The first thing millions of Americans do each morning is reach for a phone or a smart ring and check a number.
If the sleep score is low, the day starts under a small cloud. If it is high, there is a quiet lift.
Either way, the metric is setting the tone of the day before breakfast. Sleep clinicians say that daily ritual is starting to backfire.
When people rearrange their entire bedtime around the number, and lie awake anxious about tomorrow's readout, they can end up with worse sleep than they had before the tracker arrived.
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The pattern now has a clinical name.
Where the name came from
The condition is called orthosomnia.
The term was introduced in a 2017 case series in the Journal of Clinical Sleep Medicine by Kelly Glazer Baron and colleagues, who described patients arriving at sleep clinics convinced by their trackers that they had a disorder, even when medical testing showed otherwise.
The authors borrowed the "ortho" prefix from orthorexia, the well-known preoccupation with eating perfectly.
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Baron's group made a blunt point about the devices themselves.
Consumer wrist trackers cannot reliably distinguish sleep stages and are poor at detecting the moments a person is briefly awake in the night, yet patients often trusted the number on the screen over the results of a sleep study.
That mismatch is the engine of the problem.
The score itself can change your day
A striking Oxford experiment shows how much power the number holds.
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Researchers gave participants sleep trackers whose scores had been secretly randomized, so the readings had no connection to the night they had just spent.
Matthew Reid, a postdoctoral researcher at Oxford, explained the results in The Conversation.
People who were told they had slept badly reported lower mood, more sleepiness and more trouble concentrating that day.
People told they had slept well reported the opposite. The sleep was identical. The score wrote the day.
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How common it is starting to look
A 2024 cross-sectional study in Brain Sciences tried to put numbers on it.
Of 523 adults surveyed, about 36 percent regularly used a wearable sleep tracker.
Depending on how strictly the researchers defined obsessive score-chasing, between 3 and 14 percent of the sample met the criteria for orthosomnia risk.
Those who did had significantly higher insomnia severity scores than those who did not.
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It is not proof that the tracker caused the insomnia, but it puts the clinical worry on firmer ground.
What experts actually recommend
The evidence-based first step for chronic insomnia is not a better tracker.
It is a form of talk therapy called cognitive behavioral therapy for insomnia, or CBT-I, which combines sleep restriction, stimulus control and work on unhelpful beliefs about sleep.
Back in 2016 the American College of Physicians recommended CBT-I as first-line treatment for adults with chronic insomnia, noting that sleep medications carry potentially serious harms.
For the many people whose sleep is broadly fine, the practical advice from sleep specialists is smaller and calmer.
Keep a consistent bedtime and wake time, get bright light in the morning, cool and darken the bedroom, and step away from screens well before bed.
If the number on the app is making you dread the night, the useful move is to stop checking it every morning, or take the device off altogether.
If trouble sleeping continues for more than a few weeks, talk to your doctor.
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.