ONCE UPON A time, a run was just a run, and a night’s sleep was just another night’s sleep.

Now each activity is a detailed quarterly performance review conducted by a tiny, judgmental rectangle that lives on your wrist. It buzzes to let you know that you’ve “under slept” or interrupts your morning coffee, while you’re mid-yawn, to inform you of your “poor sleep quality” during the night. 

This little device continues throughout the day, buzzing to notify you that you’re “under-recovered,” “need to move more”, and are somehow both “too slow” and “working too hard.” You set off on your run, determined to get out in the fresh air, de-stress and yet, you return with a colour-coded report and mild existential dread.

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Fitness trackers promised to revolutionise exercise, turning us into athletic marvels, but as we wake in the morning to a disappointing sleep score and pause mid-run to argue with pace count, sprinting the last 200 metres to avoid an embarrassing average pace, is it worth asking if your fitness tracker is making your training worse?

Research, however, consistently shows that fitness trackers have positively impacted our awareness and engagement with physical activity. They have their place. I often encourage their use with my patients, tracking their step counts and using this visual feedback to motivate greater engagement in consistent movement and exercise. The good news is, it works more often than not.

The visual report acts as a easily digestible examination of how little the patient may be moving, sparking conversation, helping us identify barriers to exercise while harnessing their abilities.

Wearable trackers encourage consistency with simple measures, providing a platform for self-directed accountability. They help support positive behaviour change. For someone starting out, seeing step count rise or resting heart rate fall can be both motivating and empowering.

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These wearable trackers have had several positive impacts on health and behaviour. Research has found that the use of this technology resulted in a meaningful boost in physical activity, leading to an increase in daily step counts and more time spent in moderate-to-vigorous exercise.

This increase in activity supports better cardiovascular health, which may lead to a reduction in the risk of chronic diseases. Trackers have also been found to improve motivation, accountability and habit formation by helping users set goals and monitor progress. The development of fitness trackers has undeniably transformed the way we plan and monitor exercise.

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There’s a role too for wearables in the monitoring of clinical populations, supporting better awareness and treatment of chronic diseases by enabling continuous, real-time health monitoring. Devices such as continuous glucose monitors (CGMs) are invaluable, allowing individuals with diabetes to track blood sugar levels using their phone without the need for frequent finger-prick tests.

This not only improves comfort but also provides real-time feedback and a better ability to control glucose levels. They are playing their part too when it comes to heart health, keeping track of cardiovascular markers like blood pressure, and there are bound to be greater improvements on that front in the future. For clinicians, the opportunity to use Remote Patient Monitoring (RPM) is also developing, allowing them to track patients’ vital signs and health data from a distance.

This reduces the need for frequent in-person visits to hospitals and clinics while enabling early detection of potential issues, ultimately improving outcomes through quicker response times to changes, making chronic disease care more efficient and accessible.

Fitness trackers are not always as accurate as you may think. Studies have found significant errors in calorie estimates and reported data, leading to misleading data on how much exercise has actually been completed and calories burned.

Continuous monitoring and feedback of stats has also been shown to negatively impact mental health in some cases. Anxiety, rumination and feelings of inadequacy can develop when users focus on numbers and unmet goals rather than overall well-being and exercise engagement.

Researchers have linked fitness trackers to unhealthy behaviours of obsessive tracking and excessive goal chasing. Rigid dieting and fixation on data can steal the enjoyment of physical activity, where people begin to prioritise their data output over their overall health and wellbeing.

‘Data shame’, is also reported, where users feel guilt or disappointment for not hitting targets, which can sometimes undermine motivation and be counterproductive. This obsessive tracking can lead to unhealthy exercise behaviours and risk-taking.

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Sleep, as neuroscientist Matthew Walker argues in Why We Sleep, is not a lifestyle luxury but a biological necessity as vital as food or water. Your nightly slumber reset strengthens your memory, repairs muscle, balances hormones and steadies your mood.

Miss it, he warns, and nearly every system in the body pays a price. In the age of wearable tech, many of us now analyse our sleep daily, poring over graphs of REM cycles and “sleep scores”.

For some, that data can be a helpful nudge toward earlier bedtimes and better habits. For others, it can spark a new form of anxiety, a phenomenon dubbed “orthosomnia”, an obsession over perfect sleep which ironically can lead to worse sleep, anxiety and insomnia.

I, for one, have most definitely fallen victim to this obsession. I found myself reaching for my phone to check how I had slept first thing each morning before even sitting up in bed. More often than not, my fitness tracker would insist I’d been awake for hours, tossing and turning, logging every flicker of movement as evidence of a “terrible” night.

I would drag myself from my bed deflated, convinced I was exhausted because a graph had told me so, when truthfully, I didn’t feel too bad. What began as mild curiosity quickly hardened into a routine ritual.

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The 2017 coining of the term “orthosomnia”, this unhealthy fixation on achieving perfect sleep data, suddenly felt uncomfortably familiar. I may not have ticked every symptom box, but my daily sleep score had become less of a helpful insight and more of a morning obsession, shaping my mood before the day had even begun.

I soon parted ways with my sleep tracker, reflecting on the real lesson echoed in Walker’s message: sleep works best when we respect it, protect it and occasionally stop trying to micromanage it.

Recently, there has been a lot of discourse online regarding wearable fitness trackers and their impact on our health. Wearables do emit radiation in the form of non-ionising radiation, similar to that used in Wi-Fi, Bluetooth and phone usage. However, the extremely low and harmless levels emitted by wearables to communicate do not have enough energy to damage DNA cells. There is no evidence to date linking this radiation and illness.

The World Health Organization (WHO) and similar national health bodies reported that there is no credible link between radiofrequency radiation emitted by wearables and cancer. Wearables operate within safe limits and often below internationally set safety limits.

A recent study, however, did find that many of these wearables can emit high levels of toxic PFAS, the ‘forever chemicals’ we are exposed to in many modern settings. There is an ongoing debate in the EU about the banning of these PFAS chemicals. 

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Overall, fitness trackers are most effective when used as part of a broader health strategy that includes goal setting and personalised feedback.

Set realistic goals instead of rigid targets. Research suggests treating them as informational adjuncts to training.

Avoid over-reliance on your metrics and focus on broader health trends. Fitness trackers can be useful in setting healthy habits without negatively impacting your mental well-being when used appropriately. The healthiest approach may be to use the data to inform you, not define you.

Stephen O’Rourke is a Clinical Specialist Musculoskeletal Physiotherapist at the Mater University Hospital, Dublin, with a specialist focus on spinal care and low back pain. He is also a guest lecturer at the Royal College of Surgeons in Ireland and a former health contributor to The Farmer’s Journal.

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