Is Your Sleep Tracker Making Your Insomnia Worse?
Updated: Sep 8
Why sleep trackers can sometimes worsen insomnia, what orthosomnia is, and how to trust your own experience of sleep again.
Sleep trackers can be wonderfully seductive.
I’m talking about those small devices that sit on your wrist or finger, like the Fitbit, Garmin, Whoop and Applewatch, that promise to explain the night. How long you slept, how much deep sleep you had, whether you were restless, and perhaps a score out of 100 to let you know whether you may enter society today.
When you have been lying awake wondering what on earth is going on, the idea of finally having some answers is very tempting. Numbers look solid. Graphs look authoritative. Data feels useful.
Sometimes trackers are useful, but often, when a person is experiencing insomnia, they can make sleep harder and the day tougher to manage.
How sleep trackers work and why they often get it wrong
One of the easiest mistakes to make when reading tracker data is to assume that what it says is true.
Most sleep trackers estimate sleep using things such as movement, heart rate, oxygen levels and maybe body temperature. They are not the same as a clinical sleep study and, importantly, they cannot measure brain activity (you've probably noticed there is no brain in your wrist).
Sleep is a brain state. Your tracker is making an educated guess about what is happening while you sleep.
Sometimes it gets it right and sometimes it doesn't.
This matters because many people start treating the numbers as though they are true:
“It says I only had 22 minutes of deep sleep.”
“The app says I woke nine times.”
“No wonder I feel awful.”
Can sleep tracking cause insomnia?
Good sleepers rarely think much about sleep. They may have a poor night, shrug, and carry on.
With insomnia, sleep can become something we monitor closely. Checking the clock, noticing every sensation, calculating hours lost and anticipating how bad we will feel tomorrow.
Sleep tracking can add fuel to this process because when you are already worried about your sleep, the data can give you yet another thing to monitor.
Then you start paying even more attention to your sleep. You may start checking your score as soon as you wake. You may worry about how little deep sleep you had. You may change your bedtime because you want a better score. You may even find yourself lying awake wondering what your tracker will say tomorrow.
There is a term for this pattern - orthosomnia.
It describes a pattern in which insomnia becomes closely tied to a preoccupation with achieving “perfect” sleep.
The important thing is not the label. It is recognising when what started as a desire to understand sleep has shifted into something helping to keep you awake.
Why what you believe about your sleep matters as much as the sleep itself
If your tracker tells you that you slept badly, it is very easy for that information to colour the rest of your day.
You may notice every yawn, every lapse in concentration and every slight dip in mood. You may start thinking, “I knew I hadn't slept properly.”
We tend to assume that how we feel during the day is simply a reflection of how well we slept. But our experience is influenced not only by how we slept, but also by what we believe about how we slept. Research has shown that giving people inaccurate negative information about their sleep, can affect how they feel and function, even when their actual sleep was better than they were led to believe.
This tells us something important. What you believe about your sleep can therefore become part of what makes both the day and the night harder.
Once sleep becomes something you need to get right, your brain can start treating it as a high-stakes problem. You begin watching for signs that something is wrong.
Sleep, unfortunately, does not respond particularly well to being watched. It is a bit like a wet bar of soap. The harder you grip it, the more it slips away.
But surely more information is better?
Not necessarily.
Information is useful when it helps you understand something or make a helpful change. It is less useful when it leaves you anxious, confused or less trusting of your own experience.
If checking your tracker leaves you:
worrying about what the numbers mean
feeling as though you have received a bad grade in a school assignment
changing your behaviour to chase a better score
questioning whether you can trust how you actually feel
…it may be time to step back.
This doesn't mean the tracker is bad. It means it may not be helpful for you, at this point in time.
When can a sleep tracker be helpful?
Trackers can sometimes be useful for looking at broad patterns over time, rather than the details of a single night, such as changes in sleep timing or what happens around a significant change in your routine.
Often, it is helpful to consider, “What would I actually do differently because of this information?”
If the answer is nothing, you may not need the information.
Your tracker does not need to be your nightly judge.
What to do if your sleep tracker is making your sleep worse
Try shifting your attention away from the details of last night's sleep and back towards the bigger picture.
Rather than asking:
How many minutes of deep sleep did I get?
you might ask:
How am I actually feeling?
How am I responding to a difficult night?
Am I getting on with my day, even if my sleep wasn't ideal?
What would I believe about last night if I had no graph to look at?
Sometimes the most useful experiment is simply to put the tracker away for a couple of weeks.
If this sounds familiar
If sleep tracking has left you more preoccupied, more anxious or less confident in your own nights, you are not alone.
It is a surprisingly easy trap to fall into, particularly when you are already worried about your sleep.
Fortunately, there are better ways of addressing insomnia.
CBT for Insomnia (CBT-I) can help reduce sleep anxiety, rebuild confidence around sleep and improve sleep.
If this sounds helpful, I offer online support for adults who feel stuck with sleep.
Questions I'm Often Asked About Sleep Trackers
What is orthosomnia?
Orthosomnia is a pattern in which the pursuit of perfect sleep data, usually through a wearable device, begins to cause or worsen insomnia. The term was coined by Baron et al. in 2017 to describe patients who were seeking treatment for sleep problems that had emerged from their preoccupation with tracker data rather than from any underlying sleep disorder.
Are sleep trackers accurate?
Consumer sleep trackers estimate sleep using movement, heart rate, and other measurements. They cannot measure brain activity or sleep directly, only infer it. Validation studies comparing wristband devices to polysomnography (the gold-standard clinical sleep study) consistently find that trackers tend to underestimate wakefulness and misrepresent sleep stages, with accuracy falling further in people who already have sleep difficulties.
Can a sleep tracker make insomnia worse?
Yes. Trackers can worsen insomnia by increasing the amount of attention a person directs towards their sleep - checking scores, monitoring stages, adjusting behaviour to improve a nightly grade. Research has shown that simply receiving negative feedback about sleep (even inaccurate feedback) can impair mood, alertness, and daytime functioning. The tracker doesn't need to be wrong to do harm; the preoccupation it creates is often enough.
How do I know if my sleep tracker is making things worse?
A useful question to ask is whether checking your tracker leaves you more anxious, more preoccupied or less trusting of how you actually feel. If the answer is yes, the data is probably costing more than it gives. The test is not whether the tracker is accurate, it is whether the information is helping you. If it isn't, putting it away for a couple of weeks is a reasonable and often surprisingly useful experiment.
What is the difference between a sleep tracker and a clinical sleep study?
A clinical sleep study (polysomnography) measures brain wave activity, allowing accurate identification of sleep stages, arousals, and disorders such as sleep apnoea. Consumer wearables measure movement, heart rate and sometimes oxygen levels, then use proprietary algorithms to infer what is happening. They can be useful for spotting broad patterns over time, but they are not diagnostic tools and should not be treated as a reliable nightly record of what your brain did while you slept.
References
Baron, K.G., Abbott, S., Jao, N., Manalo, N., & Mullen, R. (2017). Orthosomnia: Are some patients taking the quantified self too far? Journal of Clinical Sleep Medicine, 13(2), 351–354. https://doi.org/10.5664/jcsm.6472
Chinoy, E. D., Cuellar, J. A., Huwa, K. E., Jameson, J. T., Watson, C. H., Bessman, S. C., Hirsch, D.A., Cooper, A.D., Drummond, S. & Markwald, R. R. (2021). Performance of seven consumer sleep-tracking devices compared with polysomnography. Sleep, 44(5), zsaa291.
Gavriloff, D., Sheaves, B., Juss, A., Espie, C.A., Miller, C.B., & Kyle, S.D. (2018). Sham sleep feedback delivered via actigraphy biases daytime symptom reports in people with insomnia: Implications for insomnia disorder and wearable devices. Journal of Sleep Research, 27(6). https://doi.org/10.1111/jsr.12726
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