- Since personal sleep trackers have become common, sleep clinicians noticed a new disorder: “orthosomnia” or “correct sleep.”
- Our physical and digital lives have become so intertwined that the real and virtual boundaries have become complex.
- Sleep trackers may emphasize an ideal sleep pattern and pressure users to force their sleep into it, even though it may not suit them.
Sleep is a necessity. We all know the difference a good night of sleep makes: We wake up refreshed, our minds are sharp, our moods are elevated, and we feel better physically.
In contrast, sleep deprivation makes us sluggish; we crave junk food, our moods are labile, and our overall health takes a toll.
Good sleep is not always a given. Work deamnds, children’s schedules, caregiving duties, noisy neighbourhoods, worries and anxieties, and a new season of Stranger Things are among the factors that may rob us of sleep.
Many apps and gadgets promise to help us get more sleep and thus feel better, be more productive, and live our best lives. But can technology really “fix our sleep”? How do we know that our sleep needs fixing? Are we fundamentally changing our relationship to sleep by relying on what is considered to be “good sleep” by our tech of choice?
Performance Anxiety and Manufactured Norms
Recently, as personal sleep trackers have become common, sleep clinicians noticed a new disorder and coined it “orthosomnia” or “correct sleep.” Researchers Kelly Glazer Baron and her colleagues reported that some of their patients, who initially started using their sleep trackers to sleep better, were becoming excessively preoccupied with their quest for “good sleep,” as defined by the scores they would receive via their sleep app.
They were also becoming overly reliant on what their apps told them, rejecting clinicians’ assessments and even their own subjective feeling of being rested when it was incongruent with their scores.
While it seems pretty obvious how to track physical activity or calories—we can input absolute values for the number of squats or hamburgers—how do we track sleep? What is the “input” in our relationship with our sleep app?
As many sleep clinicians will tell you, the worst thing to do if you cannot sleep is to try to sleep. Sleep cannot be forced. It has to happen. And we have little control over how much of each sleep stage we will get and whether we are able to get back to sleep after waking up too early.
In a sleep lab, sleep is measured using a technique called polysomnography, which consists of recording brain activity and identifying sleep stages. Apps and wearables measure sleep indirectly and typically have a relatively poor concordance with objective ways to measure and quantify sleep.
But even if we could reliably quantify sleep duration, sleep stability, and sleep architecture, there is still significant individual variability. Some people are short sleepers, while others require a long night of sleep; some are night owls, and others are morning larks; some sleep more than once per day-night cycle, and some wake up a lot and do not seem to mind, while others cannot go back to sleep after awakening.
New mothers, caregivers, and shift workers, for example, rarely get uninterrupted nights of sleep. But does that mean that they are all chronically sleep-deprived and unwell?
One major problem with sleep apps is that what is considered good sleep is based on the idea that an uninterrupted and quiet 8-hour sleep period with as few awakenings as possible is the ideal for human sleep. While it must feel amazing to sleep this way, many people either do not have access to such conditions or have entirely different sleep needs/practices.
Humans are a remarkably flexible species. We are able to adjust our sleep to many different pressures: We adapt to changing time zones (jet lag), to social obligations that require us to wake up early (“social jet lag”), and to the needs of small children and bed partners.
Is it possible that sleep trackers that emphasize the normative, average, desirable sleep pattern put extra pressure on users to force their sleep into a pattern that does not suit them?
Broken Cyborgs and the Tyranny of Wellness
As Donna Haraway proposed in 1985, “we are all cyborgs." She argued that the nature/culture and body/technology divides are vestiges of traditional dualisms and that, rather, we can see ourselves as constructed, created entities that incorporate culture, technology, and different forms of artifice into our being and our identities.
Today, our physical and digital lives are so profoundly intertwined that the real and virtual boundaries are becoming increasingly complex. Our relationship with devices has become symbiotic. Our phones/smartwatches/Fitbits are reliable and trusted prosthetics. There are apps and gadgets for everything and countless apps for sleep.
Many apps promise to “fix” something in us that we consider sub-optimal. Some apps help us track calories (because we don’t eat well), our iPhones count our steps (because we ought to walk more), and our Fitbits track our heart rate and estimate stress levels. We subscribe to personalized workout schedules and track the hours (OK, minutes) that we put into meditation.
All of these technologies operate under the premise that we should constantly strive to improve ourselves. Wellness is big business, and we live in a social and technological climate in which we are constantly reminded (and convinced) that we are not well enough. This tendency for compulsive self-improvement has been criticized by many and described as “the wellness syndrome” or a “wellness epidemic.” Being well can become synonymous with being a good person and a sort of philosophy of the good life.
In a recent reflection, researcher Diletta De Cristofaro pointed out that many sleep apps are marketed not only to improve your sleep—which we are taught is broken, insufficient, and not good enough, even if we don’t realize it—but also especially to improve your productivity. In other words, in order to be a good, productive member of society, you must fix yourself, including your sleep. And this leads to instrumentalization and devaluing of sleep.
Sleep Is to Be Cultivated and Enjoyed
While our relationship to sleep technology is problematic, there is also good news: Some apps, for example, have relaxation components that can be effective in helping wind down and improve the subjective sleep experience.
Sleep education, demystifying sleep facts, and training in healthful sleep practices, including home treatment for insomnia, can positively affect appreciating the need for sleep, prioritizing sleep, and enjoying different aspects of good sleep, including nighttime sleep or daytime naps.
Humans are able to sleep in so many different ways: alone, with partners, with pets, with children, with entire families, in beds, outside, during the day, in public, for 8-hour stretches, for 20-minute power naps.
Sleep brings rest, restores vitality, and lets us dream. Restricting “good sleep” to a very specific normative pattern while insisting that we are more sleep-deprived than we know may not be the best way to promote sleep. Instead, sleep apps could focus on experimentation and promoting an open-minded relationship with one’s sleep, encouraging users to try out different strategies, patterns, techniques, and schedules until they find what works best.
Baron, K. G., Abbott, S., Jao, N., Manalo, N., & Mullen, R. (2017). Orthosomnia: are some patients taking the quantified self too far?. Journal of Clinical Sleep Medicine, 13(2), 351-354.
Ameen, M. S., Cheung, L. M., Hauser, T., Hahn, M. A., & Schabus, M. (2019). About the accuracy and problems of consumer devices in the assessment of sleep. Sensors, 19(19), 4160.
Huberty, J., Puzia, M. E., Larkey, L., Vranceanu, A. M., & Irwin, M. R. (2021). Can a meditation app help my sleep? A cross-sectional survey of Calm users. PloS one, 16(10), e0257518.
Shin, J. C., Kim, J., & Grigsby-Toussaint, D. (2017). Mobile phone interventions for sleep disorders and sleep quality: systematic review. JMIR mHealth and uHealth, 5(9), e7244.