Wearable devices such as FitBits that help us to (supposedly) track our sleep may actually have the potential to harm sleep, instead. 
That’s according to a new case study report from the Journal of Clinical Sleep Medicine. In the article the researchers have dubbed a new sleep disorder related to sleep tracker use as “orthosomnia.”
There are ways, however, to use sleep trackers to our advantage, the researchers say, as long as we keep their limitations in mind, listen to our instincts, and trust our sleep therapists’ expertise.
What’s Orthosomnia?
If you have a wearable step-counter and sleep-tracking device, such as a FitBit or Jawbone, how often do you check its sleep-related data? If you notice that the data indicates that you didn’t sleep your ideal 8 hours last night, do you feel disappointed? Worried? Depressed? Or even perhaps more tired than you did a few minutes ago? Do you find yourself spending more time in bed in order to achieve the sleep data perceived as “perfect”? Any of these may be signs of the new sleep disorder that sleep specialists writing in the Journal of Clinical Sleep Medicine are calling orthosomnia. They chose the term orthosomnia because it means, essentially, “straight” or “correct” sleep. In that way it’s similar to a rather new eating disorder called orthorexia in which sufferers are overly preoccupied with the health value (or lack thereof) of the foods they consume.
Basically, a person suffering from orthosomnia may be so obsessed with sleep that their sleep is actually suffering. With orthosomnia, the affected person is overly concerned with getting “perfect” sleep. Such a fixation can lead to stress and anxiety that, in turn, makes getting quality sleep harder.
How Accurate are Wearable Sleep Trackers?
Part of the problem with orthosomnia and the type of sleep trackers the average person uses, and how we use them, is that these devices can be limited in their ability to reliably track sleep. Most consumer-grade sleep trackers use a sleep quality score that’s not based on sound sleep science, especially when it comes to figuring out how much deep or “good” sleep a person is getting. They just can’t differentiate between levels of sleep very well and the “goals” being set are often not clinically sound. This can lead to orthosomniacs harming their sleep with stress over information that’s potentially inaccurate, inappropriately targeted, and wrongly interpreted. In the case study report mentioned above, the researchers note that some people indicate that they didn’t even know they had a “sleep problem” until they started using a sleep tracker. In essence, they may have felt fine, but after receiving “data” from their sleep tracker, they subsequently thought they weren’t sleeping well enough.
What’s the Best Way to Use a FitBit-Style Sleep Tracker?
This is not to say you should throw your FitBit out the window – yet. Just use it wisely, recognize its limitations, record your own observations, and take the advice of your sleep therapist seriously.
- Know the limitations: Sleep trackers are not fully reliable in their ability to measure sleep. They are not like the sleep studies performed in a clinical setting. They estimate the time you are asleep based on a slowed heart rate and reduced movement. So, if you read in bed, for example, your FitBit might record that as sleep. Numerous studies have shown that consumer-wearable sleep tracking devices are unable to differentiate stages of sleep and have poor accuracy in detecting wake after sleep onset. In the orthosomnia case studies, patients were actually making their insomnia worse by spending excessive time in bed in a quest to achieve an “ideal” number of hours of sleep as per their sleep trackers.
- Make your own observations: You can better determine your sleep quality by going lower-tech for a couple weeks says a sleep expert in SHAPE magazine. Take off your wearable device at night and keep a sleep diary (either a journal or the Circady app). In the morning when you wake up, record when you got in bed, when you got out of bed (and when you awoke if those times are different), and approximately how long you think it took you to fall asleep. Also record how you’re feeling and keep notes of any daytime potentially sleep-related symptoms or lack thereof. Keep this data for two weeks. Then, put your sleep tracker back on at night. Keep recording all the same data but make sure you jot it down BEFORE you look at your sleep tracker information. How does the information you’ve recorded in your diary about the quality of your sleep jive with that of the sleep tracker? Don’t expect them to match perfectly. When it comes to sleep, remember to trust how you feel more than the numbers coming out of your device.
- Listen to the experts: If you consult a sleep therapist to assist you with your sleep quality, share your sleep diary as well as any wearable device information you may have along with your symptoms and feelings about your sleep. Your sleep therapist will help you to come up with a personalized plan of action for better sleep. This may include ditching the sleep tracker for a while, limiting other technology use if a sleep-tracker fixation is part of larger pre-bed technology problem, or reducing time in bed to “condense” sleep time. As much as many of us love the numbers our smart devices can give us, it’s good to keep in mind that they don’t tell the whole story and that good old-fashioned, one-on-one work with a fellow human is often crucial for success.
I’m wondering whether there is another device-related disorder that may soon be named… Perhaps it will be called “ortho-steppia” or “ortho-pedometer syndrome.” I certainly know a number of FitBit wearers who are obsessed with their daily step counts to the point of pacing in the bedroom at night to reach a goal number before bed. I’m sure that’s not good for their sleep or their partners’… Which gets me to the trusted saying, “Everything in moderation” including data. Wishing you a tech-smart night.