Is 'sleepmaxxing' making your sleep worse?

Sleep scores, magnesium, white noise machines - what was once the simple act of sleeping has become a minefield.

Trying to optimise sleep in this way is called "sleepmaxxing".

But take it too far, and you could end up with "orthosomnia" - the clinical term for an obsession with achieving perfect sleep.

Although orthosomnia is not formally recognised as a condition in the UK, more GPs are seeing signs of it in patients, some of whom bring sleep tracker data to appointments convinced – incorrectly - that they have a sleep disorder.

So how and why did sleep become so complicated? And if sleepmaxxing isn't the answer, what is the elusive secret to a good night's sleep?

Sleep scores are completely made up

The first commercial fitness tracker to incorporate sleep analysis was the Fitbit Classic in 2009.

Since then, many others - including Garmin, Whoop, Apple, Withings - have integrated sleep trackers into wrist-worn devices, as have smart rings such as Oura.

These devices vary, but in general they all provide users with a report of their night, broken down by sleep stages - time awake, light sleep, deep sleep, and REM (rapid eye movement). Many also give users a "sleep score".

But the concept of a sleep score is "completely made up", according to Dr Alanna Hare, a consultant of sleep medicine at the Royal Brompton Hospital in London, because there is nothing like a ‘sleep score’ recognised in science.

There is even a proposed lawsuit against Oura, filed last month in San Francisco, which alleges that Oura rings are unable to accurately measure sleep quality and sleep stages, and instead rely on AI-generated estimates that have "a coin flip's chance of being correct".

In response, Oura says that it "stands behind our science, research and accuracy claims”, even though sleep trackers work by measuring movement, heart-rate - and sometimes temperature or breathing sensors - to infer sleep duration, quality, and stages through algorithms rather than directly measuring brain activity during the night.

I’ve used both a Whoop and a Withings smart watch, and I didn’t find either of them were particularly accurate when it came to the number of hours they said I’d slept, or how well.

Daytime impact

Studies also show sleep trackers can affect how you function during the day, even if they're not accurate. In one study, from the University of Oxford, participants were given sleep trackers which assigned them a sleep score.

The scores were randomised, however, and had no relation to how the participants had slept.

The next day participants rated their mood, fatigue levels and alertness, before tests checking their focus and reaction times.

Researchers found that the people told they'd slept badly reported feeling more fatigued, and were less mentally alert - even though the sleep scores were all fake.

So how can you actually sleep well?

Here are some recommendations for a better night’s sleep:

• Keeping your bedroom cool, dark and quiet - within reason. That doesn't mean it needs to be pitch black, exactly 16C or totally silent but it should be coolish, darkish and quietish.

• Increase bright light exposure during the day, which is good for regulating your circadian rhythm - that is, your body's natural clock. In the evening, reduce blue light exposure from phones, computers, and TVs at least two hours before bed to allow melatonin production and promote relaxation.

• Eating a healthy, Mediterranean-style diet, which is rich in polyphenols, omega-3 fatty acids and fibre. And avoid caffeine, nicotine, and alcohol in the late afternoon and evening, as they can disrupt sleep.

• Moderate-intensity exercise can help you fall asleep faster and reduce night time awakenings. Schedule workouts earlier in the day and avoid strenuous activity within three hours of bedtime.

• Above all, keeping it simple.