Sleep apps backfire by causing anxiety and insomnia, says expert
Smartphone sleep-tracking apps are making people so anxious and obsessed about their sleep that they are developing insomnia, a leading neurologist has said.
Speaking at the Cheltenham science festival, Dr Guy Leschziner, a sleep disorder specialist and consultant at Guy’s hospital in London, said a growing preoccupation with getting enough sleep was backfiring.
“We’ve seen a lot of people who have developed significant insomnia as a result of either sleep trackers or reading certain things about how devastating sleep deprivation is for you,” Leschziner said before his talk.
A high proportion of patients seeking treatment for insomnia turn up at his clinic with data about their sleep patterns and are often reluctant to delete the app, he said. “It’s rather difficult to dissuade them from using it.”
Most apps have not been clinically validated and only track movement, so do not provide insight into the quality of sleep, he added.
“My view of sleep trackers is fairly cynical. If you wake up feeling tired and you’ve had an unrefreshing night’s sleep then you know you’ve got a problem,” he said. “If you wake up every day and feel refreshed, are awake throughout the day and are ready to sleep at the same time every night then you’re probably getting enough sleep for you and you don’t need an app to tell you that.”
Similar concerns were highlighted in a series of case studies published last year by a team in Chicago that described patients whose micromanagement of sleep using apps had led to a disorder called orthosomnia.
Research shows that for most people the optimum amount of sleep is around eight hours, but this varies widely across the population. For people who naturally need less sleep, being alerted to the fact that they are not sleeping “enough” could result in the nocebo effect, where the expectation of negative symptoms leads to people actually feeling worse.
Speaking in the same session at the festival, Stephanie Romiszewski, a sleep psychologist based in Exeter, said: “Everybody sleeps differently and can have a different duration. And therefore if you take a generic sleep tracker and it [says] you haven’t had the right amount of sleep, that can start to worry you.”
Some cognitive behavioural therapy (CBT) apps, however, have been found to be effective in treating insomnia in trials.
The festival was told that people should also take a relaxed approach to advice on caffeine consumption and blue light exposure before bedtime. “Caffeine is only applicable if caffeine disrupts your sleep,” said Leschziner. “There are genes that influence how your brain processes caffeine and so there are many people who drink two or three cups of espresso before they go to bed and not have any impact at all on their sleep.”
Genetics also influence the extent to which blue light disrupts the evening peak in the sleep hormone, melatonin. “If your sleep is a really good quality and you can sit there and watch Netflix until 11 o’clock at night, close your computer and then drift off to sleep and have a great night’s sleep then you don’t need to worry about it,” he said. “We know that sensitivity to blue light various tremendously.”
Leshchziner said measuring sleep was part of a broader tendency to “metricise our lives” using technology to count how many steps we have taken, how many online friends we have and how we spend our money. With sleep, this trend is particularly problematic, he said. “If you’re measuring your steps and you realise you’re not walking as far as you should you just do a bit more exercise. When you get into that obsessive state about sleep it makes sleep even more difficult.”