Is sleep tracking making your sleep worse?

Chasing a perfect sleep score? You could be making it worse. The simple act of sleeping, once a natural bodily function, has transformed into a complex arena of sleep scores, magnesium supplements, and white noise machines. This relentless pursuit of optimizing slumber is often termed "sleepmaxxing." However, when taken to extremes, it can lead to "orthosomnia," a condition characterized by an unhealthy obsession with achieving perfect sleep. While not formally recognized as a clinical disorder in the UK, healthcare professionals are observing a rise in patients exhibiting orthosomniac tendencies. These individuals often present at appointments armed with sleep tracker data, convinced they suffer from a sleep disorder, despite medical reassurances. Experts warn that this fixation on sleep metrics is paradoxically detrimental to sleep quality. This article delves into how sleep became so complicated and explores what truly constitutes a good night’s sleep, beyond the allure of digital quantification.

‘Sleep scores are completely made up’. The landscape of sleep tracking began its commercial ascent in 2009 with the introduction of the Fitbit Classic. Since then, numerous tech giants, including Garmin, Whoop, and Apple, have integrated sleep tracking functionalities into their wearable devices. Smart rings from brands like Oura, Ultrahuman, and RingConn have also joined the market. While the specific methodologies vary, these devices generally provide users with a nightly report detailing sleep stages: time awake, light sleep, deep sleep, and REM (rapid eye movement) sleep. Many also assign a "sleep score" to quantify the night’s rest. However, Dr. Alanna Hare, a consultant in sleep medicine at the Royal Brompton Hospital in London, asserts that the concept of a sleep score is "completely made up." She clarifies to the BBC that "there’s nothing recognised in sleep science that is a ‘sleep score.’ That’s just been created by manufacturers."

Dr. Hare has observed that these trackers are inducing anxiety in her patients. "I’ve noticed more patients coming to me with data from various trackers, with lots of questions about sleep that… is probably contributing to their sleep difficulties," she explains. Even when medical tests yield reassuring results, these findings often fail to alleviate their anxieties. She acknowledges the positive trend of increased focus on sleep as part of overall wellness but cautions, "sleep just does not respond well to attempts to perfect it." Adding to these concerns, a proposed lawsuit filed last month in San Francisco against Oura alleges that its rings are incapable of accurately measuring sleep quality and stages, relying instead on AI-generated estimates that have "a coin flip’s chance of being correct." In response, Oura stated to the BBC that it "stand[s] behind our science, research and accuracy claims" and is "committed to clearly communicating what Oura measures, what it estimates, and how members should use that information."

Daytime impact. Beyond the night, studies indicate that sleep trackers can negatively impact daytime functioning, irrespective of their accuracy. A study conducted by the University of Oxford involved participants who were given sleep trackers that assigned them sleep scores. Crucially, these scores were randomized and bore no correlation to the participants’ actual sleep patterns. The following day, participants reported their mood, fatigue levels, and alertness, and underwent tests assessing their focus and reaction times. The researchers discovered that individuals who were informed they had slept poorly reported feeling more fatigued and exhibited reduced mental alertness, even though their sleep scores were entirely fabricated.

‘Cycle of worrying’. Jess Hill, a 32-year-old HR professional from London, experienced this phenomenon firsthand after acquiring a Garmin watch several years ago. "I started to rely on the watch as my Bible for whether I slept well or not," she recounts to the BBC. "I would think, ‘I’ve had awful sleep so I’m going to really struggle today’, even if I actually probably had okay sleep. If I’d slept really well, I’d be convinced I’d have to be on top – even though I was tired, I was pushing through things." Her "obsession," as she terms it, with achieving a high sleep score persisted for three years, until earlier this year. She began noticing a disconnect between her watch’s readings and her actual sleep experience. "I was awake the other week for four hours in the night, and my watch was like ‘wow, great sleep!’ – I literally was awake from 01:00 until 05:00," she states. The BBC has reached out to Garmin for comment on this matter.

Dr. Neil Stanley, a renowned sleep expert and author of "How to Sleep Well," argues that the gamification of sleep is contributing to increased sleep disturbances. "The thing with tracking your sleep is that it gives you a number, and this means you have a target," he tells the BBC. "So you get into this cycle of worrying about your quality of sleep or the quantity of sleep based on figures." He reveals that his own research into actigraphy—wrist-worn sleep trackers—commenced approximately 40 years ago. While today’s commercial trackers are more sophisticated, he contends they operate on similar principles, primarily measuring movement, and therefore share the same inherent limitations. "If you want to measure sleep, you have to measure the brain," Stanley emphasizes. "Unless you’re measuring the brain’s activities, you’re not measuring sleep."

So how can we actually sleep well? Dr. Hare offers practical recommendations for improving sleep quality without the reliance on technology:

• Establish a consistent sleep schedule: Going to bed and waking up around the same time every day, even on weekends, helps regulate your body’s natural sleep-wake cycle.
• Create a relaxing bedtime routine: Engage in calming activities before bed, such as reading, taking a warm bath, or listening to gentle music. This signals to your body that it’s time to wind down.
• Optimize your sleep environment: Ensure your bedroom is dark, quiet, and cool. Invest in comfortable bedding and pillows to promote physical comfort.
• Limit exposure to screens before bed: The blue light emitted from electronic devices can interfere with melatonin production, making it harder to fall asleep. Try to avoid screens for at least an hour before bedtime.
• Be mindful of caffeine and alcohol intake: Consuming stimulants like caffeine close to bedtime can disrupt sleep. Similarly, while alcohol might initially make you feel drowsy, it can lead to fragmented sleep later in the night.

These fundamental principles, rooted in behavioral and environmental adjustments, offer a more sustainable and less anxiety-inducing path to achieving restorative sleep. The pursuit of perfect sleep scores, it seems, may be a counterproductive endeavor, leading individuals further away from the very rest they seek.