What is Orthosomnia?

Orthosomnia vs. Insomnia

Insomnia is a common sleep disorder primarily defined by difficulty falling or staying asleep Trusted Source National Heart, Lung, and Blood Institute (NHLBI) The NHLBI is the nation's leader in the prevention and treatment of heart, lung, blood and sleep disorders. View Source , while orthosomnia is not a formal disorder and describes a tendency to place undue importance on the data from personal sleep-tracking devices.

Orthosomnia can occur alongside insomnia and other sleep disorders. Orthosomnia has the potential to exacerbate sleeping problems, and it may persist even after a primary sleep disorder has been successfully treated.

The Role of Sleep Trackers

Approximately 30% of American adults Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source use a wearable device to collect health-related data. Fitness and activity trackers have grown in popularity, and some provide information about sleep.

Sleep tracking with wearable devices uses algorithms Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source to analyze data collected by the device. Over time, these algorithms have integrated more complex measurements, and now sleep tracking often claims to offer statistics on the amount of total sleep time, time spent in different sleep stages, a “sleep score” based on sleep quality, or information about breathing or heart rate during sleep.

Despite the popularity of sleep trackers, both users and researchers have expressed concerns about the accuracy of data provided by wearable devices. The FDA does not regulate sleep trackers Trusted Source U.S. Food and Drug Administration (FDA) The FDA is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation. View Source , and ongoing research shows that they may not accurately interpret some sleep metrics Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

A 2019 analysis found that sleep trackers have become more reliable over time and can provide roughly accurate estimations of total sleep and time in bed that is actually spent sleeping. However, even newer-generation sleep trackers were only moderately successful at determining sleep stages. This data was backed up by a 2021 study that found trackers only accurately identified deep sleep 59% of the time.

In addition to wearable sleep trackers, there are also smartphone applications that claim to track sleep. However, researchers suggest that smartphone-based sleep tracking is currently inaccurate and ineffective Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

Despite concerns about the risks of sleep trackers negatively impacting sleep health, these devices may help facilitate discussions Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source with a doctor or sleep specialist about sleep-related concerns. Information from a sleep tracker may help a doctor understand the nature of sleeping problems and determine if a sleep study is needed.

Sleep Trackers and Orthosomnia

People with orthosomnia develop an excessive focus on sleep tracker data and a quest for perfect sleep. Unfortunately, some sleep experts worry that this may detract from quality sleep for several reasons.

• Overreliance on imprecise data: People may overestimate the accuracy and reliability of sleep tracker data, which may cause them to misunderstand how well they are actually sleeping.
• Misplaced sleep goals: Orthosomnia may encourage habits that emphasize sleep tracker metrics to the detriment of actual sleep quality. For example, extra time lying still in bed may improve the sleep tracker data even if a person is actually awake.
• Distrust of sleep studies: If people become acclimated to only trusting their sleep tracker, they may discount information that comes from formal sleep studies, which are widely considered by sleep specialists to be the most accurate source of detailed data about sleep.

In addition, an obsessive focus on optimizing sleep tracker data may create anxiety or stress that can negatively affect sleep.

Additional research is necessary to better understand orthosomnia and its effects, especially as sleep tracker technology develops and more people use these devices over an extended period of time.

Symptoms of Orthosomnia

There is no established list of symptoms of orthosomnia.

Orthosomnia is not a recognized medical disorder. Instead, it is a relatively new concept that has been described by some sleep researchers with limited evidence-based literature. For this reason, the current understanding of symptoms of orthosomnia is based on observations from case studies of small numbers of individuals.

In those studies, people with orthosomnia believed that tracking devices offer highly accurate information about sleep and trusted sleep tracker data over more objective testing like an overnight sleep study in a specialized clinic. They spent excessive time in bed in order to improve their sleep tracker data, which may have actually contributed to their insomnia symptoms.

Beyond these specific tendencies, people with orthosomnia may also experience other symptoms related to disrupted sleep, such as:

• Fatigue
• Irritability
• Problems with concentration and memory
• Feeling unrefreshed after waking up
• Anxiety

People who believe they may be experiencing orthosomnia or who have questions or concerns about sleep data from their fitness tracker should share their concerns with their doctor.

How is Orthosomnia Diagnosed?

Orthosomnia is not an established sleep disorder Trusted Source American Academy of Sleep Medicine (AASM) AASM sets standards and promotes excellence in sleep medicine health care, education, and research. View Source that has formal criteria for diagnosis. Nevertheless, doctors may find signs of orthosomnia while evaluating a person for sleep problems. These signs typically include an exaggerated trust of sleep tracker data and an intense focus on achieving perfect sleep as measured by the sleep tracker.

Managing Orthosomnia

Even though orthosomnia is not a medical disorder, research suggests that it may negatively impact sleep. People with sleep trackers may consider steps to prevent or address orthosomnia.

One aspect of avoiding orthosomnia is remembering that sleep tracker data is not perfect and may not tell the whole story about nightly sleep. Especially for people with sleeping problems or daytime drowsiness, a doctor or sleep specialist can provide important context for understanding sleep tracker data.

In addition, people interested in improving their sleep quality may find it helpful to consider evidence-based practices to get a better night’s rest.

• Improving sleep hygiene: Keeping a regular sleep schedule, winding down before bed, and avoiding electronics in the bedroom are all components of good sleep hygiene. People who maintain their sleep hygiene create a foundation for better sleep overall Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source .
• Reducing stress or treating anxiety: Stress Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source and anxiety Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source may cause or exacerbate existing sleep disorders.
• Cognitive-behavioral therapy (CBT): CBT is a practical, goal-oriented form of therapy that involves examining one’s thought patterns and beliefs Trusted Source National Center for Biotechnology Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . An established form of CBT called CBT-I is used to treat sleep disturbances, including insomnia Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

Orthosomnia can occur alongside sleep disorders that may not be detected by a sleep tracker. A doctor is in the best position to conduct a thorough evaluation to diagnose any sleep disorder and recommend a personalized treatment plan.