A few months ago, a new patient sat down in my office and started talking before I had finished my hello. She hadn’t slept well in months, and it showed. She was short with her husband, tired at her desk, and dreading her own bed as if it had betrayed her.
My patient turned her phone toward me the way you would hand over bad bloodwork. A sleep score: 61 out of 100. An ordinary bad week or two of sleep turned serious by constant monitoring.
For a growing number of my patients, rigid discipline and the effort to sleep perfectly can tip a rough patch of poor sleep into a diagnosis of clinical insomnia. For decades, sleep was an afterthought. It was the first thing people cut when ambition or parenting demanded more.
Thomas Edison called sleep “an absurdity, a bad habit,” and believed his lightbulb would free us from needing it at all. Then, over the last decade, we swung hard the other way. Arianna Huffington’s collapse and Matthew Walker’s best-selling book Why We Sleep turned sleep into a public-health alarm.
Wearables placed a number on what used to be a feeling, and adequate sleep became a status symbol. Within a few years, the trend bloated further into “sleepmaxxing,” the latest iteration of optimizing sleep as aggressively as a workout. Sleep clinicians have named what happens when that grading goes too far.
Orthosomnia is an unhealthy preoccupation with achieving perfect sleep that produces the insomnia it was meant to prevent. The condition is a parody of itself. You cannot relax your way to good sleep while obsessively checking whether you are relaxed enough to get sleepy.
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