Meir Kryger MD
Meir Kryger MD, professor of medicine, Yale School of Medicine, New Haven, Connecticut, and author of The Mystery of Sleep.
Can a sleep tracker help me with my insomnia?
Sleep trackers such as the ones from Fitbit and other fitness trackers, smartwatches and smartphone apps such as SleepBot are marketed as giving you all sorts of details about your sleep. But the truth is, they can let you know how long you’re sleeping—and not much else. None of them have been scientifically validated to track the quality of sleep, such as how much time a user spends in the phase of sleep that is deeply restorative. They're not perfect for tracking the quantity of sleep, either—if you're sitting up in bed reading, for example, the tracker may log this time as "sleep." In short, the data from a sleep tracker is just not comparable to what is shown in the overnight assessment—aka a "sleep study"—used by sleep specialists to diagnose sleep disorders. For some people, to be sure, tracking how much sleep they get (even if it's not a perfect measure) is useful. It's like using a device—maybe even the same one—to count how many steps you take every day. If that step counter tells you even roughly that you aren't taking enough steps, you can fix that—just walk more. Similarly, if you aren’t sleeping enough, you can make an effort to get more rest. But that will work only if your lack of sleep is due to your lifestyle. If you truly have insomnia—a chronic difficulty falling and/or staying asleep— simply tracking your lack of sleep is unlikely to help. Some people try to self-diagnose their sleep problems with these trackers, but many things can cause chronic insomnia. Depression, stress, anxiety, poor sleeping habits, disorders such as sleep apnea, and medications for high blood pressure and other conditions all can lead to insomnia. To get real relief, you need to get treatment for any of these underlying causes that applies to you. In addition, actively trying too hard to fall asleep may cause you to become anxious and frustrated and to then have even more difficulty getting to sleep. It's even possible that your sleep app itself is contributing to the problem by encouraging what sleep experts call orthosomnia—"a perfectionistic quest for the ideal sleep." If you go to bed each night worrying that your sleep tracker will reveal that you "failed" again to get a good night's sleep, it's not helping. My advice: If you frequently have insomnia, talk to your doctor. He/she may refer you to a sleep specialist, who may do an overnight evaluation of your sleep patterns. Don't worry that you'll be led down a path to dependence on prescription sleep drugs. The most commonly recommended first treatment for insomnia is cognitive behavioral therapy, not a sleeping pill. And as a smart consumer of health information, you know not to just start taking pills. For more sleep tips, see Bottom Line's article, "21 Ways to Get the Best Sleep of Your Life."
