A new form of performance anxiety has emerged in our achievement-driven society: It is known as orthosomnia, and it describes an unhealthy preoccupation with obtaining the correct amount and stages of sleep.
The term was first identified by researchers who noted an increasing number of patients seeking treatment for self-diagnosed sleep disturbances, often based on data from their sleep trackers, explains Kelly Baron. Baron, a clinical psychologist who directs the behavioral sleep medicine program at the University of Utah and was the lead researcher on the paper that coined the term, states that “Ortho” signifies straight or correct, and “somnia” refers to sleep. The researchers chose this name due to its similarity to orthorexia, a condition involving an unhealthy obsession with healthy eating.
Orthosomnia is not a formal medical diagnosis, but it is a phenomenon that has grown in prominence alongside the rising popularity of sleep trackers.
“In clinical practice, we observed more and more individuals with insomnia arriving with sleep-tracking devices,” Baron details. “They placed more trust in the device than in their doctor” or even their own subjective sense of how they had rested.
After reviewing a series of individual cases, she and her fellow researchers on the paper concluded that some of the people unnecessarily worried about their sleep quality were too engrossed in their sleep-tracker data, engaged in a “perfectionistic quest for the ideal sleep in order to optimize daytime function.”
However, many individuals are unaware that “trackers are not medical devices—their accuracy is always questionable,” states Michael Breus, a clinical psychologist and founder of SleepDoctor.com. “Sleep is assessed by brain waves, so unless electrodes are connected to your head, your brain waves will not be measured.” This is precisely what is done with polysomnography, a lab-based sleep study considered the gold standard for diagnosing sleep disorders.
In contrast, wrist-worn sleep trackers typically rely on pulse or heart rate “to estimate” the brain’s electrical activity during sleep (which an electroencephalogram, or EEG, would reveal in a sleep lab), Breus explains. Furthermore, sleep-tracker rings worn on a finger utilize body temperature, physical movement, heart rate, and heart rate variability (fluctuations in the time between heartbeats) to gauge sleep quality.
Negative Impacts of Orthosomnia
The problem with an unhealthy fixation on sleep metrics is that it can intensify anxiety and exacerbate insomnia in affected individuals. Those with orthosomnia may feel apprehensive about going to sleep, or achieving specific sleep metrics such as deep sleep, REM sleep, sleep latency (the duration it takes to fall asleep), or sleep efficiency, which is the percentage of time actually spent asleep versus lying in bed. (All these metrics are included on certain sleep trackers.) Consequently, Baron notes, they may end up remaining awake longer at night.
“Sleep is one of those aspects you cannot perfect,” Baron comments. “Some nights you can do everything correctly and still not achieve a good night’s rest. You cannot over-control it.”
Yet, this does not deter some people from trying. “People excessively focus on every detail related to sleep because of the availability of data,” Breus remarks. And they often share this information with others. “It becomes a topic of conversation—what was formerly known as water-cooler talk,” he adds.
Strategies for Managing Orthosomnia
Rather than obsessing over the tiny details of your sleep, it is more beneficial to consider your objectives for improving your rest, Breus advises: Do you wish to sleep longer? Wake up feeling more refreshed? Something else?
Subsequently, the feedback from a sleep tracker can be used to modify your behavior—including your eating, drinking, and stress-management habits, as well as your use of electronic devices in the evening—to help prepare yourself for a better night’s sleep. “Self-monitoring and goal-setting are foundational to any kind of behavior change,” Baron states.
However, checking the data from your sleep tracker daily is not necessary. Instead, it is better to seek out trends or major variations once a week, or compare your weekday data to your weekend data, Breus suggests. “That is how everyone can utilize a tracker without becoming excessively preoccupied with it.”
To enhance your , strive to establish a regular schedule, with consistent bedtimes and wake-up times, Baron recommends. In the morning, prioritize how you feel rather than the numbers displayed on your tracker’s application.
If, despite implementing these measures, you continue to find yourself fixated on your sleep data or feeling anxious about your sleep, it might be time to take a break from using a tracker. “For certain individuals, paying too much attention proves counterproductive,” Baron says. “Your sleep experience should ultimately be based on how you feel.”
If resisting the monitoring of your sleep quality is difficult, maintaining a written sleep diary might be a better option, Breus suggests. Each morning, record your bedtime and wake-up time, the number of times you awoke during the night, and your self-assessment of sleep quality on a scale from one to five.
Should anxiety about sleep continue to plague you, you might benefit from cognitive behavioral therapy for insomnia (CBT-I) with a trained therapist, an online course, or an app. CBT-I employs various techniques to alter people’s sleep-related habits and attitudes that might be prolonging their sleep difficulties. It has been shown to be highly effective.