Orthosomnia: The Dark Side Of Sleep Trackers And Data Obsession

Sleep trackers have helped millions gain a deeper understanding of their sleep quality and even trigger positive behavioral change, but many didn’t realize they could backfire. Overly fixating on what the sleep data show has led many down the path to developing insomnia. All that in the attempt to get the “perfect” night of sleep. As a result, researchers in a 2017 study coined the term orthosomnia to describe one’s perfectionistic quest for ideal sleep.

Another study published in 2023 estimated that 20% of U.S. adults use a wearable device regularly for fitness or sleep, and this will likely increase each year. However, researchers pointed out that while these “technologies have the potential to offer crucial information about irregular circadian rhythms and long-term sleep habits, relying solely on algorithms from modern technology with inexperienced interpretation might lead to poor management of sleep issues that result in disturbed sleep or exacerbates undiagnosed conditions.”

What is orthosomnia?

Orthosomnia is a person's perfectionistic quest for ideal sleep. However, orthosomnia is not a diagnosable sleep disorder. Instead, it's considered a societal phenomenon brought about by technology. It combines “ortho,” meaning straight, right, or proper, and “somnia,” referring to sleep.

Annie Miller, a therapist specializing in behavioral sleep medicine, told Healthnews that orthosomnia is a form of insomnia stemming from being overly focused on sleep data and becoming preoccupied with achieving the “perfect” night's sleep and feeling the need to repeat it.

"This can lead to fixation on sleep data and tracking sleep and managing all the variables related to sleep."

Annie Miller

Additional behaviors that point to this phenomenon include frequently checking the sleep tracker and feeling anxious in the event of disassociation from the technology.

Imagine waking up feeling like you had a solid night of sleep. However, as you're getting ready for the day, but before you head out the door, you check your sleep tracker's data. It tells you didn't recover well, and your sleep score was only 32.

What would you do? Would you feel more stressed after seeing it? Would you all of a sudden reevaluate your sleep quality? Maybe your subjective perception wasn't all that accurate after all. Will your plans change in terms of how you're going to work out, what you will eat, and what you'll do before bed that night? If you are contemplating and overly stressed about sleep due to the data from a wearable, you may have developed orthosomnia.

When is sleep tracking a problem?

Tracking sleep becomes a problem if you become fixated on or preoccupied with getting “the right amount” of sleep. Reading sleep data can lead to an obsession with achieving an ideal amount of sleep and having sleep stages look just right.

"Over time, this can lead to higher levels of anxiety and stress around sleep. When we have more stress around sleep, this leads to more insomnia, <…> Like any type of perfectionistic tendency, you can start to see the sleep you do get as never enough or not the right type of sleep, and this can create a vicious cycle of anxiety, insomnia, and even physical symptoms."

Annie Miller

Are sleep trackers accurate?

Many wearables today utilize advanced sensor technology and algorithms to capture and calculate sleep quality and quantity, including movements, sleep latency, and sleep stages. However, researchers warn that everyone should take that data with a grain of salt.

Alex Dimitriu, MD, a dual board-certified psychiatrist and sleep medicine specialist, told Healthnews about a study where participants were told to wear a sleep tracking device, which randomly told them how they slept, irrespective of actual sleep quality.

"The fascinating finding was that people who were told they slept poorly, felt worse, and were sleepy by day, be careful what data you accept as truth. Even in a sleep lab, with EEG monitoring, it can be hard to perfectly track sleep, so all other home or consumer devices are not any better."

Dr. Dimitriu

A study has discussed that despite multiple studies showing that consumer-wearable sleep tracking devices are inaccurate in discriminating sleep stages and detecting awakenings after sleep onset, patients' perceptions are difficult to change. Additionally, the lack of transparency in the device algorithms makes it impossible, or at the very least confusing, to know how accurate they are, even under the best circumstances.

These cases suggest that sleep tracking may have unintended effects for a subset of patients. For example, all three patients in this given study spent excessive time in bed in an attempt to increase the sleep duration reported by the sleep tracker, which may have exacerbated their insomnia. In addition, given that these devices tend to overestimate sleep, they may have reinforced poor sleep habits by encouraging people to spend more time in bed.

Develop healthy sleep-tracking habits

Sleep tracking has been fueled by the self-quantification and biohacking movement, as many adopted an individualized approach to their health and fitness. It has taken on the role of helping people connect the dots between their daily behaviors and habits and how those would impact their sleep quality.

“Sleep tracking, in my experience, is good to set healthy bed and wake times and have a good wind-down routine,” Dr. Dimitriu said, adding that he’s noticed that patients would also benefit from avoiding late-night meals, alcohol, and exercise, from sleep tracker data. “Some sleep trackers may also pick up on sleep apnea, which is another plus,” he said.

Dr. Dimitriu pointed out that people should make a point not to be glued to their tech, especially before sleep. “Remember that relaxation and time are key.”

"Wind down the work routine early, put away technology by 10 p.m. 'Tech off at ten,' is what I tell my patients. Get to bed earlier and do something peaceful, like reading a book. Allow an eight-hour window for sleep and keep regular bed and wake times. A cool, dark bedroom helps too, and no bright lights or screens, ideally after sunset, but certainly around bedtime."

Dr. Dimitriu

Pros and cons of sleep tracking

Finding the right balance with how one uses a sleep tracker to quantify their sleep quality is key to avoid sliding down the slippery slope of stress over the perfect sleep score. Sleep, as Dr. Dimitriu described, can often “act like a finger trap — the more you force it, the worse it is.”

Here are some pros and cons of sleep tracking:

Are you taking sleep tracking too far?

More long-term research is needed to fully understand the magnitude of how much sleep trackers may impact individuals' sleep, considering all possible adverse effects, not just the beneficial ones. If you already have a sleep tracking ring, smart mattress, or wristband, it's worth asking yourself a few questions to see whether you are too focused on that data.

• Are you worrying about or contemplating about your sleep daily?
• Do you check your sleep data first thing in the morning or even in the middle of the night?
• Are you spending time researching products or ways to get “better” sleep based on what your wearable device shows?

In combination with that, checking in with your intuition on how you slept can also help paint a complete picture of your sleep quality. If you said “yes,” however, to the above questions, orthosomnia can easily creep up on you, and Miller suggests taking a break from tracking your sleep. “Often, we are better off not seeing the data about sleep,” she said. “It’s important to focus on how you feel after a night of sleep, not what the wearable device tells you about your sleep.”