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I’m captivated by my new personal health tracker, a Christmas gift from my husband. It’s fascinating to know my heart rate, respiration, activity, readiness and stress levels at any moment. Yet it’s the sleep data that has me mesmerized — and a bit worried.
Why does it say I only slept five hours when I was in bed for more than six? Wait, what? I was in light sleep for most of the night and got only 30 minutes of deep and dream sleep? That can’t be good.
I spent days trying to understand what the charts and graphs were telling me about my slumber, then finally came to my senses. As a journalist who writes about sleep (a lot), I know it’s the overall quality that matters, not whether I had any dreams or got enough deep sleep last night. After all, everyone has to stay up late at times due to a sick child, travel or an unfinished work project.
For some people, however, the fascination with their sleep tracker doesn’t wane — it becomes a stubborn obsession. In fact, enough people fret over their sleep data trying to get a perfect night’s sleep that sleep specialists have coined a term for the behavior: orthosomnia.
Orthosomnia is derived from the Latin word ortho, which means being right or correct, and somnia, the Latin word for sleep, said the term’s inventor, clinical psychologist Kelly Baron, a professor of family and preventive medicine at the University of Utah who specializes in behavioral sleep medicine.
Baron and her colleagues published the first case studies on orthosomnia in 2017 after seeing a number of patients who would insist their sleep trackers were correct despite being told otherwise. While the behavior is not considered a medical disorder, it’s disturbing nonetheless, Baron said.
“I’ve seen some real horror stories,” she said. “One 27-year-old woman said her tracker showed she wasn’t sleeping. An overnight lab study showed that she was, but she would still not believe her tracker was wrong.”
That behavior was bewildering, Baron said, because early models of sleep trackers were notoriously inaccurate.
“A lot of sleep time was considered awake, and the reported sleep cycles were completely off,” she said. “Yet we’d see people develop insomnia worrying over the lack of sleep on their tracker. Some would even take tremendous amounts of sleep medication, which is just scary.”
One woman Baron treated talked her general practitioner into prescribing large doses of an antipsychotic based on erroneous sleep data from her device.
“Her tracker was off-label — I had never heard of it — and was so inaccurate that the graphs weren’t even labeled,” Baron said. “Good quality trackers today often use multisensor inputs such as movement, heart rate variability and the like, so they’ve come a long way in accuracy.
“But until trackers actually measure brain waves like we do in a sleep lab, it’s just an estimate,” she said. “I believe being obsessed with sleep trackers contributes to a lot of sleep anxiety and insomnia.”
You don’t need a sleep tracker to sleep well, experts stress. Just follow good sleep hygiene recommendations, such as going to sleep and getting up at the same time each day. Be sure to address any sleep disorders, such as sleep apnea, which can harm your health.
OK, you already have a tracker (or want one). Use it to see how various life choices affect your sleep, experts say. Does eating too late mean you have more awakenings? How about that nightcap? Alcohol is known to disrupt sleep in the middle of the night.
Beyond that, you can keep your relationship with your tracker healthy by asking yourself the following questions, suggested sleep specialist Jennifer Mundt, an associate professor of family and preventive medicine at the University of Utah who sees patients at the school’s Sleep Wake Center.
“How do you feel when you review your sleep data? Does it lead to any tangible steps that have improved your sleep?” Mundt said in an email. “Is it telling you anything new or just reminding you that you didn’t sleep well — and making you feel more anxious about it?”
The paradox of good sleep, she added, is that the harder we strive for it, the harder it is to obtain.
“If you feel frustrated or anxious, it’s a good idea to try taking a break from the sleep tracker,” Mundt said, “because feeling anxious about sleep is not conducive to helping you sleep better.”
By educating yourself on the various stages of sleep, you can reduce anxiety about your tracker’s results, experts say.
Sleep latency: Also known as stage one sleep, this is how long it takes you to fully fall asleep. Contrary to popular belief, it’s not healthy to drop off to sleep immediately — that’s a sign of extreme sleep deprivation. Taking 20 to 30 minutes to drift off after lights out is just fine.
Light sleep: When I first opened my sleep tracker, I was shocked by how much of my night was spent in light, or stage two sleep. Yet that is also perfectly normal, experts say. Our brain uses light sleep to transition between slow-wave sleep, or deep sleep, and rapid eye movement, or REM, sleep, which is the stage in which we dream. Experts say about 50% of your night should be in light sleep.
Deep and REM sleep: During deep sleep, the brain sweeps out toxins and dead cells while also repairing and restoring the body for the next day. While we dream during REM sleep, the brain is busy processing emotions, consolidating memories and absorbing new information. It makes sense that getting quality deep and REM sleep is key to our ability to function.
Right now, experts believe that most adults should spend between 20% and 25% of their night in deep sleep as well as REM sleep. Older adults require less, while babies need much more — in fact, infants can spend about 50% of their sleep in REM, experts say.
Using that measurement, an adult who sleeps the recommended eight hours a night would require about 1.6 to two hours of sleep in REM sleep and the same amount in deep sleep. However, everyone is different, and it’s unwise to fixate on specific numbers, said sleep researcher Dr. Ana Krieger, a professor of clinical medicine in the departments of medicine, neurology and genetic medicine at Weill Cornell Medical College in New York City.
Why? Because researchers are still using rudimentary tools to understand a brain system that is truly controlled by chemicals, said Krieger, who is director of the Center for Sleep Medicine at Weill Cornell Medicine and NewYork-Presbyterian.
“Today, we measure electrical activity and brain waves, when what we need is more science to understand the true neurochemical underpinnings of sleep,” she said. “I often tell patients, it’s like this beautiful full orchestra that plays at night, with many different chemicals, or instruments if you will, that enter and recede at different times.”
Science does not yet know enough to understand fully all the stages of sleep, Krieger added, but research is underway. Stay tuned.
“In the meantime, I suggest people stop worrying about the breakdown of their sleep,” she said. “Instead, focus on relaxing and working on your environment to sleep without interference or interruption at night.”
