What is Orthosomnia?

by PFFD | 16 January, 2024

To Track My Sleep Or Not, That Is The Question

There is a new sleep disorder affecting patients all over the country. It’s called Orthosomnia. Over the past few years, I have seen countless patients, friends, and family members obsess over their sleep because of wearable devices like Apple Watches, Oura rings, Fitbits, and Whoops. You might think this increased awareness would be good, but I have seen mostly the negatives. The pursuit of healthy sleep has made sleep stressful. While wearables have brought awareness that sleep is essential to whole-body wellness, they have also obtained an unhealthy obsession that can ruin sleep. “Will I sleep well tonight? Will I get enough REM? Will I get enough deep sleep?”

“Doc, I sleep just fine. My watch tells me so.” Do you know how often I hear that? On the flip side, I hear, “Doc, I’m wearing my appliance, and it says I’m still having three events per night.”

Let me clarify a few things so you can see why these statements don’t make sense. Some newer home sleep testing units use plethysmography (a long word that uses the skin to measure pulse, oxygen, and sympathetic tone) to measure the amount of obstructive sleep apnea. However, watches and rings only test pulse and actigraphy (or movement). Not only that, but they also do not continuously monitor these few parameters. The wearables only periodically take these measurements and, in many instances, can miss events, giving you a false sense of security. I want to be clear: a wearable is NOT a sleep test. Only a sleep test can confirm the presence of a potentially life-shortening disease called Obstructive Sleep Apnea.

At the other end of the spectrum, many patients believe that the oral appliance we provided for them is not working because they may still experience a small number of apneic events. In reality, the goals of oral appliance therapy are subjective and objective. We aim to get patients subjectively feeling better while confirming this improvement objectively with sleep test results showing an AHI under 10. AHI stands for the apnea-hypopnea index, which tells us how often the airway closes down wholly or partially for 10 seconds or more. For example, if you had 70 events and slept 7 hours, the AHI would be 10. Our goal with appliance therapy is under ten and, even better, under 5. Therefore, if a patient reports that their wearable said they had three events, we would celebrate!!! That’s an AHI of 0.2.

If you don’t sleep well, the wearable doesn’t advise you on what to do about it. That’s where I wish they would send a message to the patient: “Give Dr. Erin Elliott a call!” ☺

If you or someone you know is obsessed with tracking sleep, do yourself a favor and get an actual sleep test to turn the tracker off and get your life back on track tomorrow with a healthier you tonight.