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Are you sabotaging your sleep in your quest to improve it?
Many new tools are available to monitor your sleep or help you sleep better: watches and wristbands; "Unbearable" devices that you can place on your bed or bedside table; and applications that work by monitoring biometric data, noise, and motion. They can remind you to start relaxing or to report on your sleep.
But some sleep experts warn that these apps and devices can provide inaccurate data and even exacerbate the symptoms of insomnia. After all, manipulating your phone in bed is poor sleep hygiene. And for some, worrying about sleep goals can aggravate anxiety at bedtime.
There is a name for an unhealthy obsession with achieving perfect sleep: orthosomnia. It was invented by researchers at Rush University Medical School and Feinberg School of Medicine at Northwestern University in a 2017 case study published in the Journal of Clinical Sleep Medicine.
Dr. Kelly Baron, one of the authors of the journal and director of the Behavioral Sleep Therapy Program at the University of Utah, said that sleep monitoring can be useful for identifying trends. She follows her bedtime with a Fitbit. But she said she noticed a tendency for patients to complain about unverified scores, even for things like the amount of deep sleep that varies across people.
"People were investing a lot in what it told them," she said. "For example, I'm afraid of not getting enough sleep. There is something wrong with me.
As gadgets proliferate, worries multiply
The flow of data and buzzwords can easily be confusing: percentages of sleep debt, low heart rate, sleep rhythms, sleep disturbance graphs, and comparisons with other users.
[[[[Wirecutter has tried four popular sleep tracking apps. Read the results here.]
Dr. Seema Khosla, Medical Director of the North Dakota Center for Sleep and Chair of the Technology Committee of the American Academy of Sleep Medicine, said that she and other clinicians have been strive to stay abreast of all devices and applications available on the market. She appreciates the increased awareness of new sleep technology, but is wary of the pitfalls of inaccurate data and heightened anxiety.
"We want to work with our patients to improve their sleep," she said. "It means we need to understand sleep technology – including its limitations – without giving up this potentially valuable resource."
In the orthosomnia case study, the researchers found that patients spent too much time in bed trying to increase their sleep, which may have worsened their insomnia. And they had a hard time convincing patients to stop counting on their sleep detectors, even if the numbers had been wrong.
Researchers say that trackers can overestimate how much sleep you get, especially if they focus on tracking movements. If you are awake in bed, the tracker may think you are asleep. Although devices that track heart rate or breathing give a more complete picture, they still generate only estimates.
An inspiring story from the case study: a woman came to report that she had an efficiency of sleep of only 60% on average, according to her tracker. She received medication for restless legs syndrome, a negative breath test and a negative formal sleep test. But after learning that she had slept soundly in the lab, she was not reassured.
"In that case, why does my Fitbit say I sleep badly?" She asked.
Fitbit and other companies believe that the threat of anxiety is exaggerated
Manufacturers of devices and tracking applications defend their use and accuracy. Dr. Conor Heneghan, research director at Fitbit, said that few people were extremely anxious about sleep.
He added that sleep monitoring could help to understand the importance of a uniform bedtime and wake-up time. This can also highlight the effects that factors such as alcohol and exercise can have on sleep patterns.
"What we are trying to do is give people a tool to understand their own sleep health," he said.
He said that tapes can provide reliable estimates based on algorithms that the company has developed using machine learning in sleep labs. Trackers can also recognize the heart rate and movements associated with different phases of sleep, he said.
In 2017, a company-sponsored study compared sleep data from 60 people, using both Fitbits and medical surveillance equipment in a sleep laboratory. He found that the data corresponded 70% of the time, he said. Dr. Heneghan said that when two human analysts are asked to rate the same sleep study, they usually fit about 90% of the time.
Device users like Apple's smart watch have noticed something similar, with different apps giving different scores on the same night. Apple says its watch tracks heart rate and movement data. Application manufacturers are responsible for the algorithms that interpret them. "Every experience is unique to this application," said the company.
Eugene Spiritus, Executive Director of SleepWatch, an Apple Watch app, said his company's main goal was to get users to pay attention to their behavior and change it. If you sleep badly, the app will send a prompt asking what could have gone wrong. A late meal? Too much coffee? Too much to drink? Stir the gym?
"Can some people become obsessed with this and be afraid?", He said. "Sure, but a lot of people tell us that it helps them.
Dr. Roy Raymann, vice president of sleep science and scientific affairs at SleepScore Labs, said the company was focused on its apps and on an "unbearable" device because some people had found it uncomfortable to sleep with a wrist gadget. The products monitor breathing and movement using radio and sonar waves and offer a "smart alarm" feature that avoids waking the user from deep sleep, which can be more shocking.
He noted that the industry had discussed the need to standardize precision logs.
But regardless of the accuracy of sleep monitoring, he said, it is only a follow-up. It alone can not improve sleep. He made an analogy with a scale: "If you stick with it every day, it will not make you lose weight."
The Food and Drug Administration does not regulate sleep monitoring because they are low-risk devices that only make general statements about improving health and well-being rather than diagnosing or treating particular conditions.
Sleep in the old-fashioned
Health experts say that it is crucial to get enough sleep regularly: this can help you think clearly, avoid colds and other illnesses and maintain a healthy weight, among other benefits. Chronic insomnia has been associated with an increased risk of premature death, heart attack, hypertension, type 2 diabetes, depression, and anxiety.
Although sleep needs vary from one person to another, the National Sleep Foundation recommends that adults under 64 years of age have seven to nine hours per night. young people need a lot more.
Dr. Khosla stated that she had seen patients followed by trackers neglect the basics of sleep hygiene, including following a regular schedule and avoiding screenings before bedtime.
"People will pay $ 200 for some sleep devices, but we do not just want to turn off our phones and go to bed," she said.
Sleep followers have a basic technology predecessor: sleep logs. Both can be helpful in reducing anxiety by reducing "catastrophic thoughts," such as the idea that the day will be permanently lost if you only stay for six hours, for example. Dr. Khosla stated that she advised patients to abandon the unrealistic idea that they should strive for "perfect" sleep.
Dr. Hawley Montgomery-Downs, professor of psychology at West Virginia University, who has studied the limitations of sleep tracking devices, believes that the best way to assess the quantity and quality of your sleep is based on the feeling of your body.
She recommended to completely avoid sleep trackers. His advice? Find a week when you do not have to get up at a certain time, maybe on vacation, and turn off your alarm clock. At first, you will sleep a lot, but after a few days, your body will adjust and tell you when you need to get up and wake up, and how much sleep you really need.
"Trust this," she said, instead of the device.
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