Carson Daly, host of “The Voice” and co-host of “Today,” recently told People that he and his wife, Siri, “began sleep divorcing last fall — and the happy couple continues to be consciously uncoupled in separate bedrooms.” The couple began to sleep in separate bedrooms last September, when Siri was pregnant with their fourth child: “We’re both pretty good-sized humans and it just wasn’t really working when she was in her third trimester, and I also have sleep apnea, which is very sexy for the ladies out there … She couldn’t get comfortable, so we were like a commercial you would see, kicking each other and just not sleeping.”
Carson added, “We woke up and we just shook hands like, ‘I love you, but it’s time to sleep divorce. It’ll be the best thing for all of us.'”
After baby Goldie was born in March, they continued to sleep apart, but for a different reason. The Daly family moved to California to finish the season of “The Voice,” but he also needed to wake up at 3 a.m. for his work on “Today.”
Although Carson joked that he didn’t “know if [they’ll] ever sleep together again,” he’s not averse to trying it out again. “Maybe a Friday, when I don’t have to wake up the next day at 3 a.m.”
Couples sleeping in separate beds or bedrooms is not a new phenomenon. Although many speculate that classic TV shows, like “I Love Lucy” and “The Dick Van Dyke Show,” showed married couples sleeping in separate beds for modesty reasons, the practice was encouraged during the Victorian era. Co-sleeping, which was the norm for many centuries, was identified as a potential source of disease transmission, and the Victorian era’s fear of the appearance of immorality made the practice unappealing. A book by Emma Frances Angell Drake in 1902 encouraged newlyweds to sleep in separate bedrooms, lest “self-control give way to license.” After World War II, houses got bigger and mass manufacturing of beds made having separate beds/bedrooms more affordable.
The practice seemed to wane in the 1970s, but is once again becoming popular.
Partner snoring, sleep apnea, restless sleeping, and the use of electronic devices in bed have become sources of sleep disruption. People have learned about the importance of adequate sleep and are now making their own sleep quality a priority. A 2005 survey by the National Sleep Foundation found that one in four couples sleep in separate bedrooms or beds. The National Association of Home Builders is finding a dramatic rise for dual master bedrooms in custom homes.
An increasing number of scientific studies are looking at the effects of co-sleeping versus separate sleeping on the health and interpersonal relationships of couples. A 2016 study by Richter et al. concluded that “couple sleeping still has underestimated implications for the quality of the relationship, quality of sleep and for physical and psychological health which are not consistently positive.”
A 14-day study by Gordon et al. showed that “participants reported more conflict in their romantic relationships following poor nights of sleep.” A second study by the authors showed that poor sleep leads to impaired conflict resolution, which improved when both partners were well-rested.
Sleep apnea is a common sleep disorder characterized by brief interruptions of breathing during sleep. These episodes usually last 10 seconds or more and occur repeatedly throughout the night. People with sleep apnea will partially awaken as they struggle to breathe, but in the morning they will not be aware of the disturbances in their sleep. According to sleepapnea.org, sleep disorders, including sleep apnea, have become a significant health issue in the U.S. It is estimated that 22 million Americans suffer from sleep apnea. However, up to 80% of the cases of moderate and severe obstructive sleep apnea are undiagnosed.
The most common type of sleep apnea is obstructive sleep apnea (OSA), caused by relaxation of soft tissue in the back of the throat that blocks the passage of air. Central sleep apnea (CSA) is caused by irregularities in the brain’s normal signals to breathe. Most people with sleep apnea will have a combination of both types, called complex sleep apnea.
Sleep apnea can occur at any age. The risk for sleep apnea increases as you get older. In younger adults, sleep apnea is more common in men than in women, but the difference decreases later in life. Normal age-related changes in how the brain controls breathing during sleep partially explain the increased risk as you get older. Another possible reason is that as we age, more fatty tissue builds up in the neck and the tongue.
Drinking alcohol, smoking, and overweight or obesity can increase your risk for sleep apnea:
- Alcohol can increase relaxation of the muscles in the mouth and throat, closing the upper airway. It can also affect how the brain controls sleep or the muscles involved in breathing
- Smoking can cause inflammation in the upper airway, affecting breathing, or it can affect how the brain controls sleep or the muscles involved in breathing
- Unhealthy eating patterns and lack of physical activity can lead to overweight and obesity, which can result in sleep apnea
Researchers have identified family history as a risk factor for sleep apnea, but maintaining a healthy lifestyle can decrease this risk. Studies in twins have shown that sleep apnea can be inherited. Some of the genes related to sleep apnea are associated with the structural development of the face and skull and with how the brain controls sleep and breathing during sleep. Some genes are also associated with obesity and inflammation.
In the U.S., sleep apnea is more common among Blacks, Hispanics, and Native Americans than among whites.
Common signs of sleep apnea:
- Reduced or absent breathing, called apnea events
- Frequent loud snoring
- Gasping for air during sleep
Common symptoms of sleep apnea:
- Excessive daytime sleepiness and fatigue
- Decreases in attention, vigilance, concentration, motor skills, and verbal and visuospatial memory
- Dry mouth or headaches when waking
- Sexual dysfunction or decreased libido
- Waking up often during the night to urinate
Sleep apnea symptoms may be different for women and children compared with men. Women who have sleep apnea more often report headache, fatigue, depression, anxiety, insomnia, and sleep disruption. Children may experience bed-wetting, asthma exacerbations, hyperactivity, and learning and academic performance issues.
Sleep apnea may increase the risks of the following disorders:
- Cognitive and behavioral disorders, such as decreases in attention, vigilance, concentration, motor skills, and verbal and visuospatial memory, as well as dementia in older adults. In children, sleep apnea has been associated with learning disabilities
- Diseases of the heart and blood vessels, such as atherosclerosis, heart attacks, heart failure, difficult-to-control high blood pressure, and stroke
- Pulmonary hypertension
- Sleep-related arrhythmias
- Liver problems, such as abnormal liver functions tests and nonalcoholic fatty liver disease
- Metabolic disorders, including glucose intolerance and type 2 diabetes
- Complications with medications and surgery; those with sleep apnea are more prone to problems when they are sedated or are lying on their backs
- Pregnancy complications, including gestational diabetes and gestational high blood pressure, as well as having a baby with low birth weight
There are a variety of treatments for sleep apnea, depending on an individual’s medical history and the severity of the disorder. Most treatment regimens begin with lifestyle changes, such as avoiding alcohol and medications that relax the central nervous system (such as sedatives and muscle relaxants), losing weight, and quitting smoking. Some people are helped by special pillows or devices that keep them from sleeping on their backs, or oral appliances to keep the airway open during sleep.
If these conservative methods are inadequate, doctors often recommend continuous positive airway pressure (CPAP), in which a face mask is attached to a tube and a machine blows pressurized air into the mask and through the airway to keep it open. Also available are machines that offer variable positive airway pressure (VPAP) and automatic positive airway pressure (APAP). There are also surgical procedures that can be used to remove tissue and widen the airway. The FDA has approved a surgically implantable device placed in the upper chest that monitors a person’s respiratory signals during sleep and stimulates a nerve to send signals to a muscle to stimulate and restore normal breathing. Some individuals may need a combination of therapies to successfully treat their sleep apnea.
Michele R. Berman, MD, and Mark S. Boguski, MD, PhD, are a wife and husband team of physicians who have trained and taught at some of the top medical schools in the country, including Harvard, Johns Hopkins, and Washington University in St. Louis. Their mission is both a journalistic and educational one: to report on common diseases affecting uncommon people and summarize the evidence-based medicine behind the headlines.