Orthosomnia: The Quest for a Perfect Night’s Sleep

Is checking your sleep tracker the first thing you do in the morning? Are you obsessed with how well you slept and trying to improve it? Many people are developing an unhealthy focus on getting enough sleep.

By Sheryl Grassie

Tracking with a fitness device is the new way to understand your sleep and set goals for improvement, but some people are taking it too far. Orthosomnia, or the obsession with “a perfectionistic quest for the ideal sleep in order to optimize daytime function,” as the Journal of Clinical Sleep Medicine terms it, is a new phenomenon. It is a psychological reaction to the ability to track your sleep, respond to the data, and attempt to attain that perfect 7- 9 hours of sleep that is recommended by the National Sleep Foundation.

It Starts with Technology

A number of new and interesting mental disorders related to electronics have appeared on the landscape. In the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM 5), we see this surge reflected in the addition of new diagnoses like Internet Gaming Disorder, something that did not exist before the advance of technology.

In tandem with our technocratic society, we see trends like biohacking taking hold. Biohacking, a form of ever-evolving, do-it-yourself biology enhancement, which urges us to eat, exercise, and sleep in ways that allow us to perform at our very best.

In keeping with both these trends, companies have developed trackers that store individual data on a person’s exercise and sleep. Food, too, can be manually input for a comprehensive picture of bodily functioning. Along with these trackers, experts continue to promulgate ideas about ideal amounts of exercise and sleep, as well as what to eat for optimal nutrition.

We, as individuals, react to all this information in various ways. A percentage of us have become obsessed with optimal eating, and although it has not yet made it into the DSM 5, there is a name for it, orthorexia, and a growing body of academic literature trying to understand it.

Orthosomnia is the companion disorder to orthorexia but with sleep instead of food. Tracking and biohacking sleep are fairly new concepts, but when the pursuit of improving sleep, often dictated by information from a tracker, becomes obsessive or potentially detrimental to sleep itself, it warrants the label orthosomnia.

What Do Sleep Trackers Tell Us?  

Sleep trackers can give us lots of useful information. They track our sleep patterns, letting us know when we are in deep sleep and for how long. They track our heart rates and our total hours of sleep. Sleep tracker data can help us work on improving sleep or point out potential problems like sleep apnea. Many people successfully use a tracker to better understand their sleep habits and improve their sleep hygiene.

When Are Tracking Devices a Problem?

In this 21st century age of technology, we have available all kinds of new devices that entertain us, allow us to communicate, and give us information. If you want to know how you are sleeping, there is an app for that.

In theory, a sleep tracker could give you some valuable information and insights about how you sleep. Most people who wear a tracker at night, an estimated 10% of adults in the United States, are concerned about their sleep and looking to improve it. The problem with using a tracker can be two-fold: inaccurate information and user reaction.

Inaccurate Information

Trackers don’t necessarily give you accurate information. They are designed to interpret certain things and can essentially be fooled by various circumstances into thinking you are sleeping better or worse than you are. Sleep trackers are meant to be a guide not a diagnostic tool. The data may or may not be accurate, but sleep experts caution that you don’t take it too seriously. If you think you have a problem, try keeping a sleep diary which would allow you to annotate with more qualitative data, and consider seeing a sleep specialist for a sleep study where you can get very accurate information from tests like a polysomnogram.

User Reaction

Trackers are a somewhat interactive device. I remember once watching a co-worker swinging her arm high and low next to her desk. When I asked what she was doing, she responded, “adding steps.” She further explained that she could fool her fitness tracker into thinking she was walking when in fact she was just sitting at her desk. You might be relating, or you might be thinking, “Why would someone do that?”

This is in fact, happening with both fitness trackers and sleep trackers. People may react and want the data to be different. Depending on the user, their reaction may trigger different types of behavior: some healthy, some unhealthy. For example, people may lie in bed for long periods to accrue enough overall sleep according to their trackers, when in fact according to good sleep hygiene, they should be getting up and not lying in bed.

Further, issues arise with a tracker when the data is less than optimal, and people begin to stress over their less than perfect sleep. This stress can actually add to poor sleep and increase insomnia. If a person’s reaction to tracker data is to become obsessive about trying to perfect their sleep, if their tracker is dictating their behavior, then there is a potential problem, and possibly a disorder, which would warrant the term orthosomnia.

A Word of Warning

Experts warn that you don’t want a sleep tracking device, like a Fitbit, Apple Watch, or Nokia Sleep, to overrule how you feel. This applies in two ways. If your tracker says you aren’t getting enough sleep or that you have poor sleep quality, but you feel good, then listen to your body over your device. Conversely, if your device says you are getting a good night’s sleep, but you don’t feel rested or are experiencing excessive tiredness during the day, get some help, don’t just listen to your sleep tracker as the ultimate authority.


Summary

Orthosomnia is a new disorder that literally means “to correct sleep.” It manifests as an obsessive desire to improve one’s sleep and physicians are seeing more and more cases. Its’ onset goes hand in hand with the advent of sleep trackers, wearable sleep devices that give people data on their sleep quality. This data gives people a concrete basis from which to make improvements, however, sleep trackers may not be accurate, and corrections based on sleep trackers alone may prove erroneous. Both orthosomnia and sleep trackers should be contextualized in the bigger picture of sleep medicine. If you feel you have a problem, seek professional help.


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