REF-401 · Jahrami H, Trabelsi K, Husain W, Ammar A, BaHammam AS, Pandi-Perumal SR, Saif Z & Vitiello MV, 2024 · Brain Sciences, · Paper · PubMed
Prevalence of orthosomnia in a general population sample: A cross-sectional study
Participants
n=523 adults from the general population; 176 (35.8%) regularly used sleep-tracking wearables
Protocol
Questionnaires: GAD-7 (generalized anxiety), APSQ (anxiety and preoccupation about sleep), AIS (Athens Insomnia Scale)
Ownership/use of commercial sleep-tracking wearables recorded
Four-criteria orthosomnia algorithm: owns a sleep tracker + AIS ≥ 6 + GAD-7 ≤ 14 + APSQ ≥ 40 / ≥ 35 / ≥ 30 (conservative / moderate / lenient estimate)
Key Results
35.8% of the sample regularly used sleep trackers (95% CI 34.6-40.1%)
Orthosomnia prevalence in the whole sample: 3.0% (16 people, conservative), 8.6% (45, moderate), 14.0% (73, lenient)
Because owning a tracker is one of the criteria, all cases sit among the 176 tracker users: roughly 9% / 26% / 41% of tracker users by the conservative / moderate / lenient definition (arithmetic on the abstract's counts: 16, 45 and 73 out of 176)
Cases consistently had higher AIS (insomnia) scores than non-cases at every APSQ cutoff, with significant differences at each cutoff
Cases did not differ significantly from non-cases in age or sex
Mechanism
Inference, not tested (cross-sectional data): sleep tracking may feed a loop of monitoring → preoccupation → anxiety → worse sleep → worse tracker scores → more preoccupation. The study shows co-occurrence of tracker use, sleep preoccupation and insomnia symptoms, not the direction of causality.
Practical Application
In a 523-person general-population sample, 3-14% met orthosomnia criteria (tracker owner + insomnia symptoms + sleep preoccupation), depending on how strict the definition is; that is roughly 9-41% of the people who actually used a tracker — a sizeable minority of wearable users show insomnia symptoms coupled with preoccupation about their sleep data
Not from this paper; the base's own practice: if sleep tracking increases anxiety rather than informing improvement, discontinue it
Not from this paper; the base's own practice: prevalence is high enough that coaches should watch for data-obsessive behaviour around sleep scores
The paper offers no data on athletes or on trait anxiety as a risk factor; treat any such extrapolation as inference
Limitations
General-population convenience sample — may not represent athletic populations
Cross-sectional — cannot determine causality
Self-report measures; orthosomnia identified by an algorithm the authors devised, not a validated diagnostic
How this entry was checked and changed
Content correction 2026-09-27
"Up to 14% of wearable users may develop orthosomnia" -> 14.0% is of the whole sample (73/523); among the 176 tracker users the lenient rate is ~41% (arithmetic). Lead rewritten.
Median age 21, 81% female, Cronbach alphas (0.89/0.91/0.88) and "AIS 8-9 vs 4" -> not in the abstract, removed.
"Tracker use itself correlated with higher sleep preoccupation" -> not in the abstract, removed.
Mechanism loop and "athletes with high trait anxiety are vulnerable" -> relabelled as inference / not from this paper.