FAQ: Should I use a sleep tracker?

One of the biggest changes since I first started as a sleep doctor is the rise of wearable sleep trackers targeted to consumers. In the past few years, I have been getting lots and lots of questions from patients, friends, colleagues, and really any random person I bump into about whether they need sleep tech.

The answer is: You should get a sleep tracker only if it’s going to help you.

Let me explain.

How sleep trackers might help

Some people—ok, a lot of people, myself included—don’t  always get to bed on time or stick to a regular sleep schedule. Having something to keep you accountable and track patterns over time may be helpful to stick to your sleep goals if you are trying to get more or more regular time in bed.

A perfectly good alternative is to keep a sleep diary (aka sleep log). You can simply jot down (or chart, if you’re a visual person) your bedtime and waketime each morning. Or, use the free American Academy of Sleep Medicine sleep log, which is very straightforward. Or, use one of the many free sleep diary apps out there. The simpler the better! Personally, I use a habit tracker to simply mark off if I got 8 hours in bed.

I have had multiple patients who insisted they got sufficient and regular sleep time, and it was simply not possible that their sleep habits were contributing to their fatigue and sluggishness during the day… Two weeks later, after keeping a sleep log, they sheepishly acknowledged that the random “one off” nights of working late, going out, travel, or other things that cut into their sleep time, actually happened a lot more than they had estimated.

So you really don’t need a sleep tracker, but if keeping a sleep log is too cumbersome, or if someone is unwilling/unable to do it, then a sleep tracker is reasonable to try if it will help you stick to a good sleep schedule.

Sleep tracker accuracy

A lot of people use sleep trackers nowadays, so in the sleep clinic, we end up hearing a lot of questions about them. In a survey of sleep doctors and sleep health providers (Addison et al 2023), 35.8% of patients used consumer sleep trackers, and 23% of new sleep patients were asking their doctors to review their sleep tracker data!

That means a lot of precious doctor-patient time is spent on discussing metrics from sleep trackers… that may not be accurate.

I use a lot of actigraphy for research, and those devices have been validated against in-lab polysomnograms (sleep studies), which are the gold standard. Many consumer sleep trackers don’t have any public information on how they validated their algorithms. The algorithms are proprietary so we don’t know how they match up between different devices. Or, the company may modify its algorithm, and the metrics that the user sees changes. This can lead to confusion and anxiety, especially when a sleep “score” suddenly drops.

If you want to know how sleep doctors feel about sleep tracker accuracy: In the survey of sleep doctors mentioned above, the perceived accuracy of sleep trackers was “moderately or very accurate” according to only 16% of respondents, and 47% rated sleep trackers as “definitely unhelpful or somewhat unhelpful”

Unfortunately, based on that maybe-accurate-maybe-not information from sleep trackers, people can become fixated on maximizing their sleep, and get upset when their score isn’t “perfect.” One of the most frustrating things is seeing a patient with insomnia who now falls asleep and stays asleep all night, but insists, “My sleep tracker says I’m not getting deep sleep,” or “My sleep score went down this past week, why is that?”

Orthosomnia

This brings us to the major problem with sleep trackers, which is the risk of orthosomnia. This is a newer word, combining “ortho” meaning correct, and “somnia” meaning sleep. Orthosomnia is a problem where someone becomes overly perfectionistic and preoccupied with sleep metrics from sleep trackers.

Orthosomnia can then cause anxiety about sleep that can ironically worsen insomnia.

Orthosomnia was introduced as a concept in 2017 by sleep researchers (Baron et al 2017). The idea marinated within the sleep community for a few years, and in the past 2-3 years a surge of publications have come out on orthosomnia and sleep trackers.

In the figure, you can see the number of publications that have increased in just the past 2-3 years.

Number of publications in Pubmed with “orthosomnia” from 2017 to Oct 2025

Orthosomnia happens a lot. A large (897 people, mean age 47.5) study came out this year from a national survey representative of the US population. A whopping 56% of respondents reported using a sleep tracker. Among those who used a sleep tracker, 12.3% reported orthosomnia and worry related to sleep! (Kress et al 2025).

Stated another way: one in eight people who use a sleep tracker get orthosomnia.

If a medication or medical procedure worsened the problem it was supposed to treat in 1 of 8 people, that would be madness to use it willy-nilly in the majority of the population!

Just like how calorie-tracking apps can be enormously helpful to reinforce healthier eating habits for most people, but may contribute to disordered eating (orthorexia) in some people, sleep trackers can cause orthosomnia for some people.

In my opinion, just like people with an eating disorder should not use a calorie-tracking app, people with insomnia should not use a sleep tracker.

What to use instead of a sleep tracker

The problem is that when we have a tracker with a pretty app putting out scores and metrics, it gets easy to fixate on them, and forget about how we feel.

But we don’t need sleep trackers to tell us how good our sleep was. Our brains are remarkably sensitive to sleep disruption. You know if you have a bad night of sleep!

For example, in a study I did (Ju et al 2017), 17 people slept with a special setup that read their brain waves (EEG), and if they were in deep slow wave sleep, gave them beeps through earphones to nudge them out of slow wave sleep and into lighter sleep. On average they got 1177 ± 427 beeps over the course of the night! They also slept a separate night with the same setup, but with the mute button on. The participants didn’t wake up with the beeps, but the quality of their sleep was lighter, and their brains knew it – the next morning, the participants rated the quality of their sleep as 5.5/10 on the night with the beeps, compared to 7.4/10 on the sham night.

If you need to know how good your sleep was: seek the answer within yourself. Did you need to use an alarm? Do you feel refreshed? How is your energy level? Do you feel like your brain is swimming in molasses? Listen to your body.

If you are keeping a sleep log, you can rate your sleep quality, or how you feel during the day, or whatever metric is important to you, daily alongside the log. That’s the only data that really matters.

Other potential downsides of sleep trackers

·      Cost was identified as the most common downside in a large population based study of wearables, which is kind of a big deal since the actual benefit is hard to quantify.

·      Privacy: Information about you gets transmitted from the sleep tracker to your phone and then to a private company. What will happen to it? Will this information be made accessible to your health insurance company? What about your car insurance, which already might be tracking your driving through your phone, and doesn’t want you to drive tired?

·      Discomfort: A lot of trackers have little lights, hard edges, beeps, buzzes, or other features that are uncomfortable and slightly interrupt your sleep.

·      Rabbit hole: Once people open the app to look at their sleep tracker data, it’s just a quick swipe away to check social media, shop, or do any number of things that keep them on a screen, which at night in bed is especially bad for sleep.

 The takeaway

• If you need help with accountability for getting enough and regular time in bed, you can keep a written sleep log, or use a sleep tracker.

• Sleep tracker accuracy varies and specific metrics like “deep sleep” may change between devices and over time as algorithms change.

• 1 in 8 people who use sleep trackers report orthosomnia, a disorder where people have preoccupation and anxiety about their sleep.

• Don’t use a sleep tracker if you have trouble sleeping (if you have insomnia).

• Your own perception of sleep quality is more important than any metric from a sleep tracker.

Important: I don’t get any payment, own any stock in, or obtain any benefits from companies that make consumer sleep trackers, activity monitors, or related technology. Before you get a sleep tracker, think about who does benefit from your purchase and use of these devices.

References (alphabetical)

Addison et al. Sleep medicine provider perceptions and attitudes regarding consumer sleep technology. JCSM 2023;19(8):1457–1463. doi: 10.5664/jcsm.10604. Fulltext

Baron et al, JCSM, Orthosomnia: Are Some Patients Taking the Quantified Self Too Far? JCSM 2017 ;13(2):351–354. doi: 10.5664/jcsm.6472. Fulltext

Ju et al. Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels. Brain. 2017;140(8):2104-2111. doi: 10.1093/brain/awx148. PMID: 28899014; PMCID: PMC5790144. Fulltext.

Kress et al Perspectives regarding consumer sleep technology and barriers to its use or adoption among adults in the United States. Sleep Med 2025:128:165-173. doi: 10.1016/j.sleep.2025.02.004.) Pubmed