The new obsession with sleeping wellby Margo White
Not sleeping well? Rest assured, you’re probably normal.
Increasing numbers of people do, monitoring their unconscious selves with watches, shirts with embedded sensors or apps that can be downloaded onto their phone and put under their pillow. These sleep-trackers will, according to the typical sales pitch, allow you to collect finely calibrated data on what you did last night. They will rate your sleep with a score based on a combination of data, such as how much of it was deep or light, how much you tossed and turned, the regularity and depth of your breathing, even your “snoring events”.
As the marketers of these various devices and apps tell us, sleep, like good nutrition and physical activity, is vital to our wellbeing, so we need to keep track of our sleep patterns.
I need to keep track of my sleep patterns (and my lying-awake-in-the-early-morning patterns) like I need to stick pins in my eyes, but millions think otherwise. A study published this year estimated that more than 10 per cent of US adults use a wearable fitness/sleep-tracking device on a regular basis, and 50 per cent would consider buying one. Apple clearly sees the potential, having this year bought Beddit, a sleep-tracking device and app that can potentially be used with an Apple watch.
Our quest for a good night’s slumber has always been the target of commercial opportunism, as evidenced in all those fancy scented pillows and deep-foam mattresses and gadgets like earplugs that emit white noise to cancel out the sound of someone else’s snoring, and sleeping hats that use “Specialised Binaural Beats to slow your brain rate from an awake state to a sleeping state”. For all I know, some of them work, if only because of the placebo effect – but a sleep-tracker?
Do you really need to add performance anxiety to your sleeping problems? And could you resist checking your progress at 3am, without then lying awake worrying about your sleep score?
Sleep is complicated, and its impact on an individual’s health and well-being hard to measure. If you go to a sleep clinic, you might be subjected to various sleep-monitoring technologies – scientifically validated sleep-monitoring technologies – the results of which will be assessed by an expert. Most of the technologies aimed at concerned consumers who believe they have insomnia aren’t scientifically validated – even those marketing the average sleep-tracker would point out they’re not intended as a medical diagnostic tool. They don’t say, at least not explicitly, that products like these are aimed at the wellness market sometimes known as the worried well.
As if you didn’t have enough to worry about already in the early hours – when you find yourself desperately counting backwards from 300 in an effort to drive out memories of the wedding speech you made five years ago, the one you’re sure everyone still remembers for all the wrong reasons, the one that still keeps you awake at night. Those headlines don’t help either, about how most of us aren’t getting enough sleep, which is making us fat, increasing our risk of type 2 diabetes, cardiovascular disease, depression, cancer – all those headlines that might help researchers get funding for studies into the dangers of sleep deprivation, but don’t help the rest of us get a good night’s sleep.
A paper published this year in the American Journal of Clinical Sleep Medicine, “Orthosomnia: Are some Patients Taking the Quantified Self too Far?”, suggested sleep-tracking devices are quite likely to cause insomnia rather than cure it. They coined the word “orthosomnia”, “because the perfectionist quest to achieve perfect sleep is similar to the unhealthy preoccupation with healthy eating, termed orthorexia”.
The paper is a case study of three people who’d visited a sleep clinic because their Fitbits told them they weren’t getting enough sleep. The researchers found they quite often got more sleep than their monitoring device indicated – but the participants didn’t believe them. One of the three, Ms B, spent the night in a laboratory setting, and the results of the polysomnography – a scientifically validated test that measures brain waves, heart and other indicators during sleep – indicated she’d got a lot of deep sleep, more than most people her age typically get. “Then why,” she wondered, “does my Fitbit say I’m sleeping poorly?”
Because the Fitbit doesn’t know what it’s talking about? Interestingly, in their efforts to increase their sleep scores, the case studies were spending more time in bed than they needed to, possibly increasing their risk of insomnia.
There’s a New Yorker cartoon, in which a man walks into the kitchen and says, “I dreamed I got eight hours of sleep.” I’ve pinned it to my fridge. At 3am, I try to reassure myself with the research of historian Roger Ekirch, who uncovered hundreds of written references to the segmented sleeping patterns of our pre-industrial ancestors, and argued that the eight-hour sleep is a modern invention tied to the development of electricity. Before that, people had two sleeps – they went to bed early, got up in the middle of the night, fed the animals, did a few chores, then went back to sleep.
Sleep expert Siobhan Banks from the Centre for Sleep Research at the University of South Australia says Ekirch’s claim makes sense, that segmented sleep would have had a lot to do with the social constraints of the time. “But what’s nice about that particular narrative is it helps people to understand it’s alright to wake up in the middle of the night.” If you’re lucky, you roll over and go straight back to sleep. For others, it might take a little bit longer – if the baby is screaming at you to get up, say, or if you’re going through a life crisis, or if you’re just getting older; unfortunately the older you are, the more difficult it is to get back to sleep.
Transitory periods of sleeplessness are a normal part of life, and while it’s difficult to define the precise point at which transitory periods of poor sleep become chronic insomnia, Banks says it typically needs to go on for years before it will have health consequences. “People can become obsessed about sleep and they don’t need to be that anxious about it... but the last thing you want to do, if you’re not sleeping well, is to add an extra layer of anxiety by monitoring your sleep.”
Anyway, what can a sleep-monitoring device or app reveal that you can’t work out for yourself? If you wake up feeling like you’ve been run over, you probably didn’t sleep very well. It might make for a long day, but it’s not the end of the world, and tomorrow is another night.
This was published in the December 2017 issue of North & South.
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