Staff Perspective: The Opportunities and Limitations of Sleep Tracking Technology
The Rise of Wearable Health Technology
Wearables have become increasingly popular over the last few years, and chances are high that you own one yourself, or someone in your close circle does. In fact, over one-third of U.S. adults report using a wearable device, with significant continued growth reported annually. Wearable devices, which include smartwatches, biosensors, and activity trackers, collect physiological data to inform our understanding of health and well-being. Not only can this help individuals better understand their daily health habits and set goals for improvements (cue me immediately Googling ‘walking treadmills’ after seeing my step count following an eight-hour day at my desk), but these devices also possess significant potential for real-time health monitoring and tracking of physical and mental health conditions such as cardiovascular disease, chronic respiratory conditions, anxiety, stress, and insomnia.
Wearables for Sleep Monitoring
Sleep wearables have gained particular traction in recent years, appealing to those focused on optimizing their physical and cognitive performance from the likes of athletes and service members, and individuals navigating mental health challenges, such as insomnia and anxiety. These devices claim to detect light, deep, and REM sleep phases, and measure sleep metrics such as sleep onset latency, to compile the dataset into a “sleep score” reflecting nightly and average sleep quality. This information can be genuinely useful for understanding sleep habits and making informed changes to optimize health. The potential benefits are promising and initial validation studies show promise, but further exploration into the reliability of these metrics is still needed.
When Data Becomes a Detriment
The surge in sleep wearable device popularity has also surfaced some potential downsides worth considering. A new term has emerged, orthosomnia, defined as a preoccupation with perfecting one’s wearable sleep data. Initial research suggests that for a subgroup of users, regularly fixating on sleep metrics may actually backfire, exacerbating insomnia and reinforcing their sleep-related anxiety, rather than relieving it. One proposed explanation is that people may feel compelled to spend extended periods of time in bed in order to boost their numbers, but since devices tend to overestimate time spent asleep, this can be counterproductive, leading some people to believe they have a sleep problem when they are, in fact, getting adequate rest.
Wearable Data in the Clinical Setting
For providers, wearables can serve as a useful tool for objectively understanding patients’ sleep habits when coupled with evidence-based psychotherapy treatment such as Cognitive Behavioral Therapy for Insomnia (CBT-I). That said, it’s crucial to keep in mind that patients may arrive with firmly held beliefs about what their device data means, and those beliefs can be resistant to change. The decision to incorporate wearable feedback into treatment should be individualized, guided by each patient’s relationship with their device and whether engaging with that data seems likely to help or hinder progress. Some patients may even resist traditional treatment altogether, preferring to rely on their wearable data instead. As the science behind sleep wearable accuracy continues to evolve, providers are encouraged to be intentional about positioning wearable data as a supplemental resource for raising awareness, rather than a driver of treatment decisions. For those who are open to it, providers can use the opportunity creatively, for example, having patients track subjective sleep quality and daily functioning both with and without their device, turning it into a meaningful behavioral experiment.
Looking Ahead: Maximizing Benefits While Minimizing Harm
Overall, wearable technology brings exciting possibilities for physical and mental health monitoring and optimizing. As the market continues to expand rapidly, it’s important that we thoroughly weigh both the benefits and potential drawbacks of weaving these devices into our daily lives and clinical care practices.
CDP’s Research
The themes explored in this post are ones our CDP team is actively investigating in collaboration with Walter Reed Army Institute of Research-West, Malcolm Grow Medical Clinics and Surgery Center, and Tripler Army Medical Center. The clinical trial study evaluates the effectiveness of an mHealth application and group-based Cognitive Behavioral Therapy for Insomnia (CBT-I) across various provider levels and objectively measures sleep using a Fitbit device. To learn more about the study, visit the one-pager here.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Jaime Rodden is a Clinical Research Manager for the Center for Deployment Psychology (CDP). In her role she works to advance the center's research portfolio, providing management for clinical studies through supervision, administrative oversight, and coordination of research protocols.
The Rise of Wearable Health Technology
Wearables have become increasingly popular over the last few years, and chances are high that you own one yourself, or someone in your close circle does. In fact, over one-third of U.S. adults report using a wearable device, with significant continued growth reported annually. Wearable devices, which include smartwatches, biosensors, and activity trackers, collect physiological data to inform our understanding of health and well-being. Not only can this help individuals better understand their daily health habits and set goals for improvements (cue me immediately Googling ‘walking treadmills’ after seeing my step count following an eight-hour day at my desk), but these devices also possess significant potential for real-time health monitoring and tracking of physical and mental health conditions such as cardiovascular disease, chronic respiratory conditions, anxiety, stress, and insomnia.
Wearables for Sleep Monitoring
Sleep wearables have gained particular traction in recent years, appealing to those focused on optimizing their physical and cognitive performance from the likes of athletes and service members, and individuals navigating mental health challenges, such as insomnia and anxiety. These devices claim to detect light, deep, and REM sleep phases, and measure sleep metrics such as sleep onset latency, to compile the dataset into a “sleep score” reflecting nightly and average sleep quality. This information can be genuinely useful for understanding sleep habits and making informed changes to optimize health. The potential benefits are promising and initial validation studies show promise, but further exploration into the reliability of these metrics is still needed.
When Data Becomes a Detriment
The surge in sleep wearable device popularity has also surfaced some potential downsides worth considering. A new term has emerged, orthosomnia, defined as a preoccupation with perfecting one’s wearable sleep data. Initial research suggests that for a subgroup of users, regularly fixating on sleep metrics may actually backfire, exacerbating insomnia and reinforcing their sleep-related anxiety, rather than relieving it. One proposed explanation is that people may feel compelled to spend extended periods of time in bed in order to boost their numbers, but since devices tend to overestimate time spent asleep, this can be counterproductive, leading some people to believe they have a sleep problem when they are, in fact, getting adequate rest.
Wearable Data in the Clinical Setting
For providers, wearables can serve as a useful tool for objectively understanding patients’ sleep habits when coupled with evidence-based psychotherapy treatment such as Cognitive Behavioral Therapy for Insomnia (CBT-I). That said, it’s crucial to keep in mind that patients may arrive with firmly held beliefs about what their device data means, and those beliefs can be resistant to change. The decision to incorporate wearable feedback into treatment should be individualized, guided by each patient’s relationship with their device and whether engaging with that data seems likely to help or hinder progress. Some patients may even resist traditional treatment altogether, preferring to rely on their wearable data instead. As the science behind sleep wearable accuracy continues to evolve, providers are encouraged to be intentional about positioning wearable data as a supplemental resource for raising awareness, rather than a driver of treatment decisions. For those who are open to it, providers can use the opportunity creatively, for example, having patients track subjective sleep quality and daily functioning both with and without their device, turning it into a meaningful behavioral experiment.
Looking Ahead: Maximizing Benefits While Minimizing Harm
Overall, wearable technology brings exciting possibilities for physical and mental health monitoring and optimizing. As the market continues to expand rapidly, it’s important that we thoroughly weigh both the benefits and potential drawbacks of weaving these devices into our daily lives and clinical care practices.
CDP’s Research
The themes explored in this post are ones our CDP team is actively investigating in collaboration with Walter Reed Army Institute of Research-West, Malcolm Grow Medical Clinics and Surgery Center, and Tripler Army Medical Center. The clinical trial study evaluates the effectiveness of an mHealth application and group-based Cognitive Behavioral Therapy for Insomnia (CBT-I) across various provider levels and objectively measures sleep using a Fitbit device. To learn more about the study, visit the one-pager here.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Jaime Rodden is a Clinical Research Manager for the Center for Deployment Psychology (CDP). In her role she works to advance the center's research portfolio, providing management for clinical studies through supervision, administrative oversight, and coordination of research protocols.