Sleep Apnea

  • Five Weird Signs of Sleep Apnea

    Original Article | By Sandee Lamotte CNN

    Sign up for CNN’s Sleep, But Better newsletter series. Our seven-part guide has helpful hints to achieve better sleep.CNN — 

    If you snore the house down, you may be suffering from obstructive sleep apnea, or OSA — a potentially dangerous condition in which people stop breathing for 10 seconds or more at a time.

    The condition has been linked to smaller brain volume, damage to the white matter communication pathway in the brain and even a three times higher risk of dying from any cause. If left untreated, obstructive sleep apnea puts you at higher risk for hypertension, heart disease, type 2 diabetes, depression and even an early death, according to the American Academy of Sleep Medicine.

    Yet even if you’re a rock star at snoring, you may not know you have obstructive sleep apnea unless someone tells you about your nocturnal roars. That’s why it’s important for partners and friends to speak up and encourage snorers to get professional help.

    But what if you have an odd or quirky symptom besides snoring? You and your loved ones may have no idea that you are in danger, and the condition could go undiagnosed for years.

    “Greater than 30 million people have sleep apnea in the United States, yet it’s often underdiagnosed or misdiagnosed,” said sleep specialist and pulmonologist Dr. Raj Dasgupta, an associate professor of clinical medicine at the University of Southern California’s Keck School of Medicine.

    “It’s really misdiagnosed in women versus men because women may not present with the classic, heroic snoring that men often show,” he said.

    Here are five weird signs of obstructive sleep apnea to watch for, according to Dasgupta.

    Headache as a result of sleep apnea

    Night sweats

    There are many reasons people may sweat at night. It could be too hot, especially with the persistent heat waves in the past few years due to the climate crisis. Certain medications can cause night sweats, as can cancer, thyroid issues, the flu and bacterial infections, and the onset of menopausal symptoms, according to the Mayo Clinic.

    But research has shown that about 30% of people with obstructive sleep apnea have reported night sweats, Dasgupta said.

    “It’s because your body isn’t getting enough oxygen you fall into this sympathetic fight-or-flight mode, which triggers night sweats,” he said. “The research showed people with OSA that had night sweats were also more likely to have really low oxygen levels on top of having obstructive sleep apnea.”

    Sleep apnea can cause you to wake up tired, have difficulty regulating emotions and suffer from brain fog, experts say.

    Frequent awakenings

    Many people get up at night to empty their bladders — it can be caused by alcohol overindulgence, diabetes, edema, high blood pressure, certain medications, pregnancy, prostate issues and even drinking too many fluids before bed, according to the Cleveland Clinic.

    But getting up at least two times a night to urinate — which is called nocturia — can also be a sign of obstructive sleep apnea, Dasgupta said.

    “One study found about 50% of patients with OSA had nocturia, and they noted that treatment for the sleep disorder did cut back on awakenings,” he said.

    Nevertheless, frequent nighttime urination is not commonly asked about in screening questionnaires on sleep apnea in primary provider offices, Dasgupta said.

    Teeth grinding

    Grinding or clenching teeth while sleeping is called bruxism, and it too may be a sign of obstructive sleep apnea, Dasgupta said.

    “Certainly, anxiety and other factors can cause bruxism, but a common cause is obstructive sleep apnea,” he said. “There’s a theory on why — the airway becomes obstructed, so the muscles in the mouth and jaw move to try to free the blocked airway. That’s not been proven, but it is an interesting hypothesis.”

    Most people who grind or clench their teeth use a mouthguard suggested by their dentist for protection, but it won’t protect the jaw, Dasgupta said.

    “So, a person might also develop TMJ (dysfunction), which is pain in the temporomandibular joint, and that may also lead to other issues, such as headaches,” he said.

    Morning headaches

    Studies have found a link between having obstructive sleep apnea and waking up with a headache, Dasgupta said.

    “They typically occur daily or most days of the week and may last for several hours after awakening in the morning,” he said. “The cause of the headaches is not well-established and may be multifactorial.”

    Headaches caused by obstructive sleep apnea don’t appear to lead to nausea or increased sensitivity to light and sound. Instead, they seem to be a pressing sensation on both sides of the forehead that lasts about 30 minutes, according to a June 2015 study.

    Depression, fatigue and insomnia

    Some symptoms of obstructive sleep apnea can disguise themselves as issues of mental health, brain fog or other sleep problems, Dasgupta said.

    “Sleep affects our ability to think, react, remember and solve problems,” he said. “Women especially have a tendency to underreport atypical symptoms such as insomnia, fatigue and depression.”

    If obstructive sleep apnea awakens you, it may be hard to go back to sleep. A person may suspect insomnia, not realizing that a different issue may be triggering the awakenings.

    Symptoms of daytime fatigue include a lack of motivation to accomplish everyday tasks, a lack of productivity at work, memory problems and a low interest in being social, Dasgupta said. Those are also signs of depression, so if the sleep issues aren’t brought up at a health visit, the underlying cause may be missed.

  • New research finds deep-sleep brain waves predict blood sugar control

    Original Article | Berkley News

    Researchers have known that a lack of quality sleep can increase a person’s risk of diabetes. What has remained a mystery, however, is why.

    Now, new findings from a team of sleep scientists at the University of California, Berkeley, are closer to an answer. The researchers have uncovered a potential mechanism in humans that explains how and why deep-sleep brain waves at night are able to regulate the body’s sensitivity to insulin, which in turn improves blood sugar control the next day. 

    “These synchronized brain waves act like a finger that flicks the first domino to start an associated chain reaction from the brain, down to the heart, and then out to alter the body’s regulation of blood sugar,” said Matthew Walker, a UC Berkeley professor of neuroscience and psychology and senior author of the new study. “In particular, the combination of two brain waves, called sleep spindles and slow waves, predict an increase in the body’s sensitivity to the hormone called insulin, which consequentially and beneficially lowers blood glucose levels.” 

    The researchers say this is an exciting advance because sleep is a modifiable lifestyle factor that could now be used as part of a therapeutic and painless adjunct treatment for those with high blood sugar or Type 2 diabetes.

    Scientists also noted an additional benefit besides the potential new mechanistic pathway. 

    “Beyond revealing a new mechanism, our results also show that these deep-sleep brain waves could be used as a sensitive marker of someone’s next-day blood sugar levels, more so than traditional sleep metrics,” said Vyoma D. Shah, a researcher at Walker’s Center for Human Sleep Science and co-author of the study. “Adding to the therapeutic relevance of this new discovery, the findings also suggest a novel, non-invasive tool — deep-sleep brain waves — for mapping and predicting someone’s blood sugar control.”

    The team’s findings were published today in the journal Cell Reports Medicine. 

    For years, researchers have studied how the coupling of non-rapid eye movement sleep spindles and deep, slow brain waves corresponded to an entirely different function — that of learning and memory. Indeed, the same team of UC Berkeley researchers previously found that deep-sleep brain waves improved the ability of the hippocampus — the part of the brain associated with learning — to retain information.

    Researchers have uncovered a potential mechanism in humans that explains how and why deep-sleep brain waves at night are able to regulate the body’s sensitivity to insulin, which in turn improves blood sugar control the next day. (Illustration courtesy Matthew Walker)

    But this new research builds on a 2021 rodent study and reveals a novel and previously unrecognized role for these combined brain waves in humans when it comes to the critical bodily function of blood sugar management. 

    The UC Berkeley researchers first examined sleep data in a group of 600 individuals. They found that this particular coupled set of deep-sleep brain waves predicted next-day glucose control, even after controlling for other factors such as age, gender and the duration and quality of sleep. 

    “This particular coupling of deep-sleep brain waves was more predictive of glucose than an individual’s sleep duration or sleep efficiency,” said Raphael Vallat, a UC Berkeley postdoctoral fellow and co-author of the study. “That indicates there is something uniquely special about the electrophysiological quality and coordinated ballet of these brain oscillations during deep sleep.”

    Next, the team then set out to explore the descending pathway that might explain the connection between these deep-sleep brain waves sending a signal down into the body, ultimately predicting the regulation of blood glucose. 

    The findings from the team reveal an unfolding set of steps that could help explain how and why these deep-sleep brain waves are related to superior blood sugar control. First, they found that stronger and more frequent coupling of the deep-sleep brain waves predicted a switch in the body’s nervous system state into the more quiescent and calming branch, called the parasympathetic nervous system. They measured that change in the body and the shift to this low-stress state using heart rate variability as a proxy. 

    Next, the team turned its attention to the final step of blood sugar balance. 

    The researchers further discovered that this deep sleep switch to the calming branch of the nervous system further predicted an increased sensitivity of the body to the glucose-regulating hormone called insulin, which instructs cells to absorb glucose from the bloodstream, preventing a deleterious blood sugar spike.

    That’s particularly important for people trying to back away from hyperglycemia and Type 2 diabetes.

    “In the electrical static of sleep at night, there is a series of connected associations, such that deep-sleep brain waves telegraph a recalibration and calming of your nervous system the following day,” Walker said. “This rather marvelous associated soothing effect on your nervous system is then associated with a reboot of your body’s sensitivity to insulin, resulting in a more effective control of blood sugar the next day.” 

    The researchers subsequently replicated the same effects by examining a separate group of 1,900 participants.

    “Once we replicated the findings in a different cohort, I think we actually started to feel more confident in the results ourselves,” Walker said. “But I’ll wait for others to replicate it before I truly start believing, such is my British skepticism.”

    The scientists said the research is particularly exciting given the potential clinical significance years down the line. Diabetes treatments already on the market can sometimes be difficult for patients to adhere to. The same is true of the recommended lifestyle changes, including different eating habits and regular exercise.

    Sleep, however, is a largely painless experience for most people. 

    And while sleep is not going to be the single magic bullet, the prospect of new technologies that can safely alter brain waves during deep sleep that this new research has uncovered may help people better manage their blood sugar. That, the research team said, is reason for hope.

  • Diets high in fats and sugar impact deep sleep quality, study finds

    Original Article | Medical News Today

    For better sleep quality, it’s best to avoid foods high in fats and sugars, a new study confirms. CWP, LLC/Stocksy

    • A study conducted by scientists from Uppsala University investigated the impact of a high-fat/high-sugar diet, also known as a junk food diet, on sleep.
    • The researchers found that after consuming the unhealthy diet, the quality of deep sleep in participants worsened compared to when they followed a healthier diet.
    • Although the duration of sleep and overall sleep structure were not significantly different between the two diets, the unhealthy diet was associated with reduced deep sleep quality and changes in some important sleep patterns.
    Burger and Fries

    Limited evidence exists regarding the influence of certain foods on sleep, leading researchers to conduct a randomised trial investigating the effects of a high-fat/high-sugar diet on sleep.

    A new study, published in ObesityTrusted Source, aimed to gather intervention-based evidence by examining the impact of this diet on sleep patterns in healthy individuals.

    The researchers found that after consuming the unhealthy diet, the quality of deep sleep in the participants worsened compared to when they followed the healthier diet.

    A group of 15 healthy men took part in a study where they were given two different diets to follow. They were randomly assigned to either a high-fat/high-sugar diet or a low-fat/low-sugar diet for one week each.

    After each diet, the researchers recorded the participants’ sleep patterns in a laboratory setting using a method called polysomnography, a sleep monitoring technique.

    They looked at the duration of sleep, as well as the different stages and patterns of sleep, including things like oscillatory patterns and slow waves.

    Using machine learning to analyze sleep

    The study found that the duration of sleep was not significantly different between the two diets, as measured by both actigraphy — a method of monitoring sleep using a wearable device — and in-lab polysomnography.

    When comparing two different diets, the researchers found that the structure of sleep remained similar after one week on each diet.

    However, when they compared a diet high in fat and sugar to a diet low in fat and sugar, they noticed that the former diet was linked to lower levels of certain sleep characteristics during deep sleep.

    These characteristics included delta power, which is a measure of slow brain waves, the ratio of delta to beta waves, and the amplitude of slow waves.

    All of these changes suggested that the quality of deep sleep was reduced on the high-fat/high-sugar diet.

    Dr. Florencia Halperin, chief medical officer at Form, a company that provides medical treatment for obesity and associated metabolic conditions, not involved in this research, told Medical News Today that “evidence has been mounting over the last decade about the relationship between sleep and metabolic disease.”

    “Poor sleep adversely affects hormonal and metabolic parameters and increases the risk of weight gain and metabolic disease. At the same time, weight gain increases the risk of sleep disorders such as sleep apnea. So the relationship is very complex, and there is so much we still don’t understand.”

    – Dr. Florencia Halperin

    Limited sample size

    Dr. Halperin pointed out that “the results suggested that consumption of an unhealthier [high-fat/high-sugar] diet results in changes to the pattern of sleep.”

    “While the macro-architecture was not affected, changes in some sleep parameters observed (less relative power in delta frequencies and a lower delta to beta ratio) were consistent with a less restorative sleep state, as might be seen in an older population,” Dr. Halperin noted.

    Kristen Carli, a registered dietitian nutritionist, also not involved in this research, highlighted a few limitations to the study, noting the small sample size of only 15 healthy young men.

    “No women, older adults, or children were evaluated meaning that these results should not be extrapolated to the general population,” Carli pointed out.

    Dr. Halperin agreed, saying that “we must keep in mind only 15 people were studied, they were all men, and only studied for 1 week — so we will need further research to validate these findings.”

    Unhealthy diet may impact sleep patterns

    However, Dr. Halperin noted that “this study is important and relevant to patients and the public because it provides novel insight into how lifestyle factors such as the diet we consume affect our sleep, which in turn affects our overall health.”

    “This is early evidence that a typical unhealthier diet may affect our sleep in very specific ways, and therefore our sleep-regulated health parameters, such as cognition and hormone secretion, which then modulate other effects on our health.”

    – Dr. Florencia Halperin

    Dr. Halperin explained that while the study helps to raise awareness about the relationship between sleep and overall health, the current findings are unlikely to impact medical practice at the current time, given the early nature of this research.

    However, “I may share this research with [my patients] to educate them about the many many ways changing our diet can contribute to improved health — even without any weight loss!” Dr. Halperin said.

    Carli pointed out that the “implications of this study are that the high-fat/high-sugar diet can impact sleep quality.”

    Does diet impact sleep or vice versa?

    “While the results of this one study should not be extrapolated widely, these results are not exactly surprising,” she added.

    “Sugar has been shown to impact sleep quality in prior researchTrusted Source, as well as a high-fat diet. However, I will note many researchers pose whether the diet is impacting the sleep quality or the other way around. Regardless, as a registered dietitian, there are many other health benefits, besides sleep quality, to consider choosing a low-fat/low-sugar diet, including weight lossheart health, chronic disease prevention, etc.”

    – Kristin Carli

    Ultimately, as Dr. Halperin explained, “this evidence suggests that a healthier diet might help us get healthier sleep.”

    “Another way to look at it is that this is perhaps one more proof point that our parents were right after all — we all need to eat our veggies, and go to bed on time!”

  • Sleep and Time with Pets Help People Living with Bipolar Disorder

    by University of Western Sydney | Original Article Feb 2018

    Bipolar disorder is characterized by transitions between depression and mania. Credit: Wikipedia

    New research from Western Sydney University has revealed that simple self-care strategies, such as spending time with animals and getting enough sleep, are helpful for people managing bipolar disorder symptoms.

    The research, published in Clinical Psychologist this week, involved 80 participants with bipolar disorder reviewing the frequency and perceived helpfulness of 69 self-care strategies. These strategies were diverse, and included things such as abstaining from drugs and alcohol, practising yoga and finding things that make you laugh.

    The study found that an increased engagement in self-care strategies was associated with improved quality of life, reduced the impact of the illness, and reduced depression, anxiety and stress. Getting enough sleep was the most commonly rated strategy as “very helpful,” with “spending time with pets,” also rating highly.

    Lead researcher, honours student Edward Wynter from Western Sydney University’s School of Social Sciences and Psychology, says the study provides encouraging findings about the relationship between self-care and important functional and symptomatic outcomes, i.e. the ability of these strategies to alleviate the impact of the disorder.

    “The benefits of self-care have been reported in other chronic illnesses, but bipolar disorder research has focused primarily on medication management,” Mr Wynter says.

    “This research reveals support for strategies already well known to professionals and people living with bipolar disorder, including those relating to quality and quantity of sleep, and drug and alcohol abstinence; but this study also highlights the effectiveness of several strategies yet to be explored such as spending time with pets and engaging in creative pursuits.”

    Mr Wynter says he hopes this research leads to further exploration of self-care strategies used by people living with bipolar disorder, and their relationship with long-term quality of life.

    “I hope that knowledge of effective strategies can inspire proactive therapeutic engagement and empower people living with bipolar disorder to improve their health and wellbeing,” he says.

  • Link Between Sleep Apnea and Depression

    New research has explored the link between sleep apnea and depression and suggests that the former may be one reason that depression treatments fail.

    Around 20–30%Trusted Source of people with depression and other mood disorders do not get the help they need from existing therapies.

    Depression is the “leading cause of disabilityTrusted Source worldwide.”

    For this reason, coming up with effective therapies is paramount.

    New research points to obstructive sleep apnea (OSA) as a potential culprit for treatment resistant depression and suggests that screening for and treating the sleep condition may alleviate symptoms of depression.

    Dr. William V. McCall — chair of the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Augusta University — is the first and corresponding author of the study.

    He says, “No one is talking about evaluating for [OSA] as a potential cause of treatment resistant depression, which occurs in about 50% of [people] with major depressive disorder.”

    He hopes that the team’s new paper — appearing in The Journal of Psychiatric Research — will remedy this.

    14% of those with depression had OSA

    Dr. McCall and team examined the rate of undiagnosed OSA in a randomized clinical trial of people with major depressive disorder and suicidal tendencies.

    They recruited 125 people with depression, originally for the purpose of determining if treating their insomnia would improve their depression symptoms.

    The original trial excluded people at risk of OSA, such as those taking sleeping pills, or people with obesity or restless legs syndrome.

    The scientists tested the participants with a sleep study and found that 17 out of the 125 (nearly 14%) had OSA.

    Dr. McCall and colleagues note that people who had OSA did not present with the usual indicators of OSA severity, such as daytime sleepiness. Also, 6 of the 17 people were non-obese women.

    This is contrast with the demographic group usually at risk of OSA: overweight men.

    “We were completely caught by surprise,” says Dr. McCall, “that people did not fit the picture of what [OSA] is supposed to look like.”

    Also, 52 of the 125 participants had treatment resistant depression; 8 of those with treatment resistant depression also had OSA.

    Future treatment options

    The researchers point out that underlying conditions — such as hypothyroidismcancer, and carotid artery disease — may often be the cause of treatment resistant depression.

    Therefore, many people with depression undergo a series of invasive and costly tests in an attempt to figure out the cause of depression treatment failure.

    Such tests may include an MRI scan or even a spinal tap — but Dr. McCall and team urge for sleep tests first. “I am thinking before we do a spinal tap for treatment resistant depression, we might need to do a sleep test first,” he says.

    “We know that [people] with sleep apnea talk about depression symptoms,” he goes on. “We know that if you have [OSA], you are not going to respond well to an antidepressant.”

    “We know that if you have sleep apnea and get [a CPAP machine], it gets better and now we know that there are hidden cases of sleep apnea in people who are depressed and [have] suicidal [tendencies].”

    Dr. William V. McCall

    However, the study authors also acknowledge that other factors — such as the side effects of other medications, including beta-blockers and corticosteroids — may cause treatment resistant depression.

    They also point out that suicidal tendencies are also a key factor, and the researchers suggest that a further area of investigation should be the question of whether or not treating sleep apnea will also reduce suicide ideation.

    In the United States, suicide is the 10th leading cause of deathTrusted Source among people of all ages.

  • How to tell if it’s time for a ‘sleep divorce’

    (CNN)He snores until the walls rattle. She gives off a massive amount of body heat. One of you is a cover hog, kicks at night or takes consistent 3 a.m. bathroom breaks. Maybe you sleepwalk or suffer from insomnia. The list of reasons why your bed partner might be keeping you up at night could be long and as dreary as your mood when you drag yourself from bed each morning.

    When it comes to your health, that’s nothing to yawn at: Being deprived of a full seven to eight hours of sleep each night has been linked to a higher risk of diabetes, stroke, cardiovascular disease and dementia, according to the US Centers for Disease Control and Prevention.

    Sleep Divorce As A Result of Sleep Deprivation

    There’s an emotional toll as well, said sleep specialist Wendy Troxel, a senior behavioral scientist at RAND Corporation who authored “Sharing the Covers: Every Couple’s Guide to Better Sleep.”

    “Sleep deprivation can affect key aspects of relationship functioning, like your mood, your level of frustration, your tolerance, your empathy, and your ability to communicate with your partner and other important people in your life,” Troxel said.Poor sleep — and that resulting crummy mood — makes people “less able to engage in ‘perspective taking,’ or putting small adverse events in context,” said sleep specialist Rebecca Robbins, an instructor in the division of sleep medicine for Harvard Medical School, who coauthored the book “Sleep for Success!”

    That strain can contribute to depression, anxiety, and other emotional and relationship dysfunction, Robbins said.

    Sleep training for adults prevents depression, study findsResearch done by Troxel and her team found that a well-rested person is “a better communicator, happier, more empathic, more attractive and funnier” — all traits that are key to developing and sustaining strong relationships, she said.Sleeping apart can help couples be happier, less resentful and more able to enjoy their time together in bed, particularly on weekends when work demands are lighter, Troxel said.”I tell couples to try to think of it not as a filing for sleep divorce, but as forging a sleep alliance,” she added. “At the end of the day, there is nothing healthier, happier and even sexier than a good night of sleep.”

    Rule out underlying sleep issues

    Sleep partners are often the ones to flag signs of sleep disorders and encourage their loved one to visit a doctor or sleep specialist. Undiagnosed, sleep disorders may well harm you and your partner’s future health.That’s why experts say it’s best to check with a sleep specialist to rule out and treat any underlying condition before you leave your loved one’s bed — you may well be the key to identifying and treating a true health issue.

    Coping skills

    Once any serious health issue is ruled out, couples who find it emotionally bonding to sleep in the same bed may wish to try some practical coping tips before making the decision to sleep apart, Troxel said. No alcohol please. If you struggle with insomnia, cut out alcohol well before bed, experts say. It may appear to be helping you sleep, but booze actually causes middle of the night awakenings that can be hard to overcome. Snorers should eliminate alcohol as well, Troxel said, “because as everyone probably knows, if you sleep with a snorer and they have one too many drinks, the snoring will be much worse that night.” That’s because the alcohol further relaxes the throat muscles, encouraging that loud snore.

    Keep your brain sharp by finding your sleep ‘sweet spot,’ study saysThis is where partners can be powerful and beneficial sources of what experts call “social control,” Troxel said.”If you’re prone to drinking but you know that the consequences are not only going to bad for your sleep, but your partner’s sleep as well, then maybe you’ll be more motivated to cut back a bit,” she said.Raise the head. For snoring, try sleeping on additional pillows or using an adjustable bed — anything that raises the head to keep the throat open, Troxel said.”For many people snoring tends to be worse when they are flying flat on their backs, so raising the head a little bit can be useful,” she said.If the underlying issue is congestion, try adding a humidifier to the room, she added. “Some people have had success with over-the-counter nasal strips to keep the airway open.”Drown the sound. Survival 101 for dealing with a snoring partner is trying to deafen the noise, Troxel said. Try ear plugs and run a fan or white noise machine.Try sleep scheduling. A snorer who sleeps with a partner with insomnia can help that partner get more sleep by going to bed later than their partner, Troxel said.”For example, a snorer can delay their bedtime by a half an hour to an hour,” Troxel said. “That allows the partner to fall into a deeper stage of sleep and possibly stay that way once the snorer comes to bed.”Turn the snorer. Sleeping on the back is the worse position for snoring, because the soft tissues of the mouth and tongue collapse into the throat. As the sleeper unconsciously forces air past those soft tissues, snores emerge.

    How to fall asleep more quickly — the healthy way“If you can keep someone on their side, that can attenuate the snoring,” Robbins said. “I’ve heard of all kinds of creative techniques, such as putting a bra on the snorer in reverse and then putting tennis balls in the cups.”Full support body pillows may be an option, if they stay in place, said sleep specialist Dr. Raj Dasgupta, an associate professor of clinical medicine at the Keck School of Medicine at the University of Southern California.”I’m a fan of the simple things, but if you want to purchase something we’ve come a long way from sewing tennis balls into the back of our pajamas,” Dasgupta said. “You can buy a strap-on to your back that has little protruding foam-like things which are supposed to make you sleep on your side.”And there are some FDA-approved devices that strap to the throat or chest and provide vibrations designed to go off when you are on your back, prompting a move to side-sleeping.”

    Time for separate rooms?

    You’ve tried it all, and good sleep is still a distant dream. At this point, there’s no reason not to do what is best for each of you to get the quality sleep you need — especially since there are other ways to nurture a relationship besides sharing a bed.

    The best alarm clocks of 2021 (CNN Underscored)“Couples can still make the bedroom a sacred space, even if they choose not to actually sleep together,” Troxel said. “You can develop pre-bedtime rituals and use that time to actually connect with your partner instead of being independently on a phone or laptop or whatnot. “She encourages couples to spend quality time together before bed, sharing details of the day and sending positive messages to each other. “We know self-disclosure is good for relationships, it’s good for sleep,” Troxel said. “If you tell your partner you’re grateful for them, that’s a deep form of connection. Gratitude is good for relationships, it’s good for sleep.”

    Nor does a “sleep divorce” have to mean separate beds every night, Troxel said. It could be just the workweek, with weekends spent in the same bed. It could be every other night — the options are as unique as each couple. “There truly is not a ‘one-size-fits-all’ sleeping strategy for every couple,” Troxel said. “It’s really about finding the strategy that’s going to work best for the two of you.”