Insomnia and Trouble Sleeping: Keep Your Nights on Record

Needs differ from person to person. The NHS gives 7 to 9 hours as the usual range for adults, and the American Academy of Sleep Medicine and the Sleep Research Society recommend that adults regularly get at least seven. Sam can't tell you how much sleep is right for you. In the monthly report, Sam sets your average sleep duration against a fixed mark of seven hours and labels it "Good" or "Below target"; the mark is the same for everyone and not a medical assessment of how much sleep you need. Sam shows how long you slept according to Apple Health and how that moves over weeks. On why duration alone can mislead: sleep duration as a health metric.

Sleeping badly now and then is common. Insomnia disorder means trouble falling asleep, staying asleep or waking too early despite enough opportunity to sleep, with effects in the daytime such as tiredness or low mood. DSM-5, ICSD-3 and ICD-11 call it chronic when it happens several times a week (DSM-5 and ICSD-3: at least three nights a week) for at least three months. These are criteria for a diagnosis, not a waiting period: you can talk to a doctor sooner. Whether that fits you is for your doctor to decide, and Sam doesn't diagnose. On the ISI questionnaire: how to use the ISI. Sam does not include the ISI.

A score combines estimates. Apple says its Sleep Score weighs sleep duration, bedtime consistency and interruptions. Sam calculates its own sleep score from up to ten parts of the night, including time awake, HRV and resting heart rate. Both rest on wrist sensors that estimate sleep stages. The European Insomnia Guideline notes that the validity of such devices for diagnosing insomnia has not been satisfactorily studied. No score replaces how you feel during the day. More: how accurate Apple Watch sleep stages are.

Sleep hygiene covers conditions and habits around sleep, such as bedroom temperature, light and noise, caffeine, alcohol and a regular daily routine. The European Insomnia Guideline states that sleep hygiene alone is not an evidence-based treatment for chronic insomnia, and the American Academy of Sleep Medicine guideline suggests not using it as a single treatment. The European guideline names cognitive behavioral therapy for insomnia (CBT-I), in person or digital, as the first-line option, and the American guideline gives CBT-I a strong recommendation. CBT-I is something to raise with your doctor or a psychotherapist.

The NHS advises seeing a doctor if changing your sleeping habits hasn't helped, you've had trouble sleeping for months, or it makes daily life hard to cope with. Loud snoring with pauses in breathing, heavy daytime sleepiness or suddenly falling asleep are worth raising promptly: they can point to another sleep disorder such as sleep apnea (what an Apple Watch apnea notification means). If you feel drowsy at the wheel, do not keep driving. If low mood or thoughts of harming yourself weigh on you, contact your doctor right away. In an emergency call your local emergency number (112 in the EU, 999 in the UK, 911 in the US). For urgent problems that are not life-threatening when your practice is closed, call its out-of-hours number or, in the UK, NHS 111. Free support lines: Samaritans 116 123 (UK and Ireland), 988 (US), Telefonseelsorge 0800 111 0 111 (Germany). The monthly report can go with you to the appointment. Which doctor to see and which tests are used is covered in What doctor to see for insomnia.

No. Sam doesn't diagnose and can't tell you why you sleep the way you do. An answer in Sam Chat may point to a possible link in your data, such as a workout the day before and a lower HRV; that is not a finding of a cause. It is also not CBT-I: there is no sleep diary where you type in bedtimes and no sleep schedule with fixed bed and wake times. Sam shows the times Apple Health records and keeps symptoms per day in the symptom diary, without a time of day or a count of awakenings. The Sleep lifestyle program (see programs) offers occasional general everyday habits and is no substitute for therapy. Sam Chat answers questions about your own data, without medical advice.

It is possible, but the evidence is limited. Case reports describe people who sought help for suspected sleep problems because of their tracker data, a pattern called orthosomnia. In an experiment with people who have insomnia, fake feedback about their sleep changed how they rated their symptoms the same day (Gavriloff et al., 2018). The European Insomnia Guideline mentions that using such devices might affect sleep behavior negatively, and it generally advises against sleep trackers for people with insomnia until their accuracy against polysomnography has been shown. Only you can tell whether the numbers help or unsettle you. If they unsettle you, that is worth mentioning at your appointment.