(Mis)Perceiving Apnea and Insomnia in Germany: A Tale of Two Disorders

Abstract

In Germany, both apnea and insomnia are highly prevalent sleep disorders. But while there is an extensive and growing infrastructure to deal with apnea, there is very little support for insomnia patients. I argue that this is due to various interrelated factors: the role of evidence and experience in diagnosis, the availability of treatment, and—importantly—how evidence, experience, and treatment can (or cannot) be materialized in the medical economy. Drawing on phenomenology and affordance theory, and based on fieldwork among German sleep doctors and their patients, I analyze how different sleep disorders are perceived, evaluated, and acted upon. I use different examples to reflect on the possibilities of “objectively” knowing and “subjectively” experiencing (disordered) sleep, and on how different perspectives (patient versus doctor, first-person versus third-person) and modes of perception (direct or indirect, narrative-based anamnesis or technology-based assessment) matter (or not) for the diagnosis and treatment of sleep disorders.