Author, Ashita Nagesh
Place of work, BBC News
Published 32 minutes ago
Reading time: 5 min
Sleep quality assessments, magnesium, white noise recordings - what was once a simple sleep process has become a veritable maze of recommendations and technology. The desire to optimize sleep in every possible way is called “sleepmaxxing”. But if you go too far in such attempts, you may encounter “orthosomnia,” a term used by experts to describe the obsessive desire to achieve perfect sleep.
This is a translation of material published on the BBC News website. The original in English can be read here.
In the UK, orthosomnia is not officially recognized as a separate disorder. However, doctors told the BBC that they are increasingly noticing signs of it in patients. Some come to the appointment with data from their fitness bracelets and other sleep trackers, confident, often mistakenly, that they suffer from a sleep disorder.
According to doctors, it is this obsession with indicators and the desire to sleep “perfectly” that can ultimately worsen sleep.
How and why has sleep become such a difficult task? And if sleepmaxing doesn’t help, then what is the elusive secret to a good night’s sleep?
“Sleep quality scores are a completely made-up metric.”
The first commercial fitness tracker with sleep analysis was the Fitbit Classic, released in 2009.
Since then, sleep tracking has appeared in many other wearable devices, including gadgets from Garmin, Whoop and Apple, as well as smart rings from Oura, Ultrahuman and RingConn.
The capabilities of these devices vary, but in general they all provide the user with a report on the past night, breaking down sleep into separate phases: wakefulness, light and deep sleep, and rapid eye movement (REM) sleep. Many devices also provide the user with what is called a “sleep score.”
But the concept of such an assessment is "completely fictitious," says Dr Alanna Hare, a sleep medicine specialist at London's Royal Brompton Hospital.
"In sleep science there is no universally accepted measure called 'sleep score'," she tells the BBC. “It was just invented by device manufacturers.”
Hare says she sees the tracker data causing anxiety in her patients.
“I’ve had more people come to me with data from various trackers and a lot of questions about sleep, which may themselves be contributing to their sleep problems,” she says.
According to Hare, even if medical tests show there is no reason to worry, this does not always help patients get rid of anxiety.
“It’s good that sleep is getting more attention as an important part of health,” she adds. “But sleep is very difficult to perfect.”
A class action lawsuit against Oura, filed last month in San Francisco, alleges that the company's rings fail to accurately measure sleep quality and phases. According to the authors of the lawsuit, instead, AI-generated estimates are used, the scale of accuracy of which is comparable to “tossing a coin.”
In response, Oura told the BBC it was "confident in the scientific validity of its research and claims about the accuracy" of the devices.
“We are committed to clearly explaining what Oura actually measures, what it evaluates, and how users should interpret that information,” the company added.
Impact on well-being throughout the day
Research also shows that sleep trackers can influence a person's well-being and performance throughout the day, even if the data they provide is inaccurate.
In one study from the University of Oxford, participants were given trackers that rated their sleep quality every morning.
However, these ratings were generated randomly and were in no way dependent on how well the participants actually slept.
The next day, participants assessed their mood, level of fatigue and vigor, after which they took tests on concentration and reaction speed.
The researchers found that people who were told they slept poorly actually felt more tired and less alert—even though the sleep quality ratings were all fictitious.
"The Vicious Circle of Anxiety"
That's exactly what Jess Hill says she noticed after she bought a Garmin watch a few years ago.
“I started to think of the clock almost as a Bible that determined whether I slept well or not,” the 32-year-old HR professional from London told the BBC.
“I thought, ‘I slept terribly, so today will be very difficult for me,’ when in fact I probably slept quite well. And if the clock showed that I slept very well, I convinced myself that I had to be at my best - and even if I felt tired, I still pushed myself to continue working,” says Jess.
Her “obsession,” as she calls it, with achieving high sleep scores lasted three years. The situation only changed earlier this year, when Jess began to notice that the clock readings did not correspond to how she actually slept.
“The other night I was up for four hours, and the watch said something like, 'Wow, great sleep!' I was literally awake from one in the morning until five in the morning,” she says.
The BBC has contacted Garmin for comment.
"When you track your sleep, you get a specific number and it gives you a target," he tells the BBC. “As a result, you end up in a vicious circle and start worrying about the quality or duration of sleep, focusing on these indicators.”
“If you want to measure sleep, you need to measure brain function,” Stanley adds. “If you're not measuring brain activity, you're not measuring sleep itself.”
So how can you get a good night's sleep?
Hare recommends:
Keep the bedroom cool, dark and quiet - but without fanaticism. “This doesn’t mean the room has to be pitch black, exactly 16°C and absolutely silent,” she says. “It’s enough to keep it relatively cool, dark and quiet.”
Staying in bright light more in the morning helps regulate circadian rhythms, the body's internal biological clock.
Engage in light exercise and eat a “healthy, Mediterranean-style diet with a wide variety of plant-based foods.”
