how

such models inform behavior and perception with particular regard to

parental behavior Building on a cultural consensus analysis from our

study ofparenting and development ofchild self-regulation in American

families I delineate two key dimensions in an American cultural model

ofsleep along with the resultant scripts for sleep and parenting practices

Then based on our comparative work contrasting elements in nonshy

Western cultural models ofsleep and their attendant scripts are proposed

A central insight from this perspective is that sleep is embedded in a moral framework that powerfully shapes not only behavior but also evalshy

uations ofsleep as appropriate or disordered Thus the cultural construcshy

tion ofsleep across the life course can also be understood as a project that

directly concerns crucial intangibles such as personhood morality and social relations as well as the urgent practical ones ofhealth subsistence

and survival

De-

Adaptive and Evolutionary Back

The lingeringly mysterious adaptive fa

scope of this chapter (see Worthman 2

tive constraints on human sleep patten

comparative study and raises four poi

range of environments using an array tions to flourish under widely diver

sociality and culture are obligatory to

and integral to development and func

ture shapes human ecology Children a become competent by living in socia

through culture Fourth and related

mental design anticipates reliable inr

ments ofrearing for assembling comp

nervous system (Worthman 2003) Tl Design implications for sleep ir

the daily activities necessary for sum

leable to the range of ecological and inhabit Indeed humans manifest pro

schedules and tolerating sleep restricti culturally prescribed sleep practices r

lenges presented by specific environ

analysis of selected non-Western cul

afternoon napping is not related to h

to the presence of malaria and oth (Barone 2000) Then in line with

sleep should commonly occur in soci

sion of group life Co-sleeping has b

instance all reports in an ethnograph identifIed infants as sleeping in the s

Paxson 1971) Finally dependence ( ing conditions suggests that onto~

shaped by sleeping practices The dt

is regularities in patterning and COl

an important factor in the develoJ

regulation






































































regulation

bull 1


































































middot

























































Elements of sleep

ecology

Microecology


Bedding


structure






Macropredators




gender)


Ecology climate

Demography and

settlement patterns


historic

Security





odors bedding

sleep surfaces and



conditions





variable

human active

episodic erratic

low-minimal

solitary limited

limited stable no


stable

climate-control

absentIminiroal





































historic

Western I

IS present absent

ments



extensive limited

heatcold stable

yes no

dynamic silent

dimldark darkdim

present minimal

minimal elaborate

rough smooth padded




light)





























































































lpter





















































(McKenna 2000)










sleep








Develo)



























































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction



















































































regulation

bull 1


































































middot

























































Elements of sleep

ecology

Microecology


Bedding


structure






Macropredators




gender)


Ecology climate

Demography and

settlement patterns


historic

Security





odors bedding

sleep surfaces and



conditions





variable

human active

episodic erratic

low-minimal

solitary limited

limited stable no


stable

climate-control

absentIminiroal





































historic

Western I

IS present absent

ments



extensive limited

heatcold stable

yes no

dynamic silent

dimldark darkdim

present minimal

minimal elaborate

rough smooth padded




light)





























































































lpter





















































(McKenna 2000)










sleep








Develo)



























































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction














bull 1


































































middot

























































Elements of sleep

ecology

Microecology


Bedding


structure






Macropredators




gender)


Ecology climate

Demography and

settlement patterns


historic

Security





odors bedding

sleep surfaces and



conditions





variable

human active

episodic erratic

low-minimal

solitary limited

limited stable no


stable

climate-control

absentIminiroal





































historic

Western I

IS present absent

ments



extensive limited

heatcold stable

yes no

dynamic silent

dimldark darkdim

present minimal

minimal elaborate

rough smooth padded




light)





























































































lpter





















































(McKenna 2000)










sleep








Develo)



























































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction














middot

























































Elements of sleep

ecology

Microecology


Bedding


structure






Macropredators




gender)


Ecology climate

Demography and

settlement patterns


historic

Security





odors bedding

sleep surfaces and



conditions





variable

human active

episodic erratic

low-minimal

solitary limited

limited stable no


stable

climate-control

absentIminiroal





































historic

Western I

IS present absent

ments



extensive limited

heatcold stable

yes no

dynamic silent

dimldark darkdim

present minimal

minimal elaborate

rough smooth padded




light)





























































































lpter





















































(McKenna 2000)










sleep








Develo)



























































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction















Elements of sleep

ecology

Microecology


Bedding


structure






Macropredators




gender)


Ecology climate

Demography and

settlement patterns


historic

Security





odors bedding

sleep surfaces and



conditions





variable

human active

episodic erratic

low-minimal

solitary limited

limited stable no


stable

climate-control

absentIminiroal





































historic

Western I

IS present absent

ments



extensive limited

heatcold stable

yes no

dynamic silent

dimldark darkdim

present minimal

minimal elaborate

rough smooth padded




light)





























































































lpter





















































(McKenna 2000)










sleep








Develo)



























































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction















historic

Western I

IS present absent

ments



extensive limited

heatcold stable

yes no

dynamic silent

dimldark darkdim

present minimal

minimal elaborate

rough smooth padded




light)





























































































lpter





















































(McKenna 2000)










sleep








Develo)



























































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction













































































lpter





















































(McKenna 2000)










sleep








Develo)



























































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction































(McKenna 2000)










sleep








Develo)



























































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction






































irections















































Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction



















Rosado 2009)



























networks

Develo





























































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction















































































































Develol















health

Cultural Models











































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction












































ting sleep

















health

Cultural Models



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction



















matic and visceral































Devel












































nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction



























nent us














































2002 and comments)










model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction

















model scripts

Restoration





stimuli Regulation




Moral frame



Foundational schema












Deveilt












tion and parenting






















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction















































tion and parenting



























































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction

















































Deveh












model















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction


















































ifSleep








Sociability

Fluid unbounded

Social behavior





Moral logic







Do not sleep alone



deep sleep








































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction









































fits in










Develop

Conclusion



























global shifts



















~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction
































~ep













Conclusion



































global shifts





















REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction


































REFERENCES







265-274

Develc

























I


































































Developn























Press

































































Introduction














I


































































Developn























Press

































































Introduction






























Developn























Press

































































Introduction














































































Introduction














developmental cultural ecology of sleepanthropology.emory.edu/home/documents/worthman-lab/book...

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