Chasing a perfect sleep score? You could be making it worse

**Is Your Quest for Perfect Sleep Actually Harming It?**

The pursuit of an ideal sleep score, once a straightforward nightly routine, has evolved into a complex endeavor, with many now engaging in "sleepmaxxing"—an intense effort to optimize sleep through various means like magnesium supplements and white noise machines. However, taking this optimization too far can lead to "orthosomnia," a clinical term describing an excessive preoccupation with achieving flawless sleep.

While not officially recognized as a condition in the UK, medical professionals have observed indicators of orthosomnia in their patients. Some individuals are even presenting sleep tracker data at appointments, mistakenly convinced they suffer from a sleep disorder. Doctors caution that this very fixation on sleep is, paradoxically, exacerbating people's sleep problems.

This raises the question: how and why did sleep become so intricate? And if sleepmaxxing isn't the solution, what truly unlocks a restful night's sleep?

The journey into quantified sleep began in 2009 with the Fitbit Classic, the first commercial fitness tracker to incorporate sleep analysis. Since then, numerous companies, including Garmin, Whoop, and Apple, have integrated sleep tracking into wrist-worn devices. Smart rings like Oura, Ultrahuman, and RingConn have also joined this trend.

These devices offer varying functionalities, but generally provide users with a nightly report detailing sleep stages: time awake, light sleep, deep sleep, and REM (rapid eye movement). Many also assign a "sleep score."

However, Dr. Alanna Hare, a consultant in sleep medicine at the Royal Brompton Hospital in London, asserts that the concept of a sleep score is "completely made up." She informed the BBC, "There's nothing recognized in sleep science that is a 'sleep score.' That's just been created by manufacturers."

**How Sleep Tracking Can Detrimentally Affect Your Sleep**

Dr. Hare has observed that trackers are a source of anxiety for her patients. "I've noticed more patients coming to me with data from various trackers, with lots of questions about sleep that... is probably contributing to their sleep difficulties," she stated. Even when medical tests yield reassuring results, patients' fears often persist.

She acknowledges the positive aspect of increased focus on sleep as part of overall wellness. However, she emphasizes, "But sleep just does not respond well to attempts to perfect it."

Last month, a proposed lawsuit filed in San Francisco against Oura alleged that Oura rings are incapable of accurately measuring sleep quality and stages, instead relying on AI-generated estimates with "a coin flip's chance of being correct." In response, Oura told the BBC that it "stand[s] behind our science, research and accuracy claims," adding, "We're committed to clearly communicating what Oura measures, what it estimates, and how members should use that information."

Studies also indicate that sleep trackers can influence daily functioning, even if their accuracy is questionable. In one study, participants were given randomized sleep scores that bore no relation to their actual sleep. The following day, participants rated their mood, fatigue, and alertness, followed by tests of focus and reaction times. Researchers discovered that those who were told they had slept poorly reported feeling more fatigued and were less mentally alert, despite the fabricated sleep scores.

Jess Hill, a 32-year-old HR professional from London, experienced this firsthand after acquiring a Garmin watch several years ago. She told the BBC, "I started to rely on the watch as my Bible for whether I slept well or not." She would think, "I've had awful sleep so I'm going to really struggle today," even if her sleep was likely adequate. Conversely, if she had a high sleep score, she'd be convinced she had to be at her peak, even if she felt tired.

Her "obsession" with achieving a high sleep score lasted three years until earlier this year when she noticed a disconnect between the watch's data and her actual sleep experience. "I was awake the other week for four hours in the night, and my watch was like 'wow, great sleep!' - I literally was awake from 01:00 until 05:00," she recounted. The BBC has sought comment from Garmin.

Dr. Neil Stanley, a sleep expert and author of *How to Sleep Well*, contends that the gamification of sleep is contributing to more disordered sleeping patterns. He explained to the BBC, "The thing with tracking your sleep is that it gives you a number, and this means you have a target. So you get into this cycle of worrying about your quality of sleep or the quantity of sleep based on figures."

He noted that he conducted research into actigraphy—wrist-worn sleep trackers—approximately 40 years ago. While commercial trackers are now more sophisticated, they operate on a similar principle of measuring movement and share the same limitations. "If you want to measure sleep, you have to measure the brain," Stanley added. "Unless you're measuring the brain's activities, you're not measuring sleep."

Dr. Hare offers the following recommendations for better sleep:

* **Maintain a cool, dark, and quiet bedroom, within reason.** She clarifies, "That doesn't mean it needs to be pitch black, exactly 16C or totally silent. It should be coolish, darkish and quietish."

* **Expose yourself to bright light in the morning** to help regulate your circadian rhythm, your body's natural clock.

* **Engage in light exercise** and consume a "healthy, Mediterranean-style diet with plenty of plant variability."

* **Above all, keep it simple.** "Anything else, you don't need it."