Doctors are seeing a rise in patients who are anxious about their sleep scores rather than their sleep, and clinics are starting to prescribe fewer trackers, not more.
Renata Choudhary-Falk used to wake up, check her sleep score, and feel her mood for the day set before her feet hit the floor. A 62 meant a bad day was coming. It didn't matter how she actually felt.
"I was more tired from worrying about my sleep than from the sleep itself," she said.
Sleep clinicians have a term for this now: orthosomnia, a preoccupation with achieving perfect sleep-tracker data that itself becomes a driver of poor sleep. First named in a small 2017 case study, it has moved from clinical curiosity to a regular presenting complaint.
The devices got better; the anxiety didn't
Modern trackers are more accurate than ever at estimating sleep stages, which is precisely the problem, according to sleep physician Kwame Osei-Bergstrom. "Five years ago the data was noisy enough that patients discounted it a little. Now it's good enough that people trust it completely, including the parts of the score that are still statistical guesswork."
Some clinics have started running "tracker fasts" — two-week periods where patients wear the device but don't look at the app — as a first-line intervention, before medication or formal cognitive behavioral therapy for insomnia.
The industry's own data is starting to show it
One major wearable maker quietly added a setting last year that hides nightly scores by default for new users, showing only weekly trends instead. The company hasn't publicized the reasoning, but two people familiar with the internal research say it followed data showing score-checking frequency correlated with worse reported sleep quality, not better.
Not every specialist thinks the trackers are the villain. "The device just measured what was already an anxious relationship with rest," said Osei-Bergstrom. "Take away the tracker and some of these patients will just start counting sheep more obsessively instead."