
Sleep trackers can make insomnia worse - bookofjoe
https://www.nytimes.com/2019/06/13/health/sleep-tracker-insomnia-orthosomnia.html
======
StavrosK
This reminds me of Goodhart's law:

"When a measure becomes a target, it ceases to be a good measure."

[https://en.wikipedia.org/wiki/Goodhart%27s_law](https://en.wikipedia.org/wiki/Goodhart%27s_law)

~~~
max76
I don't think this is a textbox example of Goodhart's law.

A healthy amount of sleep is a great target and measure, just like staying
within a healthy weight range and lots of other biometrics.

I think Goodhart's law applies to people gaming the system or juking the stats
to inflate a measured number causing the number to lose meaning. It doesn't
matter what you do, getting enough sleep is important.

~~~
sametmax
I see your point, but this ignores anxiety, sleep quality and training
yourself to answer your body signals.

First, targeting a metric may create a counter productive stress that can make
you sleep less.

Second, the device, and the process, may induce a sleep of lesser quality.

Last, always targeting numbers doesn't force you to listen to your body, an
ability that our society is losing more and more. You don't need "8h of
sleep". You need to sleep at the time and duration that your feelings indicate
to you. Failing to do that result in plenty of problems, including
oversleeping, sleeping at bad hours, neglecting diet related to sleep,
ignoring light, not adapting to punctual overloads, etc.

Now, yes, Goodhart's law is more about cheating a system. But it's kinda what
you do: you try to bypass your natural way of calibrating with sleep and only
see a metric. We do that for a lot of things: food, sport, work, etc. And
because of that, we behave erratically.

~~~
brokenkebab
_You need to sleep at the time and duration that your feelings indicate to
you_

It's oversimplification. Those signals are dependent on light, among other
things. And unless you live with no electricity they may fool you.

~~~
maccard
> And unless you live with no electricity they may fool you.

I live in Scotland - during the winter we get 8-ish hours of daylight, during
the summer we get more like 17,(to the point that it doesn't actually get
properly dark at night). Routine is far more important here than natural
light.

~~~
brokenkebab
Absolutely, but establishing routine means overwriting your natural signals
with acquired habit, not following them.

------
disordinary
I found it to be the opposite. I knew I wasn't getting enough sleep and so I
would constantly look at my clock, phone, watch, etc. so that I could get an
idea of how little I was getting. When I got a fitbit I stopped worrying about
looking at my watch constantly to see when I fell asleep as it would tell me
in the morning. I still have sleep anxiety and I'm only averaging 5 hours of
sleep per night, if I have something I can't miss (like a flight) the next
morning I still will often get none, but it's not as bad as it was.

~~~
mdgrech23
I had the same. I'll just reply w/ a laundry list of things that helped me.
Black out blinds and eye mask, eliminate all sources of light in the room.
Keep the heat down about 64 in the winter, in the summer I sleep w/ a thin
blanket and in my underwear. Go to bed at the same time and get up at the same
time even on the weekends. Exercise daily. No coffee after 3pm. No eletronics
2 hours before bed. I also sometimes take melatonin.

~~~
disordinary
Thanks for that.

Unfortunately because I live in New Zealand for a global company I often have
meetings in the middle of the night so the no computer before sleep is tough,
I'm also worked up after those meetings and usually need to wind down somehow.

I do try and do most of the above, including no coffee after 12 (which is
tough because I love coffee).

~~~
mpfundstein
No offense but why don’t you change jobs? It seems as if the ‘lifestyle’ that
your company forces upon you does not fit your personal needs

~~~
disordinary
None taken, it's more interesting to work for a large scale global company.
Solutions that I help develop are used by hundreds of millions if not billions
of people every day. Very few companies in the local market have that scale.

It will get better at some point, we're just delivering a lot of projects in
Europe but attention will shift to this part of the world next. But if it
doesn't look like it will improve I'll probably look for something else when
the current set of products are in market.

I also choose to have meetings at night, work would happily pay for me to fly
to Europe but I try and avoid flights when bluejeans will suffice for
environmental reasons.

~~~
Angostura
Also - you get to live in New Zealand

------
brlewis
I work for Fitbit. Even though I don't speak for Fitbit, usually I try to keep
my personal tone consistent with the friendly, positive tone Fitbit's branding
wants to use. But I feel driven to respond to one part of the article in a way
that's bluntly critical.

 _One cautionary tale from the case study: A woman came in reporting that she
had an average sleep efficiency of only 60 percent, according to her tracker.
She was given medication for restless leg syndrome, tested negative for
disordered breathing, and underwent a formal sleep study. But after being told
that she had slept deeply in the lab, she was not reassured.

“Then why does my Fitbit say I am sleeping poorly?” she asked._

The "cautionary tale" part seems to be saying that this is an example of
irrational anxiety caused by home sleep tracking. That's a stupid assumption
to make. A sleep study does a precise measurement of how well you sleep _in a
lab_. The words "in the lab" are right there in the article. Did this article
really have to be rushed to press so fast that nobody could take 2 seconds to
realize that there could be issues present in her nightly sleep environment
that aren't present in the lab? Her question is valid.

~~~
JulianMorrison
It could be as simple as "you sleep badly because your cat jumps up on the
bed". No cat in the lab.

~~~
ASalazarMX
Or a bright blue LED of one of her bedroom appliances, noise, temperature,
blanket, night owl neighbors, etc. Never had one of these studies, but I
suppose the lab strives towards an ideal sleeping environment to identify
pathological causes.

~~~
waterhouse
Btw, it's also possible for the lab environment to be unrealistically bad. You
have all these electrodes and wires attached to your head and other body
parts, sleeping in an unfamiliar environment, if you need to use the bathroom
then you have to tell the technician to come unhook you from the wires and
then re-hook you when you're back... and on the subject of bright LEDs, there
were a couple in the room that I covered up with spare items of clothing the
last time I got a sleep study.

But yes, there might well be much worse problems at home. I think a lab sleep
study is best suited for detecting problems like sleep apnea, where it doesn't
matter _when_ you fell asleep as long as you did eventually. Though even for
that, you'd probably have to make sure your sleeping position is about the
same.

------
BurningFrog
Yeah, _worrying_ about sleep trackers can make insomnia worse.

This is basic sleep hygiene, and I don't know that there any other way than
through.

One of the first things to learn is that worrying about bad sleep is one of
the major causes of bad sleep. Getting out of that riddle solved a substantial
part of my sleep problems.

Once you're on the other side, having data is much better than not having it.

~~~
Avamander
I have about six years worth of sleep duration (and activity during sleep)
data. There still isn't a single piece of FOSS software that would deal with
that, I could import it into Postgres and view with Grafana, but I ain't no
scientist or super interested in sleep science so there's very few conclusions
I could make from it. Would love someone picking up this task :P

~~~
phonon
What's wrong with Excel?

~~~
Avamander
It's Windows-only and doesn't contain any knowledge about sleep science. As I
said, I could import the data anywhere, but that alone is not worth much.

------
nestorherre
I started tracking the "Sleep as Android" app and it made my insomnia worse.

Someone recommended me a treatment called "Cognitive Behaviour Therapy for
Insomnia" \- or CBT-I, and it was just amazing. What worked out the most was
Sleep Privation and not worrying about my sleep, I Highly recommend this to
everyone who is struggling. (Note aside, the first days of sleep privation are
an absolute hell, I wanted to literally die, but it's worth at the end).

~~~
qntty
Can you explain what sleep privation is? It's pretty hard to google.

~~~
slothtrop
A component of CBTi is sleep restriction, whereby you limit your hours in bed
and wake at the same time every day. By both anchoring your circadian rhythm
to that waking time and building sleep drive at night you can reduce sleep
onset latency, and maintenance issues throughout the night.

If you spend 8h total, you can dial back to 7, or as low as 6, on a temporary
basis. Once your sleep restructures itself (which doesn't actually take that
long), you can increase your total time in bed back to 8.

Even sleep therapy apps are pretty useless as they just regurgitate what ought
to be freely available information.

~~~
graeme
Do you nap in this phase, or just have a few days totally dead?

Onset insomnia is (or was) my main thing. I tried this and remember feeling
totally dead. Couldn't get through it.

~~~
slothtrop
I might rest my eyes for a few minutes, but avoid napping.

Keeping a steady waking time is the main thing. Rather than limiting myself to
6 or 7 hours I'll stay up reading to a low warm light until sufficient sleep
pressure has built up (easy enough to identify). A preceding relaxation
routine helps, and time away from electronics. I do a quick yoga stretching
thing. If it so happens I hit the sack and can't fall asleep, I'll sit up for
a couple of minutes, then try again.

------
ianai
The best thing I’ve found for insomnia, other than medication/melatonin, is
imagining myself flying. Basically going to silly fantasy land bootstraps a
sleep state pretty reliably.

~~~
Steve44
I try and build little worlds in my head and fly around them, working on
adding details as I go. I think it works because it blocks everything out and
requires zero physical effort.

~~~
ianai
It’s usually flying for me as well. It’s just interesting enough to not be too
Beijing. But it’s completely independent of what happened during the day, will
tomorrow, etc.

------
annamargot
Just read “Why We Sleep”. Never had a problem getting to sleep until I started
reading that book.

I started stressing hard if I didn’t get to sleep right away. Put it down for
a few days and all is well again.

Excellent book, freaked me the f out.

~~~
Apocryphon
That book is one of those hyped volumes on Hacker News which, while good, can
have diminishing returns. When everyone claims to get benefits from it, a
dissenting opinion can make oneself question one's lifestyle. "Deep Work" by
Cal Newport is another example.

------
taneq
Isn't this just the next level of "If I go to sleep right now I'll get 7 hours
... 6 hours ... 4.5 hours ... <panics>"?

------
newsbinator
For me the problem isn't getting to sleep or sleep duration- it's that my
Xiaomi band reports consistently that I only get 10 - 30 mins of deep sleep in
an 8 hour period.

And I consistently feel tired even before checking those stats, so I think
they're accurate.

I can't seem to figure out how to solve this.

I'm average size (a bit under weight) and not a snorer. I stop eating by 7pm,
stop screen time by 8pm, eliminate all light, and sleep in a cool, comfortable
bed (that I only use for sleeping).

Aerobic exercise and morning sunlight don't seem to matter.

What else is there to do?

~~~
rashkov
A few things you could try: taking a magnesium supplement, use a weighted
blanket, add some exercise to your routine. Is there noise that might be
waking you up? A white noise machine or earplugs could help. Are you sharing
your bed with someone? Their tossing and turning could affect your sleep, so
fixing your bed frame and getting a mattress which isolates motion could both
help. Is your life stressful? That could be something else to address.

Finally, keep in mind that possibly, these wrist sensors may not actually be
able to detect deep sleep all that well.

~~~
newsbinator
A lot of good things to consider there, thank you.

To start with, I'll try to add lifting to my routine and maybe a magnesium
supplement. I might do the supplement first for a week, to see if it has any
impact.

~~~
SmellyGeekBoy
Magnesium makes a huge difference for me.

------
whywhywhywhy
Best thing for my insomnia has honestly just been finding a job where it
doesn't matter if it turn up 10-30 minutes late whenever.

I came to terms that I have a night learning circadian rhythm and if I don't
have to worry about being told off for turning up "late" I've slept so much
better and consistently and no stressing in a panic that I can't sleep at 5am.

------
mlang23
I have one golden rule: Where I sleep, there are no electronic devices. I am
surrounded by techy stuff all day long. I _want_ a break from all of it
altleast 8 hours a day. I would never let a device track my sleep on a regular
basis. Feels great, I sleep tight and feel restored in the morning.

~~~
balfirevic
Yes, people who sleep well and feel restful after sleeping have no need for
sleep tracking devices.

~~~
krtkush
I'm not sure about this.

I have no sleeping disorder but track my sleep via Fitbit. It helps me plan my
sleep. So for example, if I find that I have not slept enough for the night I
make sure I retire early the next day. Also, the days I find I have not had
enough sleep I don't go for my morning runs so as to avoid injury. Of course
relying on body's own signals would do the job but I find that the trackers
augment the process.

In my experience my quality of life has increased because of sleep tracking.

------
waterhouse
For the type of people who get anxious about tracking sleep, is reading this
article going to cause them sleep anxiety anxiety? If so, should the authors
of the article consider their responsibility in publishing it? I'm only about
40% serious here... but, rereading the opening sentence—"Are you sabotaging
your sleep in your quest to improve it?"—that seems _remarkably_ well-
optimized to exacerbate the worries of an already nervous person.

Another question: among the people who act like hypochondriacs about their
sleep trackers, how many of them would act like hypochondriacs about something
else if they didn't have sleep trackers? (How many of them do this while
_also_ having a sleep tracker?) I think the null hypothesis is that being an
orthosomniac is much more a function of the person (predisposed towards
anxiety conditions) than of the device.

The only thing I see mentioned that (some) sleep trackers do that seems like
it might specifically promote anxiety is this: "If you sleep poorly, the app
will send a prompt asking what might have gone wrong. A late meal? Too much
coffee? Too much to drink? Skipped the gym?" But if that were the point, the
article would have a much different title.

------
vorpalhex
I anecdotally found this to be true for myself. Especially on Sunday night I
would start stressing about my sleep numbers.

Needless to say, if anyone would like to buy a used fitbit versa...

------
Genetikl33
Sleep trackers helped me discover the cause of my constant day time fatigue. I
discovered just how much I was snoring at night. I was able to self diagnose
my sleep apnea and took steps to improve it. I use the tracker as a habit now,
but only look at the number once a month or so to get a snapshot of my sleep
health.

So overall for me, tracking sleep gave me priceless insights which I could
improve upon.

~~~
balfirevic
How do you improve symptoms of sleep apnea without CPAP device?

------
CommieBobDole
This doesn't surprise me. When I have insomnia, it is invariably caused by
being aware of and worrying about the process of sleeping.

~~~
SketchySeaBeast
Yeah - the less I think about sleep the more likely it's going to happen. I
also find that I can't care about not getting enough sleep - I used to do math
in my head "ok if I fall asleep now it'll still be 4 hours" \- I've learned
that I can function on zero sleep for a day if I really have to, so it's no
longer a threat to myself, and I don't worry about not sleeping because of it.

------
IronWolve
I have 2 sleep trackers, the beauty rest wifi unit that goes under the
mattress and a fitbit. I have sleep apnea and wanted to watch my sleep for
scores. I normally dont get much deep sleep after 4 hours, or 3rd cycle of
sleep. Setting my alarm to wake up at 4 am, then go back to sleep, body resets
for 1 more cycle with a short deep sleep cycle. Sleep Hacking.

~~~
bestnameever
what time do you go to sleep?

~~~
IronWolve
10 most times, Midnight on occasion.

------
scarejunba
Interesting. My bed tracks my sleep but I only get the report in the morning
and not live. My phone isn’t near my bed and I only interact with the Internet
using my Google Home when I’m in my bedroom. All the sleep tracker has done is
let me know what my sleep looks like.

Most weeks it’s good but lately I’ve been doing poorly - sleeping too little.

------
zigzaggy
My experience has been the opposite of making it worse. When I started using
my watch to track sleep I was sleeping 3-4 hours per night then one long night
of sleep (7-8 hours) once a week. I was basically crashing from exhaustion.

I started tracking my sleep, and used the app to find the best “go to sleep”
time target. I’ve gradually increased my sleep time to just over 6 hours a
night with one or two 8 hour nights on the weekend.

My watch has been a critical tool for improving my sleep.

Edit to add: I also use the “Sleep with Me” podcast to fall asleep. That guy’s
mumbling are pretty easy to fall asleep to.

------
deepakhj
It’s the opposite for me. With the tracker, I have solid evidence I got a few
hours of sleep when I think I didn’t sleep at all. It makes me calm down and
stops insomnia attacks from occurring.

------
richardhod
Useful sleep hack from the military. I tried it and it seems to work:
[https://www.independent.co.uk/life-style/national-napping-
da...](https://www.independent.co.uk/life-style/national-napping-
day-2019-fall-asleep-fast-military-trick-sleep-a8817826.html)

------
ex3ndr
For me Apple Watch with ECG caused panic attacks.

~~~
saagarjha
Why, did it report anything unusual?

~~~
derefr
There’s a known correlation between increased
[https://en.m.wikipedia.org/wiki/Interoception](https://en.m.wikipedia.org/wiki/Interoception)
and anxiety.

Part of how panic attacks work, for example is a feedback loop where you’re
aware of the way your body is reacting to panicking (feeling your heart speed
up, etc.), which makes you panic more.

~~~
ex3ndr
Exactly. I was in traffic jam, checked my pulse routinely and it was slightly
more than usual: 80 BPM. I started to think that something wrong. now it
became 90BPM, and here closed feedback loop caused almost 1800BPM. I have
rushed to the ER and good doctors (thank god we have cheap medicine) helped me
to go through this. Panic attacks continued for almost half year.

~~~
saagarjha
> almost 1800BPM

Uh…

------
anilakar
Anecdote: My most exhausted coworkers are those who openly admit and talk
about using sleep trackers.

I believe that the effect of sleep trackers is mostly psychological and they
work in the same way all those self-help books do.

~~~
louhike
It seems logical that the ones having difficulties sleeping use tools to sleep
better. So I'm not sure I understand your point and comparison with self-help
books.

------
TheHwangover
I got a solution. Ready? Marijuana

------
durdleturtle
Eh I just use the free program f.lux as it dims your computer screen's colours
so that you aren't exposed to blue light before you sleep.

~~~
sschueller
I wish my Samsung TV had such a feature.

