The Score That Made Sleep Infinitely Worse
- Maša Nobilo, Sleep Coach
- Jul 5
- 4 min read
Before she tells me how she feels, she tells me the number.
Seventy-eight. Sleep efficiency down four points. REM was low again. This happens most weeks, with most new clients who wear a ring or a strap to bed. I ask how they slept and they open an app first, as if the app might know before they do.
I don't blame them for it. I want to be clear about that before I say anything else. But there's a pattern showing up across nearly every client who comes to me holding a screenshot of their sleep, and it has a name now, one that sleep researchers only started using in 2017.
Orthosomnia.
Where the word came from
A clinical psychologist called Kelly Baron, who runs the behavioural sleep medicine programme at the University of Utah, first described it in a paper with two colleagues at Rush University. They'd noticed something odd showing up in their sleep clinic: patients arriving not with a diagnosable disorder, but with a fixation on their tracker data.
One case was a 40-year-old man who felt he needed to hit eight hours according to his device every single night. When he fell short, he attributed his entire day, the irritability, the fog, the mistakes, to that number. Another was a woman whose restless leg syndrome had already been successfully treated in a clinical sleep lab. Her actual sleep study said she was doing well. Her Fitbit disagreed. She trusted the Fitbit.
Baron built the word from the same root as orthorexia, the eating disorder where the pursuit of correct eating becomes the disorder itself. Ortho, meaning correct. Somnia, sleep. The pursuit of correct sleep, becoming the thing that ruins it.
It's not a formal diagnosis. It doesn't need to be, to be real. A 2024 study of over five hundred adults found that somewhere between three and fourteen percent showed clear signs of it, depending on how strictly you measure, and that the people who had it scored higher on standard insomnia scales than the people who didn't. The anxiety and the poor sleep don't sit side by side. They feed each other. Researchers have since built a validated scale to measure it, the Bergen Orthosomnia Scale, which is usually a sign a phenomenon has stopped being a curiosity and started being a public health pattern.
What I actually see
Almost everyone I work with owns one of these devices. Most of them didn't buy it to become obsessive. They bought it hoping a number might finally explain what was wrong with them, after months of feeling tired for reasons they couldn't name.
What happens instead, again and again: the device becomes the second opinion they trust over their own body. A woman feels rested, genuinely rested, walks downstairs, checks her score, sees a 61, and spends the next hour convinced she's about to crash. A man sleeps deeply enough to dream vividly, wakes with energy, opens the app, sees low deep sleep percentage, and starts his day already bracing for the version of himself the graph told him to expect.
This is the exact shape of what most of my clients arrive with, whether or not they've ever heard the word for it. They've outsourced the one piece of information only their own body can actually give them: how they feel. A ring worn on a finger cannot measure that. It infers sleep stages from movement and heart rate, and even the people who build these devices will tell you the margin of error on deep sleep and REM is wide. But the app doesn't hand you a margin of error. It hands you a single number, out of a hundred, every morning, like a school grade for something you did unconscious.
The part that's genuinely unfair
A sleep score is one of the most effective anxiety triggers you could design if that were the goal, and nobody designed it to be that. It arrives first thing in the morning, before the nervous system has had a chance to settle into the day. It's precise-looking, so it feels objective, even when the underlying measurement isn't. And it invites exactly the kind of daily self-monitoring that every form of anxiety feeds on.
For someone who already struggles to trust their sleep, that's a hard thing to hand them every morning on a screen.
What actually helps
I'm not going to tell you to throw the ring in a drawer, mostly because I know almost none of you will, and because for some people the data genuinely is useful once it stops running the show. What I ask clients to do instead is smaller and harder: don't check the score until you've already answered the question yourself. How did you feel when you woke up. Not what did the app say you should feel. If those two answers keep disagreeing, that gap is the actual thing worth working on, not the score itself.
Your body has been producing sleep for your entire life without a graph to confirm it was working. It hasn't forgotten how. What it's lost, for a lot of the people I work with, is permission to trust its own signal over a number generated by an algorithm trained on someone else's wrist.
That's usually where the real work starts. Not with a better score. With the body getting its vote back.
Good sleep starts the moment you wake up.
M.
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Sources
Baron, K. G., Abbott, S., Jao, N., Manalo, N., Mullen, R. (2017). Orthosomnia: Are Some Patients Taking the Quantified Self Too Far? Journal of Clinical Sleep Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC5263088/
Prevalence of Orthosomnia in a General Population Sample: A Cross-Sectional Study (2024). https://pmc.ncbi.nlm.nih.gov/articles/PMC11592250/
Development of a Scale for Measuring Orthosomnia: the Bergen Orthosomnia Scale (BOS) (2025). Frontiers in Sleep. https://www.frontiersin.org/journals/sleep/articles/10.3389/frsle.2025.1640355/full
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