Sleep Separately at Your Own Risk!
-Dr. Robert Oexman
I concluded the interview with my patient. As I cleaned up my notes I was thinking about what it must be like to have my slumber rudely interrupted each night by a bed partner that cannot sleep. My patient “Tom” said he used to love going to sleep prior to getting married. He reported falling asleep “before his head would hit the pillow” and he slept all night. Although he would wake up each morning feeling a little groggy, he blamed this on stress from his new job fresh out of graduate school. With the addition of a new bed partner, his sleep was now episodic due to his partner demanding him to “move to your side.” If the verbal commands did not elicit the desired result they were followed by a firm jab to the shoulder or side. Tom showed me bruises on his right arm as a testament to the fact that his new wife was getting physical in her attempts to punish him for her inability to sleep. Fortunately for Tom however, his wife persisted.
One of the paradoxes to understanding our own poor sleep is that we do it while we are sleeping. With the exception of a few sleep disorders like insomnia, we are often unaware of the sleep disorder that causes so many of the health issues that manifest themselves in our waking day. Unlike the painful knee that we know resulted from that fall on the ice covered sidewalk, our high blood pressure will most likely not be associated with our inability to breathe normally at night. This is because we just simply don’t remember most of what goes on while we are sleeping, or think we are sleeping. The fact that poor sleep often happens while we perceive ourselves to be sleeping well may be one of the reasons that sleep disorders often go undiagnosed and untreated.
Sleep, as a medical specialty and recognized by the American Medical Association, has fully emerged only in the past 20 years. Research on the serious consequences of sleep disruption is beginning to trickle down to primary care physicians and the unaware public. What used to be a badge of honor, “I only need 5 hours of sleep”, has been replaced by a quest for better quality and quantity of sleep. Studies are revealing what happens in our sleep, or lack of, which can cause a long list of heath issues ranging from high blood pressure, heart attack, stroke, obesity, diabetes, and work related or driving accidents.
Remember my patient Tom? After 28 years of sleeping alone he was unaware that his lack of energy in the morning after 8 hours of sleep; his inability to stay awake watching TV at night; his lack of concentration at work, and his high blood pressure were all related to the fact that he stopped breathing over 120 times at night. At first it seemed like his new bride had the problem sleeping. After all, he could not hear himself snore and gasp for air as she reported each morning. After his bride threatened to move to another bedroom in less than one year together, Tom agreed to seek advice. Tom was diagnosed with sleep apnea, a potentially life-threatening condition. Without his wife in the same room he would have never been properly diagnosed and treated. What if Tom would have accepted the offer to sleep apart? If that would have been the solution to their problem, the consequences could have been deadly.
Unfortunately not all couples stories end the way Tom’s played out. I recently read an article written by Heather Boerner for NewsMax. The story puts a positive spin on the fact that some couples are choosing to sleep apart in response to sleep disruption caused by one of the partners. Heather reported that according to the National Association of Home Builders, two out of every three custom built homes will have dual master suites by 2015. A New York Times article reported that one in four new construction homes already have dual master suites. Heather describes the new master suites as a place of refuge costing as much as $100,000, and they are designed to be soundproof. In the article, couples describe how nice it is to sleep apart from the offending partner that snores or thrashes about. As a person involved in “sleep” this is a disturbing trend given the fact that most people seek treatment for a sleep disorder at the insistence of a bed partner. A survey completed by Wachovia Securities revealed what most people in the field of sleep already know; over 70% of people that present for a sleep study are there because of discussions with spouses and friends, not a primary care physician. The move to separate bedrooms should not be an option until a diagnosis and treatment program have been considered. Using an extra bedroom to solve a sleeping problem is only covering up the problem instead of solving it. The consequences of ignoring the cause could be life threatening.
The partner of a person with a sleep disorder plays a pivotal role in their diagnosis and treatment. Partner support is crucial for the long term compliance with devices used to treat sleep apnea. Removing the partner with a sleep problem to another bedroom could possibly lead to a delayed diagnosis and decreased compliance to treatment. The comfort, security, and romance associated with sharing the same bed have always been a strong incentive for men and women alike to seek treatment for a sleeping problem. I can only hope that the trend to dual master suites does not play out like the National Home Builders Association predicts. I know at least one patient that is grateful that a “dual master suite” was not the option for their problem. The bruised arm and threats of separate beds may have saved his life.
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