Sleep trackers ‘could cause insomnia’ because users worry too much

Sleep trackers ‘could cause insomnia’ because users of the trendy gadgets worry about how much shut eye they get, expert claims

• Watches can monitor sleep by measuring pulse or movement in bed
• But they do not give ‘true’ results, expert said, and cause unnecessary stress
• People can ‘obsess’ about sleep and trying to get the right amount
• The result is orthosomnia, a recently coined sleep disorder

Trendy sleep trackers could cause insomnia, as people lose sleep worrying about how much they are getting.

‘Obsessing’ about sleep, through monitoring sleeping patterns on an app, can make it harder to get the right amount, according to experts.

There is a word for this affliction – orthosomnia – and it can cause stress and anxiety, producing hormones like adrenaline and cortisol which keep people awake.

Trendy sleep trackers could cause insomnia, as people lose sleep worrying about how much they are getting. Stock photo

Wearable trackers, such as Fitbit Versa (pictured) monitor movement and heart rate during sleep and normally present the data on a phone app 

Dr Guy Leschziner, a sleep expert at the Sleep Disorders Centre in Guy’s Hospital, London, says trackers rely on data which ‘doesn’t truly represent sleep’.

The consultant neurologist, speaking before a talk on the science of sleep at Cheltenham Science Festival, said: ‘We’ve seen a lot of people who have developed significant insomnia as a result of either sleep trackers or reading certain things about how devastating sleep deprivation is for you.

‘My view of sleep trackers is fairly cynical. If you wake up feeling tired and you’ve had an unrefreshing night’s sleep, then you know you’ve got a problem.

Most top fitness trackers monitor movement and heart rate during sleep when they are strapped to your wrist.    

One of the key measuring tools of wearable sleep monitors is called actigraphy which has been used in medical sleep tests for decades.

Actigraphy records movement through a measuring device called an accelerometer.

The idea is that a certain amount of movement will be recorded as ‘awake’ and periods of being still corresponds with being ‘asleep’.  

Sleep trackers with a heart rate tracking feature can measure your variations in heart rate to assess sleep quality and other parameters.

When you fall asleep, your heart rate and blood pressure drop. Your heart rate stays fairly steady through the duration of your sleep. Except in REM sleep when you may experience an increase in heart rate and overall more variations in your heart rate.

Wearable sleep trackers use personal heart rate monitor (HRM) technology while mattress sleep trackers use ballistocardiography (BCG).

Sleep trackers that sit on your bedside that measure environmental factors like light and temperature which affect sleep.

They can also listen for respiration such as snoring which could indicate a disrupted sleep.

The accuracy of sleep tech is debated among scientists.  

‘If you wake up every day and feel refreshed, are awake throughout the day and are ready to sleep at the same time every night, then you’re probably getting enough sleep for you and you don’t need an app to tell you that.

‘That obsessional state about sleep makes sleep even more difficult.’

In a briefing on sleep last year, the Parliamentary Office of Science and Technology reported doctors’ concerns that sleep trackers may lead to ‘normal sleepers becoming anxious about non-existent sleep problems’.

The British Sleep Council says people should not be trying to ‘micromanage’ sleep, as the best sleepers tend not to think about it very much at all.

Sleep physiologist Stephanie Romiszewski told an audience at Cheltenham Science Festival: ‘When it comes to tracking in general, I think the research tends to show just using tracking as an anecdotal thing, because you’re curious, is fine.

‘But if you’re starting to look at it and starting to worry about what’s going on, and that worry starts to make you anxious around your sleep, and then you start worrying when you go to bed at night, it might not be very good.’

She added: ‘We are effectively making sleep problems worse through tracking, through ill-reported research, and it can be slight scaremongering sometimes, and that’s actually not helping – it’s hindering.’

Four million people a year in Britain are estimated to buy smart watches and fitness trackers, which often record sleep as well as exercise.

The cheapest can cost as little as £50 and are worn on the wrist where they measure movement patterns via an accelerometer.

Sleep tracker will analyse whether you’re asleep or awake, and chart the total amount of time you spend asleep. Pictured, information from Nokia Steel Withings

Some sleep trackers claim to have data on how much time you spend in each stage of sleep including REM. Pictured, Fitbit data 

Four million people a year in Britain are estimated to buy smart watches and fitness trackers such as these. But Dr Guy Leschziner, a sleep expert at the Sleep Disorders Centre in Guy’s Hospital, London, says trackers rely on data which ‘doesn’t truly represent sleep’

WHAT IS ORTHOSOMNIA?  

Orthosomnia was coined in 2017 by University of Chicago. 

The researcher said there are growing number of patients who are seeking treatment for self-diagnosed sleep disturbances.

They might feel they have insufficient sleep duration or insomnia due to periods of light or restless sleep observed on their sleep tracker data.

People become fixated on improving their recorded sleep data in the ‘quest to achieve perfect sleep’.  

‘Ortho’ means straight or correct, and ‘somnia’ means sleep. The researchers said the goal to get perfect sleep is ‘similar to the unhealthy preoccupation with healthy eating, termed orthorexia.’

The more well-known insomnia is when you regularly have problems sleeping: You find it hard to go to sleep, wake up several times during the night, lie awake at night, wake up early and can’t go back to sleep and still feel tired after waking up. 

More expensive models include a heartbeat monitor which measures your pulse by illuminating and measuring the movement of arteries close to the skin.

A 2017 study from the University of Chicago coined the term ‘orthosomnia’, stating that people become fixated on improving their recorded sleep data in the ‘quest to achieve perfect sleep’.

Dr Leschziner sees a high proportion of people with insomnia bringing data from smartphone sleep apps into his clinic.

He said: ‘No matter what people say, they rely on data that doesn’t truly represent sleep. A lot of them work by tracking movement.

‘Some are a little more advanced, they probably give a reasonable measure of how you’re sleeping.

‘They don’t tell you about the stage of sleep or sleep quality. That’s even more the case if you’ve got a sleep disorder.’

The sleep experts told an audience at Cheltenham that caffeine does not disrupt everyone’s sleep, because of differences in genes, and blue light can also affect individuals differently.

People struggling to sleep are advised to try to wake up around the same time, rather than lying in at weekends, and only to go to bed when properly tired.

HOW TO COPE WITH SLEEP PROBLEMS

Poor sleep can lead to worrying and worrying can lead to poor sleep, according to the mental-health charity Mind.

A lack of shut eye is considered a problem when it impacts on a person’s daily life.

As a result, they may feel anxious if they believe lack of sleep prevents them from rationalising their thoughts.

Insomnia is also associated with depression, psychosis and PTSD.

Establishing a sleep routine where you go to bed and get up at the same time every day can help a person spend less time in bed and more time asleep.

Calming music, breathing exercises, visualising pleasant memories and meditation also encourage shut eye. 

Having tech-free time an hour or so before bed can also prepare you for sleep. 

If you still struggle to nod off, keeping a sleep diary where you record the hours you spend asleep and the quality of your shut eye on a scale of one to five can be a good thing to show your doctor.

Also note how many times you wake in the night, if you need to nap, if you have nightmares, your diet and your general mood.

Sleep problems can be a sign of an underlying physical condition, like pain.

Talking therapies can help your recongise unhelpful thought patterns that might affect sleep.

While medication, such as sleeping pills, can help break short periods of insomnia and help you return to better a sleeping pattern. 

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