Dreamland: Adventures in the Strange Science of Sleep (5 page)

BOOK: Dreamland: Adventures in the Strange Science of Sleep
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The Hays Code was officially abandoned by the late 1960s, but attitudes toward sex in marriage changed well before that. What seemed modern at the turn of the twentieth century simply felt outdated by the middle of it, in part because baby boomers saw twin beds as something out of their parents’ generation. Sex became recognized as not only an obvious part of marriage but also an important part of maintaining a healthy one. Freudian-influenced marriage counselors started worrying about “frigid” wives, and magazines and self-help manuals urged women to become receptive to their husband’s sexual needs. Sleeping apart began to be seen as either a sign of a marital problem or something that would eventually lead to one. If a couple wasn’t enjoying every moment together—even when those moments conflicted with something as prosaic as sleep—then something was amiss. The pendulum swung back to the shared bed, and for many it took better sleep along with it. “I have taken oral histories of women who mentioned that they had really wanted a separate bed, because their husband snored or thrashed about, but were afraid to ask for fear he would ‘take it wrong’ or just felt there was something wrong with them for not being able to adjust,” Coontz told me.

Attitudes are changing once again, however. It is impossible to know to what extent, but the once-unquestioned idea that relationships are healthy only if a shared bed is involved is weakening just like the dogma of the twin beds before it. Because of busy work schedules, better and more open communication, or the fact that many people wait until they are older to get married and don’t want to give up the power of controlling their sleep environment, more couples in happy relationships are choosing to spend their nights in separate beds. As one young physician said, “To be honest, I have never really seen the appeal of spending the whole night sleeping next to somebody. Just because I love someone and want to spend my life with them doesn’t mean I want to be in the same bed at the same time. I just don’t see the connection.” Architects and construction companies surveyed by the National Association of Home Builders predict that by 2016 more than half of all new custom-built homes in the United States will have separate master bedrooms. And yet lingering cultural assumptions make some couples feel like they have to hide it. “The builder knows, the architect knows, the cabinet maker knows, but it’s not something they like to advertise because right away people will think something is wrong,” one interior designer said about his work designing separate bedrooms for married couples.

Intriguingly, the move back toward separate beds comes at a time when researchers are finding new links between a woman’s sleep quality and marital happiness. Wendy Troxel is a professor of psychiatry at the University of Pittsburgh. Early in her career, she noticed that subjects who said they were in high-quality marriages tended to be healthier overall. She began wondering what it was, exactly, about marriages on the less happy end of the spectrum that manifested itself in higher rates of cardiovascular disease and other negative outcomes. Studies had offered theories on stress, smoking, family income, and physical activity. But to Troxel, it seemed like the field was overlooking one of the most obvious aspects of daily life between two people in a relationship. “Sleep was largely neglected despite the fact that we know it’s a critically important health behavior,” she told me. Even though more than 60 percent of couples sleep with their partner, most studies of marital happiness never considered that it could be a factor.

Troxel recruited couples to wear wristwatch sleep monitors while they shared their bed each night and to rate each of their interactions with their partner for ten days. When describing each time they had a conversation with their spouse, subjects were given the choice between four positive ratings, such as feeling supported, and four negative ones, such as feeling ignored. Each person in the relationship submitted his or her responses separately, so that a spouse wouldn’t feel pressured to modify a rating to appease the other.

The results were clear: the most severe negative ratings came after nights when the woman had slept poorly. Not only that, but the quality of wives’ sleep was a more important predictor of happy interactions than a hard day at work or any other form of stress. “Some of that can be because women drive the emotional climate of a relationship more strongly than men in general,” Troxel said. “If they have a poor night of sleep they may be more expressive and tend to be more communicative in relationships. A husband is much more likely to pick on his wife’s cues that she’s had a bad night of sleep than his own.”

Men tend to sleep better next to their partners than when they go to bed alone, but that may be because they get to enjoy the emotional benefits of proximity without having to listen to their partner snoring. In one of nature’s dark jokes, women not only are far less likely to snore than men but also tend to be lighter sleepers. The result is a nightly farce that is one reason why wives also suffer from insomnia more often than their husbands.

The fact that the importance of sleep is becoming more recognized as a health concern may have the side effect of shaping healthier—and happier—marriages. “One of the values of sleep is that it is a very effective gateway treatment,” Troxel told me. “I’m a clinical psychiatrist with a specialty in relationships. In many cases I see patients who would never show up in a general psychotherapy clinic. The idea of sitting on a couch in some therapist’s office would go against their entire worldview. But they are concerned about their sleep enough that they’re willing to see whomever. And once you get started on sleep, you can address some other issues that otherwise would have been swept under the rug.” Returning soldiers, for instance, may be willing to talk about signs of post-traumatic stress disorder if they see it as a way to improve their rest. Because sleep doesn’t carry the same stigma that still unfairly lingers for mental health issues such as depression and anxiety, dealing with sleep issues somehow seems both less scary and more practical to some patients. Couples are often willing to change their routine and try separate beds at night if both partners are aware that they are splitting up for better sleep alone, and not because of some unspoken change of heart.

Given that sleep studies consistently find that subjects sleep better when given their own bed at night, why do so many couples decide to deprive themselves of a lifetime of better sleep and remain on a shared mattress? For an answer to that question I tracked down Paul Rosenblatt, a professor in the Department of Family Social Science at the University of Minnesota and one of the few sociologists who has studied couples’ sleeping patterns in the United States. He became interested in the topic after what he calls a traumatic experience. A number of years ago he was working on a research project that documented the lives of rural farmers. One family invited him to stay for the weekend, and suggested that he bring his twelve-year-old son along. Rosenblatt readily agreed, thinking it would be a nice father-son bonding experience. But when they arrived at the family’s house, he learned that his hosts had only one double bed for the two of them to share. It was the first time that his son had ever spent a night on the same mattress as someone else. “It was hell,” Rosenblatt told me. “He had no concept of where his body was in relationship to me. No concept of sleeping on the long side of the bed. By the middle of the night I was clinging to the edge of the bed as if my life depended on it.”

Curious after that ordeal, he began looking for academic research on what to him seemed an obvious topic, bed sharing. But out of the more than thirty thousand studies he found that looked at human sleep, couples, or marriage, only nine breached the topic of sharing a mattress. The research overlooked what Rosenblatt considered an important building block in navigating and surviving a relationship. “You learn things by sharing a bed,” he told me. “The shock of ending virginity and having sex for the first time is a big deal. But the first time that you share a bed is also a very big deal. Couples can have a very romantic or sexual interest in each other, but if neither has shared a bed before, they are going to have to learn something about getting along—how they spread out, what they do about toenails that are sharp, or if the other person steals a blanket.”

He set out to discover why couples opted to share a bed and how the experience affected their relationships. He rounded up couples who lived in Minneapolis and its suburbs, taking care to include subjects spread across the spectrum of love. Some were older and married, some were young and living together, and others were same-sex couples in long-term relationships. Rosenblatt spent several hours interviewing each pair about why they were willing to spend the energy learning to happily coexist on a mattress when it would have been much easier to continue sleeping in separate beds.

The answers were consistent. Couple after couple told Rosenblatt that sleeping in the same bed was often one of their only chances to spend time alone together. If life consisted of playing the roles of parent, employee, or friend, then the shared mattress functioned as a backstage, away from everyday responsibilities and judgments. Bedding down on the same mattress next to a loved one was what made it easier to face tomorrow and the day after that.

That isn’t to say that the transition from sleeping in one’s own bed to sharing a mattress was an easy one. In one interview, Rosenblatt casually remarked to a subject, a man in his twenties, that it sounded like he somehow learned to swing his elbows less in bed over time. “Not ‘somehow,’ ” the man responded. “There’s no ‘somehow.’ It’s her telling me, ‘That hurt!’ Or, ‘Don’t do that!’ Or ‘Watch where you’re swinging that elbow!’ ” Many couples told Rosenblatt that they initially began to share a mattress because that’s what they thought everyone did. But, over time, they felt less constrained by their expectations and allowed themselves the freedom to adapt. In another interview, for instance, a couple revealed that one of the most liberating moments of their relationship was when they realized that they didn’t have to spoon every night. They could now wake up without sore shoulders, secure in the knowledge that moving to separate sides of the mattress to fall asleep had no greater significance than physical comfort.

Other subjects highlighted the fact that, despite the drawbacks, having another person in bed simply made them feel safer. This was especially true for women. Some female subjects admitted to going to their sister’s homes to share a bed rather than face the prospect of sleeping in a room alone when their partner was out of town. Security was also a big concern for older couples. One man told Rosenblatt that he once went into diabetic shock in the middle of the night. His wife woke up, recognized the signs, and called an ambulance. “That is one guy who is never going to want to lie down by himself again, no matter how hot his wife wants the bedroom or whether she likes putting a nightlight on,” Rosenblatt said. For these couples, the give-and-take of bedding down on the same mattress was outweighed by a sense of emotional support that could be given only by proximity.

One question still gnawed at me, however. Stanley, the British sleep scientist, argued that there is only one good reason to share a mattress. I asked Rosenblatt about the contention that sleeping in the same bed as one’s partner is good for sex and little else. He laughed. If any man actually followed that, Rosenblatt said, he would realize that men who sleep by themselves actually have less sex than those who share a bed with their partners. The change in a couple’s sex life after one moves to the room down the hall was so pronounced that men in his study couldn’t stop talking about it.

“Some of the men were really grieving the loss of sexual access when they stopped sharing a bed,” he told me. “None of the women said that,” he added.

The mystery of the shared mattress was solved.

4

 

And Baby Makes Three

 

 

A
bigail’s bedroom perfectly appeals to the tastes of a two-year-old girl, which, as luck would have it, is exactly what she is. Disney princesses smile down at her from the lilac walls. A small white bookcase sits in the corner, topped with a lamp in the shape of a tulip. If you ask Abigail if she has a favorite pair of shoes—and she’s hoping that you will—she will open up her closet, move aside a basket of toys and dolls, and emerge with every single pair that she owns.

In the middle of the room sits a white bed frame, holding a small mattress covered by a comforter with a pattern of daisies on it. This is perhaps the only object in the tidy, small bedroom that she has no opinion of. And why would she? Abigail has never slept in a bed by herself, much less this one, which her parents picked out for her several months ago. For her, the routine of going to sleep means putting on her pajamas, brushing her teeth, and listening to one of her parents sing a lullaby as they put her down in the middle of the king-sized bed in their room. They join her anywhere from twenty minutes to two hours later. It is the same basic script that the family has followed every night since she was born.

Abigail’s parents, two white-collar professionals in a major city, didn’t mean for their daughter to sleep this way. Before she was born, they bought a cherry-wood crib and spent an afternoon assembling it in what would become her room. Next came the purchase of a white bassinet, which they put in their room and intended for Abigail to sleep in during her first few months, a way station that would make nighttime feedings easier and calm their nerves when she was out of sight. The day soon came when they brought their newborn home. They put her down in the bassinet that first night as planned, but something strange happened as they lay in their bed staring at the ceiling and trying to sleep. Abigail, in the corner of their modest bedroom, felt much too far away. Her father strained to hear her every breath. Her mother wondered if the bassinet was sturdy enough. When Abigail woke up and began crying, both of her parents jumped out of bed together. While her mother held her, Abigail’s father dragged the bassinet next to his wife’s side of the bed, closing the three-yard gulf that seemed much larger when the lights went down. Finally, with Abigail practically on their mattress, they drifted off to sleep.

At first, they attributed their feelings to first-night jitters. But the next night, they again felt like something was amiss while their daughter slept soundly in the corner. Abigail’s father moved her bassinet flush with the side of the bed for the second time. After the third straight night of this, Abigail’s parents bought a tiny crib that had barriers on only three sides. The fourth was open except for a small padded rail. Abigail’s new space was permanently fixed next to her parents’ mattress, an annex that allowed the three of them to effectively sleep in one family bed. She remained in the side-sleeper until she outgrew it. At that point, she began sleeping on the mattress itself, wedged between her mother and father.

Her parents knew they were breaking rules laid down by their doctor, who strongly discouraged the notion of co-sleeping. Not only that, but they were inviting criticism from their own parents as well. Both sets of Abigail’s grandparents had been vocal with their thoughts that anyone who slept in the same bed with an infant was negligent. But Abigail’s parents had come to enjoy what they saw as an intense bonding time with their child. They went ahead and bought a child-sized bed, knowing that the day will soon come when it will be put to use. In the meantime, they let their parents assume that Abigail spends each night in her own room.

Abigail is one of countless children whose sleeping patterns were far from the mainstream just a generation ago. About one in fifteen parents admitted to sharing a bed with their child in a study published in 1993. By 2007, the number had grown to about one in three. The actual number of
co-sleepers
, a fuzzy term that for some means sleeping in the same bed with their child and for others means sleeping in the same room, might be much higher. Like Abigail’s mother and father, parents who sleep in the same bed with their kids can be reticent to admit it, worried that they are going to be scorned by their family, questioned by their friends, and criticized by their doctors.

The growing popularity of co-sleeping troubles many public health officials because the body of an adult can pose a danger to a baby sleeping on the same mattress, especially when that adult has had too much alcohol. Public health officials point to studies such as one conducted in Santa Clara, an upscale California county that makes up most of Silicon Valley, which found that twenty-seven infants over a five-year span died as a result of being placed in the same bed as a sleeping adult. More than half of those accidents were caused when the adult rolled over onto the child. The others were caused by suffocation. The American Academy of Pediatrics warned against co-sleeping in the early 1990s, citing the risk of an infant becoming entrapped in bedding or an adult’s clothing.

What accounts for such a dramatic shift in where children sleep despite all of the official warnings against it? It may be nothing more than a newfound willingness on the part of parents to try anything to tame the often-unhappy relationship between children and sleep. Getting children to sleep is the first problem that parents are expected to solve, and yet it is also one of the most difficult. One study found that parents seek advice from their doctors regarding this issue more than any other health concern or behavior.

Part of the reason for the confusion comes down to biology. Infants initially make no distinction between day and night. The inner clock that tells them when it is time to be awake and alert and when it is time to sleep emerges gradually, which means that babies who want to eat or play at two in the morning have no idea why this might be out of the ordinary, and explains why babies who get tired at seven one evening won’t necessarily do the same thing the next. During the first weeks of life, infants will typically sleep about sixteen or seventeen hours each day, although the longest stretch will last only about four or five hours at a time. Unlike children who are a few months older, newborns pay little attention to the surrounding environment. Hunger, loud noises, and lights usually won’t be enough to keep them from falling asleep when their brain needs it. It is an urge that comes frequently and intensely: infants spend nearly half of the time that they are asleep in deep REM sleep, a level of brain activity that is as busy as when they are awake.

This type of sleep pattern—bouncing between sleep and wakefulness outside of a twenty-four-hour schedule—is known as polyphasic sleep. Sleeping in a more or less single period based on the time of day is called monophasic sleep. Nothing good happens when a polyphasic sleeper comes into a household of monophasic parents. Nighttime feedings may take place at one in the morning one day, and then at three in the morning the next, without any pattern or schedule beyond an infant’s capricious cries. Parents have to deal with the consequences of the delayed circadian clock until infants reach about four months old, which is when most children start to sleep in eight- to nine-hour blocks during the night.

Parents aren’t quite out of the woods once their children reach toddlerhood, however. While the total amount of time children sleep each night decreases as they get older, their resistance to it builds. Stonewalling becomes a new part of the bedtime routine. Parents soon hear endless requests for another cup of water, for another story, or another song. These nightly struggles take place despite the fact that sleep—whether in long stretches at night or in short doses in the form of naps—is one of the most reliable things that make very young children happy. In one study, researchers identified two groups of three-year-olds. Children in the first group had strict nap schedules that mandated the hours they had to spend in bed, whether they wanted to or not. Children in the second group napped whenever they felt like it, which was rarely. All of the children in both groups slept for a total of about ten and a half hours each night, regardless of whether they napped or not. Yet the children in the dedicated napping group slept more, logging an average of two additional hours over a twenty-four-hour period compared with those with irregular naptimes. The outcome of the extra sleep was better interactions between parents and their children. The children in the napping group were “more fun to be around, more sociable and less demanding,” researchers noted. With their longer attention spans and calmer dispositions, they were able to learn and adapt to changing circumstances. Children who didn’t sleep as much, meanwhile, were hyperactive and fussy, a result of missing out on the time spent in deep REM sleep that allowed the nappers to better react and respond to the world around them.

No one debates the fact that young children need a lot of sleep. Yet the difficulties in getting them to do it have spawned a mini-economy of parenting books focused solely on sleep, written by a number of competing experts, each of whom claims to know best. Richard Ferber, a pediatrician at Children’s Hospital in Boston, wrote one of the landmark books of the field in 1985:
Solve Your Child’s Sleep Problems
. Before then, sleep was barely mentioned in the standard child-rearing guides.

Ferber became interested in sleep in the 1970s, shortly after the birth of his own children. As he spent night after night rocking his son to sleep in his arms, only to watch him wake up the minute Ferber placed him in his own bed, Ferber began to wonder why it was difficult for a child to fall back to sleep on his own. He slowly came to the realization that infants simply don’t know how to do it by themselves. Gradually, Ferber began weaning his children from what had become the family bed by letting them cry for progressively longer periods of time before he or his wife would check in on them. Ferber hoped that his son would no longer associate falling asleep with being rocked or held and would learn that a parent will not always be available to attend to every one of his cries. Instead, his son would begin to develop the ability to calm himself down. “A baby cannot count sheep,” Ferber later told an interviewer. “So we have to find a way to help them. To teach them in a simple, gentle way that they need to sleep. And that they need to do it all by themselves. It really isn’t so hard for them, either. Babies love to learn.”

The philosophy, which became known as either the sleep-training or the cry-it-out method, became so popular that Ferber’s name morphed into a verb. New parents began asking their friends whether they, too, were “Ferberizing” their children, and whether it was working. The drill itself was fairly simple. A parent would place a child down in his or her own bed, and come back to the room at longer and longer intervals to soothe the child. Ferber advised parents to steel themselves against the sound of their children wailing and to stick with the sleep-training plan. With time, a child wouldn’t need help. In the first editions of his book, Ferber noted that sharing a bed with a child would likely make the process of developing effortless sleep more difficult. “Although taking your child into bed with you for a night or two may be reasonable if he is ill or very upset about something, for the most part this is not a good idea,” he wrote. Parents were also warned that co-sleeping could slow the emergence of a child’s sense of independence. “If you find that you actually prefer to sleep with your infant,” Ferber wrote, “you should consider your own feelings very carefully.”

Part of the appeal of sleep training is that it is designed to allow parents to sleep. In his practice in Boston, Ferber consistently heard from a steady stream of parents about how sharing a bed with their child meant that they never slept for more than an hour or two at a time. They described living in a half-asleep daze, woken up by every cry, and resenting the fact that they felt inadequate at both work and home. This form of chronic sleeplessness has an outsized effect on mothers. One poll of twenty thousand working parents conducted by a team from the University of Michigan found that women are two and a half times more likely to interrupt their sleep to care for a child compared with men. Once a mother is awake, she tends to stay that way for an average of forty-four minutes. When a father wakes up to attend to a crying child, however, he is often able to fall back asleep within a half hour. These moments of male alertness were short and rare. Nearly one out of every three mothers said that they woke up to care for their infants every night. Just one out of every ten men did so. “Obviously, the child-rearing responsibilities maybe slanted at first due to breast-feeding,” one of the lead researchers said. And yet “the responsibilities are never renegotiated,” she added.

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