The OP has said she acknowledges this is just a temporary thing with him working late while he sets up his own practice.
I have asked the OP what sort of practice is he setting up, because it is sort of vague. Could be a medical practice, could be a consultancy practice, could be an architecture practice, who knows. All she has said is it's a practice, so my mind is jumping to medical.
Is it a medical practice? Is he a GP? Is he working in a practice alongside trying to set up his own medical practice? Does she know GPs rules have recently changed for GPs. They can't close their e-consult forms when they're at capacity anymore, and they've got to keep them open for all working hours, and all patients must know on the same day how their request will be managed, a new target has been set by NHS england that GPs should see 90% of all urgent cases on the same day, and that these changes started on 1st October 2025.
This means there are a lot of aditional administrative changes that are needed in order to remain compliant and receive funding.
A lot of GPs are having reduced lunch times because of these extremely recent changes. Add on top, trying to set up your own practice and the additional administration this also takes.
Then you've got the appointments themselves, it could be anything from seeing patients for common coughs and colds, to telling somebody their hospital results have come back and they've got cancer, to telling someone they've hit the menopause and all their hopes and dreams for starting a family are a pipe dream now, to we've run out of medication options for treatment resistent depression, to the medication you've been taking for years is now no longer permitted even though it was the only thing reducing the pain. I know many GPs who will feel completely overwhelmed by lunchtime, and any lunchtime they get will be spent decompressing in a way that works for them, and might mean that they don't have the headspace for superficial and coerced text messages.
Then there are GPs who do out of hours services too, with a high rate of GP absence so other GPs are having to pick up the slack, especially with many GP practices closing due to lack of funding or resource.
Our GPs lead partner who established the practice has since become a more administrative role within the practice and he does have more time to make sure that he is taking restful, and meaningful breaks, but it takes time to help your staff also get into the flow of things and make sure that your service isn't completely overwhelmed. On top of that they're not allowed to close off their registration process, meaning that currently they serve around 10,000 people, and that number will just increase the more people register to that practice which is likely to happen the more other practices close. There's a national shortage of available GP appointments.
So the more practices there are in an area, the more that number is shared, and the less busy they will be.
This is with the assumption that when OP said practice she meant medical of course and I am making massive presumptions here.
Setting up a business is never easy in the early days of it. It is usually temporary, despite the work never ending.
What the OP is saying she needs is directly contradictory to what he needs. There isn't an absence of a show of affection, the OP has listed all of the things he does for her, and he sounds really considerate and caring, but instead the OP has accused him of an affair, purposefully pretended to be asleep so that she can avoid him, and you can tell when someone is pretending to be asleep, and can't see the things he does do for her in a positive light. She's expecting him to be loving, warm and affectionate when she has rejected him too so that she doesn't feel rejected first due to the temporary circumstance he is in with work.
I do think that if the OP is not happy with the arrangement she should leave the relationship because it sounds like she could be asking for an immediate resolution to something that can't be given an immediate resolution.