When it Hurts to Stay Awake

7 July 2008

Further Thoughts on Sleep and Pain

The two most fundamental warning signals we encounter in our many days, through the long nights of our lives, are tiredness and pain. They remind us of our limits and encourage us to change our ways. Individually they’re manageable, at least in small doses. But together they can spiral us down into the depths of illness. When sleep deprivation and the infliction of pain are combined they have a single name – torture. This might seem a little melodramatic, but think about it from an everyday perspective. You work a long day, sweating at physical labour. At night you ache, you hurt, and rest returns you to something approaching normality the next day. But what if you can’t sleep properly?

More pointedly, what if your job doesn’t allow you to sleep properly?

In recent posts I’ve written about sleep and pain separately, but I’ve been thinking about their combined effect increasingly often. The disappearance and death of Vicky Flores here in Discovery Bay, Hong Kong has had a lot to do with that. For those who haven’t read my previous posts on Vicky, she was a domestic helper who fled her employer’s house for no established reason and drowned later that night. The police have commented that she was very stressed, but friends have also mentioned that she was suffering from various aches and pains before she died. Domestic helpers are often expected to work extremely long hours in Hong Kong, and Vicky died with mild pain killers still in her system, so I began to wonder whether there could be a link.

This line of inquiry certainly won’t solve the mystery of Vicky’s disappearance, but it could well illuminate one of the darker corners in the lives of lowly paid contract workers around the world.

Two recent studies offer a glimpse into the socio-economics of pain, fatigue and how they combine. The first, covered briefly in the July print edition of Scientific American, reports a survey of the extent to which Americans feel pain in their daily lives. A majority of the interviewees who were feeling pain were also dissatisfied with life. Hardly a surprise there – it’s what the Americans call a ‘no-brainer’. But hold that thought for the moment. Another two statistics that add something more specific to the scenario are the percentages of those in pain who were earning more than US$100,000 per year and less than US$30,000 per year.

The corresponding figures were 22.9% and 34.2%. In other words, and obviously leaving aside 42.9% of sufferers between these two income thresholds, there is an almost 50% increase when we move from people in pain who are well off to those in pain who are just scraping to get by. Add in dissatisfaction with life and you get hint of what low income, and more often than not physical labour, can do. But we still haven’t touched on sleep, and it turns out that interrupted sleep could well lower pain thresholds and make people suffer more. This in itself is worrisome, but the effect is particularly noticeable in women, especially those who need to wake frequently, like new mothers and – you guessed it – lowly paid domestic helpers.

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Sleep, Damn It!

21 June 2008

On the Perils of Work-Related Fatigue

Tired eyes, by lianneviau, with Creative Commons licenceSpending time around someone who constantly lacks sleep is not a pleasant experience. My family could tell a few tales about me recently – irritability, weight gain, poor decision making and an immune system that seems to invite every small illness that’s floating around. This week has been particularly difficult for them, with work dragging me ever further away from the fabled land of Nod. But at least I have time to rest and reflect on the weekend, time to change my ways. What about people don’t?

As I’ve mentioned before, there are many tens of thousands of migrant workers here in Hong Kong who work around 18 hours a day, 6 days a week. Or, to put it another way, they sleep 6 hours or less a night. How does that affect their work and their health? And what are the long-term consequences of contract-inspired sleep loss? First, allow me to set the scene with a story I know well.

Insomnia, by EasyPickle, with Creative Commons licenceMy sister-in-law is the domestic helper to a wealthy family who quite frankly don’t need to be waited on hand and foot. But such is their acquired dependence on children woken, breakfast made and late-night snacks prepared by someone else that she rarely sleeps before midnight and rises by six. On Sunday she visits my family and me, sleeping a few hours until she leaves at 6 pm to beat a draconian curfew. At dinner she’s back at work, and won’t rest again until late at night. Each week her fatigue combined with hard work becomes a little more difficult to endure. But ask if she’s coping and she’ll tell you she is.

Clearly the need to sleep during the day on Sunday suggests she’s wrong. Read the rest of this entry »