Meet Orthosomnia, the on-the-Rise (and Counterproductive) Cultural Obsession With Hacking Your Sleep
Need evidence? Consider the Apple Watch and certain FitBit editions, which promise to not only tell you how many hours you sleep a night, but how much of that is deep sleep. Then there are smart beds and mattresses, like Eight Sleep, that give you a "score" of how well you sleep each night. Or, you could consider the Oura Ring, which uses body temperature and heart rate to let you know how much time you spend in light, deep, and REM sleep.
On face value, this seems like good news for our data- and metric-obsessed culture that intends to invest in and use such information to better our lives. For example, if you know you're only 150 steps away from hitting your daily step goal (whatever number that may be), you'll probably do what you can to reach it, moving more than you might otherwise—and that's great. So it would follow that if your sleep tracker is giving you a sleep score of 60 percent, you'd do what you can to raise that stat, which is also good for overall health, right? Well, it's complicated.
Orthosomnia points to a situation of sleep-information overload, since many who deal with it are so consumed by the notion of perfect sleep that they couldn't possibly achieve it.
While sleep trackers can provide helpful insight, a 2017 case report published in The Journal of Clinical Sleep Medicine concluded that they're also leading to a rise in orthosomnia, a term coined in the paper describing a condition marked by an obsession with the quest for perfect sleep. And, more specifically, orthosomnia points to a situation of sleep-information overload, since many who deal with it are so consumed by the notion of perfect sleep that they couldn't possibly achieve it, thus making certain cases of insomnia worse.
Consider the event of having a sleepless night—one surefire way you won't be able to slip into a slumber during one? By thinking exhaustively and about how you can't sleep. So, the rise of orthosomnia raises a few interesting questions: Namely, when does information transition from being helpful to hurtful? And, given that answer, what place—if any—does sleep tech really have in the bedroom?
How the sleep-tracking obsession was born
According to sleep specialist and The Sleep Solution author Chris Winter, MD, many people have developed a sleep-tracking habit in part because they're navigating sleep problems and are hopeful about finding solutions. "People are so desperate to get a good night's sleep," he tells me. And, in fact, according to a Well+Good survey of nearly 1,500 people, 92 percent of participants said they felt fatigued more than once a week, and 83 percent said lack of sleep was taking away from their quality of life.
"Patients will come in and say, 'I bought this thing off Amazon to measure my sleep, but it's not working. I'm still not sleeping great.' And I'll say to them, 'Well, what did you expect it to do exactly?'" Because information doesn't magically shape-shift into a noticeable change without deliberate actions taken no matter how hard we try to find shortcuts to life's unavoidable biological requirements of us via phenomenons like orthosomnia.
To this point, Dr. Winter also calls out "hacking culture" as a contributor to orthosomnia. "I have patients out in Silicon Valley who only want to sleep for four hours a night so they can spend more time working or training for triathlons," he says. "You could sleep for four hours a night and seem great, but it will catch up with you; it isn't sustainable." In other words, you can't cheat sleep.
When tracking sleep is actually helpful
But Dr. Winter maintains that sleep trackers can be helpful; it just depends on how they're used. He and Kelly Baron, PhD, the lead researcher behind the aforementioned orthosomnia case report, say trackers are great for providing a general sense of how you're sleeping, and a snapshot for how certain habits may come into play.
"Maybe you sleep at your partner's house on the weekends and you think that might be affecting your sleep. You can use sleep data to tell you if you actually are, in fact, sleeping less at their house than your own," Dr. Winter says. "Or maybe you drink a lot on Friday and Saturday nights and you want to see if that is affecting your sleep. You can check your data to see." The info, he says, might lead to lifestyle shifts that then, in turn, lead to better sleep.
But when I asked Dr. Baron why any of this should supersede simply checking in with how you feel on given day as a barometer for sleep quality the previous night, she finished my thought: "I don't need a sleep tracker to diagnose someone with poor sleep," she says, adding that it's common to wake up during the night without even knowing it. "People will often come to me with their sleep data and say, 'I thought I slept great, but my tracker is showing that I woke up six times.' I tell them not to sweat it. If you don't remember it, it probably doesn't matter."
How having too much information can backfire
While both pros contend that sleep data is certainly helpful in an overarching sense, inching into orthosomnia territory is easy and counterproductive. "If you want general information about your sleep, it can show that, but if you're using it to try to hit a certain number or score, that's when it can become problematic," Dr. Baron says, pointing out that you can do everything "right" yet still have a night of restless sleep. "Lying there, obsessing, isn't going to help." This laser focus on willing your body to perform optimally rather than organically, she says, is how having too much information in our hands (or on our wrists or mattresses) can actually compromise sleep rather than promote it.
A laser focus on willing your body to perform optimally rather than organically is how having too much information can actually compromise sleep rather than promote it.
Another point against the information overload? Both experts note that research supports a placebo effect at play, wherein how someone perceives the way they slept affects how they feel more than the actual amount of time they spent sleeping. So, let's say you feel great, but your sleep data isn't perfect; in this case, the data alone may shift your otherwise-positive understanding of how you felt about your night of sleep. Furthermore, the experts say the metrics delivered from these wearables aren't yet perfected and may overestimate the amount of sleep your getting in addition to offering imperfect breakdowns of how long you spent in each sleep stage. "They’ve done studies where they’ve even given people fictitious data about their sleep and that influences how they feel during the day. It’s pretty fascinating," Dr. Baron says. "The devices aren’t going to improve things for [the people] unless they do something and change something about their behavior."
Her point is that while sleep data can provide information, it can't force people to make the lifestyle changes required to clock better sleep. Dr. Baron also notes that how you feel during the day is more complicated than any kind of sleep score. "There are so many factors to consider, including mental exhaustion, physical exhaustion, and stress. Knowing your sleep number isn't the whole story as far as how you're going to feel during the day," she says.
Now, with all of this in mind, the big, bottom-line question: Are sleep trackers bad for sleep? According to the experts, no. They can be helpful, and they can also be decidedly not helpful. The main takeaway to keep in mind that will also keep orthosomnia at bay is that no matter how much data is at your fingertips, that's all it is: data.
If you can't sleep, this is what a sleep expert says to do. And here, a sleep doctor shares her evening routine.
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