Orthosomnia: When Obsessing Over Perfect Sleep Backfires in Poor Sleep
The chase for perfection doesn't always end well
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In an age where we can quantify nearly every aspect of our lives, from steps taken to calories burned, it’s no surprise that sleep has become the latest frontier in personal data tracking. Many of us, armed with smartwatches and bedside devices, diligently monitor our nightly Z’s, hoping to unlock the secrets to perfect rest. While the intention is often health-conscious and noble, a new and unwanted phenomenon is emerging from this quest: orthosomnia. This is a term describing an unhealthy obsession with achieving "perfect" sleep, often leading to more anxiety and, ironically, poorer sleep. This isn't about simply valuing sleep; it's when the pursuit of ideal sleep data becomes a source of distress, potentially overshadowing the very restoration we seek. Sounds familiar?
Let's start with the allure. Sleep tracking technology offers a seemingly objective window into our nocturnal world. These devices promise to reveal our sleep stages, duration, and "quality scores," empowering us with information to optimize our health. For some, this data can indeed be a helpful guide indeed, highlighting patterns or motivating positive changes in sleep habits. Additionally, it's great that more and more people are starting to become aware that taking care of their sleep is a fundamental pillar of health. However, for a growing number of individuals, this digital insight can morph into a fixation. The term "orthosomnia" itself, though not yet a formal clinical diagnosis in manuals like the DSM-5, is being notably discussed in sleep circles. This started when doctors would observed patients who, despite objective evidence of adequate sleep from polysomnography, expressed significant distress and perceived sleep impairment based on their consumer sleep tracker data. This highlights a core issue: the data can begin to dictate experience, rather than reflect it.
The crux of orthosomnia lies in how the relentless pursuit of perfect sleep metrics can paradoxically sabotage our natural sleep processes. One primary mechanism is heightened anxiety. Constantly striving for an ideal "sleep score" or specific amounts of deep or REM sleep can create performance anxiety around sleep itself. This pre-sleep anxiety can activate the body's sympathetic nervous system, releasing stress hormones like cortisol and adrenaline, which directly interfere with the ability to fall asleep and stay asleep. Research consistently shows that anxiety and rumination are significant contributors to insomnia. While specific studies directly linking higher health anxiety with sleep tracker use and increased sleep-related worry are just emerging, the broader literature supports that individuals with high health anxiety may misinterpret benign bodily sensations or data, potentially extending to sleep tracker outputs.
Furthermore, the "nocebo" effect can play a powerful role. If a sleep tracker indicates "poor sleep quality"—even if the individual might have otherwise felt reasonably rested—this negative feedback can shape their perception of their sleep and even their daytime functioning. The accuracy of consumer-grade sleep trackers also comes into question. While useful for general trends, studies comparing these devices to polysomnography (the gold standard in sleep measurement) often show discrepancies, particularly in accurately distinguishing sleep stages (see this Sleepletter to understand how accurate these devices are). Over-reliance on potentially imprecise data can lead to misguided self-assessment and anxiety.
This cycle can escalate. Poor scores might lead to increased efforts to "optimize" sleep, such as spending excessive time in bed (which can fragment sleep further) or adhering to overly rigid pre-sleep rituals that only amplify the pressure. This behavior, driven by data rather than the body’s natural cues, can disrupt the homeostatic sleep drive and circadian rhythms—the very biological forces that govern healthy sleep. Individuals might find themselves "trying harder" to sleep, a counterintuitive effort that fosters cognitive arousal and frustration, further inhibiting sleep.
So, what about individuals experiencing orthosomnia after striving for better health? The pursuit of wellness through quantified sleep can inadvertently create a new form of stress, diminishing quality of life. This doesn't mean sleep trackers are inherently bad, but their role needs to be contextualized.
The path forward from such a cycle involves shifting the focus from data perfection to a more holistic and intuitive approach to sleep well-being. It's beneficial to use trackers as tools for insight rather than as infallible oracles that dictate one's state of rest. While data can offer useful patterns over time, it shouldn't override an individual's subjective sense of restfulness or become an independent source of anxiety; feeling generally good upon waking is often a more important indicator than a slightly "off" sleep score from a device. Central to this is prioritizing established sleep hygiene principles, such as maintaining consistent sleep-wake times, engaging in a relaxing wind-down routine, which ideally does not involve scrutinizing last night’s sleep data just before attempting sleep, and ensuring a comfortable and conducive sleep environment.
Crucially, individuals should be encouraged to listen to their own bodies, paying attention to daytime energy levels, mood, and cognitive function as primary indicators of sleep adequacy, rather than deferring solely to device outputs. For those more deeply affected by sleep-related anxiety or perfectionistic tendencies fueled by tracking, cognitive restructuring techniques can be invaluable. Principles derived from Cognitive Behavioral Therapy for Insomnia (CBT-I), a highly effective treatment for sleep difficulties, are particularly relevant. CBT-I helps individuals identify and modify dysfunctional thoughts and beliefs about sleep which, in the context of orthosomnia, are often heavily intertwined with the interpretation of tracker data. Its techniques for managing sleep-related anxiety and fostering a more balanced perspective on sleep are directly applicable to countering the obsessive patterns seen in orthosomnia.
The bottom line: sleep is undeniably a fundamental biological force, crucial for our physical and mental health. However, the path to healthy sleep is paved with relaxation and trust in our body's natural rhythms, not with anxious vigilance over digital readouts. While technology can offer support, it should not become the master of our rest. True restorative sleep is less about achieving a perfect score and more about fostering a balanced, peaceful relationship with this vital aspect of our lives.
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About the author
Alen Juginović is a medical doctor and postdoctoral researcher in the Department of Neurobiology at Harvard Medical School studying the effect of poor sleep quality on health. He is the author of Sleep Science Made Simple, a book that explains how sleep affects the brain and body using clear, accessible language for both professionals and the general public. He is a member of the Editorial Board of the Journal of Clinical Sleep Medicine, the official journal of the American Academy of Sleep Medicine. As a keynote speaker at conferences and teacher at Harvard College, he often discusses sleep's importance during the educational process and in media appearances. Alen is also focused on personalized sleep optimization for individuals and athletes (e.g. jet lag management), as well as being an advisor/investor/consultant for companies and individuals in the sleep field. He leads a team at Med&X Association organizing international award-winning conferences, including the Plexus Conference, which drew over 2,400 participants from 30+ countries, featuring 10 Nobel laureates and medical leaders. Med&X also collaborates with research labs and clinics from leading universities and hospitals around the world offering invaluable internships to help accelerate the development of top medical students, physicians and scientists. Feel free to contact Alen via LinkedIn for any inquiries.
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