At this point we all know that a good’s night sleep is crucial for our mental health and physical wellbeing. We also know that most of us aren’t getting nearly as much of it as we need to—and we’ve got the hard evidence to prove it. Wearable sleep trackers and apps of all types are readily available to help us keep tabs on our healthy habits, including the quality of our sleep. Here’s the problem: That drive to get our requisite six to eight hours a night can make people obsess over their stats and lead to something researchers are calling orthosomnia.

What Is Orthosomnia (AKA Drive For Perfect Sleep), Anyway?

While not an actual medical diagnosis in the DSM-5, orthosomnia has been gaining some traction in the sleep community. A team of researchers first documented the problem in 2017. They found a growing number of patients seeking treatment for self-diagnosed sleep disturbances based on the data from their fitness trackers.

This fixation on data could lead to a kind of perfectionistic quest to try and optimize sleep performance and “beat” their numbers from night to night—which was negatively impacting their day-to-day interactions and even leading to a form of obsession with their sleep habits.

“It’s more of a trend than an actual diagnosis,” explains Dr. Daniel Jin Blum, MD, Adjunct Clinical Instructor in Psychiatry & Behavioral Sciences at the Stanford University School of Medicine, “but specialists were starting to notice people would come in and have a lot of dissatisfaction with their sleep, particularly related to the feedback they were getting from their commercial fitness trackers.”

Why Is Orthosomnia A Problem?

Being concerned about your sleep habits is only natural—as Dr. Julie Kolzet, Ph.D., a therapist in New York City who specializes in sleep disorders, notes, we’re bombarded by news of how important sleep is to our overall health. “The more we obsess about sleep and fixate on the importance, the more you’re basically trying to exert control over sleep,” she says, which, paradoxically, can actually cause you more problems falling asleep.

Those with perfectionist qualities, says Dr. Blum, can be more predisposed to developing orthosomnia, and it can be an additive effect for people who are prone to anxiety. There is no concrete evidence that insomnia and orthsomnia are intrinsically linked. While some people with orthosomnia may, in fact, have insomnia, that’s not necessarily true for all—and vice versa.

“The profile of orthosomnia is that they have this hyper-vigilant focus on their sleep and health,” says Dr. Blum. Unfortunately, they tend to be focused on an arbitrary number they think they need to hit. “People with orthosomnia can get fixated on the number—’oh, I’m only getting seven hours and 15 minutes a night, but I need the full eight and I know it’s impacting me.’”

The thought process around perfect sleep, he says, is this idea of ‘I’m going to get the exact amount all the time and feel great.’ “In a normal healthy sleeper you typically won’t get the exact same amount of sleep every night. Waking up instantaneously without an alarm doesn’t happen all the time either.”

Should You Be Worried About Your Fitness Tracker?

While trackers might be at the heart of orthosomnia, there’s no reason to chuck yours out the window just yet. “These devices are great for helping people who want to be more on top of their sleep, who are motivated, who are enthusiastic about their health, and don’t obsess about the data,” says Dr. Kolzet. “But if you really have a chronic sleep problem, these devices are not designed to be treatment devices, they have not been through FDA approval. There haven’t been a lot of validation studies to support their use in medical settings. That doesn’t mean that they are not without merit.”

Dr. Blum agrees, noting that these commercial trackers are historically not great at actually determining when you are awake or asleep and the type of sleep you are experiencing. But the technology only continues to evolve, which is promising.“I think over time more devices will be able to track sleep at a more accurate level. Every iteration of current tech is getting better at predicting wakefulness and there are some EEG monitors that people can wear like headbands that can monitor sleep and have very good accuracy of sleep stage scoring. It’s going to improve and it will get much more sophisticated.”

The other part of that equation, says Dr. Kolzet, is what you and your doctor actually do with that data your tracker is gathering. “Currently there aren’t any specific guidelines which would help people who are using these devices at home to direct them to health care providers to determine which treatment will be most beneficial to them,” she says. “It would be great if we could use these devices and incorporate them in a clinical setting—that would really help us to measure things like adherence and how they’ve been doing in-between sessions. If they could be used to direct patients into treatment—that’s where they have a lot of value.”

How Can You Help Orthosomnia?

If your fixation on your sleep quality is significantly impacting at least two domains of your life (work, family, relationships), says Dr. Blum, or it’s causing enough distress or disrupting your ability to function, it would be a good idea to seek out professional help.

Says Dr. Kolzet, “If someone is worrying about not sleeping to a great extent and giving themselves anxiety, they could be helped by a clinician. Reach out to psychiatrists or psychologists who have specialized training in behavioral sleep medicine.”

While quitting your tracker cold turkey isn’t a great idea (Dr. Blum says odds are good that removing the tracker won’t necessarily remove the obsession), it might also be a good idea to take a break.

In order to see if your device is helping or hurting, says Dr. Kolzet, remove the device and try keeping a traditional sleep diary instead. But you need to be consistent. “Don’t focus on one night—we are looking for patterns, we’re looking for trends,” she says. “We want to see if it is helping you or hurting you.”

If you do find your sleep issues persist or you just can’t shake the drive for data, both doctors recommend looking into cognitive behavioral therapy for insomnia (CBTI). CBTI helps identify and improve sleep disorders. (t’s also been shown to help treatment of other psychiatric disorders like anxiety and depression.)

It’s ok to be concerned about your sleep, but at the end of the day the goal is to get quality sleep without having to work hard at it. Says Dr. Kolzet, “Don’t buy into this belief that you have to put a lot of effort into sleep. You want to care, but not care too much.”

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Last Updated: Jul 29, 2020