Does health tracking cause anxiety? Orthosomnia, cyberchondria and how to track calmly

Short answer

Health tracking doesn't cause anxiety for most people, but it can feed anxiety that is already there. Orthosomnia, an anxious chase for perfect sleep-tracker scores, was first described in 2017. In one survey of 523 adults, 3% to 14% screened positive for it, depending on the cutoff. The risk is highest if you already have health anxiety.

If your watch or ring makes you more nervous instead of less, you're not imagining it, and it's not a character flaw. The same number can calm one person and alarm another. What decides it is less the device than the loop around it: how often you check, what you do after a "bad" reading, and whether a single score gets to decide if you feel safe.

This article covers what the research actually shows: when tracking helps and when it harms, what orthosomnia and cyberchondria are, whether a sleep tracker can make insomnia worse, the signs that tracking has turned into health anxiety, the treatment with the strongest evidence, and simple rules for tracking calmly.

At a glance: when tracking helps vs when it hurts

A simple test: after you check, do you feel more able to get on with your day, or do you need another check? Helpful tracking leaves room for your body to vary. Unhelpful tracking turns a number into the price of feeling okay.

Does health tracking cause anxiety?

Not automatically. Tracking is a feedback loop, and loops can calm or amplify.

Some research points to real benefits. In a cross-sectional survey of 930 middle-aged adults in China, heavier use of sports and health tracking devices went together with lower health anxiety. The authors described the likely pathway: real-time feedback made people feel more in control of their health and more confident they could manage it (doi.org). The study was a one-time survey, so it can't prove that devices lowered anxiety. People who feel calmer about their health may simply be more willing to wear a tracker.

Surveys of sleep wearables show a similar split. In a nationally representative survey of 1,200 Canadians, 19.3% used a wearable to monitor sleep. Nearly 45% of those users said it had a positive effect on their sleep and stress, while 4.5% said the effect was negative (doi.org). So most people who track feel fine or better. A minority feel worse.

The same Canadian survey also found a warning sign. Among wearable users, sleep time dropped more steeply as anxiety rose than it did among non-users (doi.org). In other words, for anxious people, a sleep tracker may tighten the link between worry and short sleep rather than loosen it.

Anxious people may also be the most drawn to devices. In a 2026 survey of 210 pregnant women in Germany, those with higher pregnancy-related anxiety were more willing to use smartwatches, blood pressure monitors, contraction counters and sleep trackers than women with lower anxiety (doi.org). That makes sense: when you're scared, more data feels like protection. But the people most likely to reach for constant monitoring are also the people most likely to get caught in a checking loop.

Context matters too. In a randomized trial of 110 stroke survivors, people given a smartwatch for 30 days of heart rhythm monitoring did not become more anxious than people without one, even after removing those who got an alert (doi.org). Monitoring that comes with a clear medical purpose and a care team behind it seems to land differently from open-ended self-monitoring at 2 a.m.

So the useful question isn't "Is tracking good or bad?" It's "Is my tracking helping me feel informed and capable, or is it winding me up?"

What is orthosomnia?

Orthosomnia is an anxious, perfectionistic preoccupation with getting "ideal" sleep data. The term was coined in 2017 by sleep researchers Kelly Baron and colleagues in the Journal of Clinical Sleep Medicine. It borrows "ortho" (correct) and "somnia" (sleep), echoing orthorexia, an unhealthy fixation on eating "correctly" (doi.org).

The original paper was a short case series of three patients. They came to a sleep clinic with self-diagnosed sleep problems, such as not enough sleep or "light" and "restless" sleep, based mainly on what their trackers showed. The authors noted that patients linked tracker data to their daytime tiredness, which could turn into "a perfectionistic quest for the ideal sleep." Strikingly, the tracker data often felt more believable to patients than validated clinical tests such as a lab sleep study (polysomnography) (doi.org).

Orthosomnia is not an official diagnosis. It is a descriptive term for a pattern. Researchers are still working out how to measure it, and early estimates vary a lot:

• In a general-population survey of 523 adults, 35.8% regularly used a sleep-tracking device. Using an algorithm that combined tracker ownership, insomnia symptoms and sleep preoccupation, 3.0% of the whole sample met a conservative definition of orthosomnia, 8.6% a moderate one, and 14.0% a lenient one (doi.org).

• In 2025, a Norwegian team (with Baron as co-author) built the Bergen Orthosomnia Scale, tested in almost 1,500 survey respondents. Orthosomnia scores went together with perfectionism, obsessive-compulsive symptoms, health anxiety, dysfunctional beliefs about sleep and "sleep effort", the harder-you-try-the-worse-it-gets pattern (doi.org).

That second finding matters. Orthosomnia seems to grow most easily in people who are already perfectionistic or prone to health worry. The tracker doesn't create the trait; it gives it a scoreboard.

Can a sleep tracker make insomnia worse?

It can, especially if you already have insomnia or sleep anxiety. There are three reasons.

1. What the tracker tells you changes how you feel the next day. In a clever experiment from Oxford, 63 people with insomnia disorder wore a watch that gave them fake sleep feedback in the morning. The researchers randomly told half of them they had slept poorly and half that they had slept well, whatever their sleep had actually been like. By evening, the "poor sleep" group reported feeling less alert and more sleepy and fatigued than the "good sleep" group (doi.org). The only thing that differed between the groups was the message on the screen.

That is the core risk: a low sleep score can make you feel worse, and that can happen whether or not the score is accurate.

2. Trackers are not great at spotting when you're awake. In a lab study of 34 healthy young adults, seven consumer sleep trackers were compared with polysomnography, the gold-standard sleep test. Most were very good at detecting sleep (sensitivity 0.93 or higher), but much weaker at detecting wake (specificity 0.18 to 0.54). Sleep stage estimates were inconsistent, and devices did worse on nights with disrupted sleep (doi.org). So "deep sleep" and "light sleep" numbers are estimates, and they're least reliable on exactly the rough nights that worry you most. For more on what the sensors can and can't see, read how sleep trackers work.

3. Chasing the score changes behavior. People with orthosomnia often spend extra time in bed trying to "earn" more sleep, go to bed earlier than they're sleepy, or monitor every awakening. Those are the very habits that behavioral treatment for insomnia tries to undo. Baron and colleagues argued that trackers should be folded into cognitive behavioral therapy for insomnia (CBT-I) instead of being left to run the show (doi.org). CBT-I is the first-line treatment the American Academy of Sleep Medicine strongly recommends for chronic insomnia in adults (doi.org).

None of this means sleep tracking is harmful for everyone. A tracker is useful for seeing broad patterns: your usual bedtime, how late caffeine or alcohol shifts your nights, how stress weeks look compared with calm ones. If you want to track, our guide on how to track your sleep covers the basics, and the best sleep trackers compares devices. Just treat the sleep-stage breakdown as a rough sketch, not a verdict.

If you lie awake worrying and can't pin down why, see anxious at night for no reason.

What is cyberchondria?

Cyberchondria is health anxiety that grows through repeated, anxiety-driven searching for health information online. You search to feel better, but each search makes you more alarmed.

Research shows this loop depends on who is searching. In a survey of 731 adults who searched their symptoms online, the severity of illness anxiety was the strongest predictor of feeling more anxious during and after searching. People with high illness anxiety remembered feeling worse after checking symptoms online. People with low illness anxiety remembered feeling relief (doi.org). The same action, searching, had opposite effects in two groups.

A 2019 meta-analysis pooled 20 studies with 7,373 participants. It found a moderate link between health anxiety and online health searching (r = 0.34) and a strong link between health anxiety and cyberchondria (r = 0.62) (doi.org). A 2026 scoping review of 42 studies reported cyberchondria prevalence estimates of 30.7% to 55.6% in the studies that measured it, with consistent links to health anxiety and anxiety sensitivity (fear of the body's own anxiety sensations). Reported consequences included self-diagnosis, self-medication and reliance on safety behaviors (doi.org). Those prevalence figures vary widely because studies used different groups and cutoffs.

Wearables can be the on-ramp. A heart rate spike, a low HRV value or a "poor recovery" label sends you to a search engine. The search results widen the threat from "one odd number" to "a list of frightening diseases." Now the problem is no longer the number. It's the spiral.

A practical rule: never search a single reading. If a pattern holds for a week or more, or you feel unwell, write it down and bring it to a doctor instead.

What is health anxiety?

Health anxiety is persistent, excessive worry about having or developing a serious illness. It usually comes with body scanning, reading ordinary sensations as danger, and repeated attempts to feel certain you're okay. Some worry about health is normal and even useful. Health anxiety is when the worry stays high despite normal results and starts to take over your time and choices.

When it's severe and lasting, doctors may diagnose illness anxiety disorder (the modern term for what used to be called hypochondriasis). In the American Psychiatric Association's diagnostic manual, DSM-5-TR, the main features are: preoccupation with having or getting a serious illness for at least six months; physical symptoms that are absent or only mild; a high level of anxiety about health; and either excessive health-related behavior, such as repeated checking, or avoidance, such as skipping doctor visits out of fear. When physical symptoms are prominent and the distress centers on them, the diagnosis may be somatic symptom disorder instead (doi.org).

How common is it?

• In Australia's national mental health survey, health anxiety affected about 5.7% of people at some point in life and 3.4% at the time of the interview. It was linked to more distress, disability and health service use (doi.org).

• In UK hospital outpatient clinics, 19.8% of 28,991 assessed patients had significant health anxiety, ranging from 17.5% in endocrinology to 24.7% in neurology (doi.org).

• A meta-analysis of 68 studies with 22,413 university students found that average health anxiety scores rose between 1985 and 2017. Interestingly, the rise did not track with how many people used the internet in each study year, so the internet alone doesn't explain it (doi.org).

Health anxiety is one kind of anxiety, not a separate universe. If your worry spreads across many areas of life, not just health, read about generalized anxiety disorder. For the wider picture of how anxiety shows up in the body, see anxiety symptoms.

What are health anxiety symptoms? How it looks with a wearable

Classic health anxiety symptoms include:

• frequent worry that a sensation (a headache, a skipped beat, a twinge) means something serious;

• checking your body again and again: pulse, lumps, skin, breathing;

• seeking reassurance from doctors, family or the internet, and feeling better only briefly;

• normal test results that don't settle the fear for long;

• avoiding things that trigger worry: medical news, exercise, some places, sometimes doctors themselves;

• physical anxiety symptoms such as a racing heart, tight chest, dizziness or stomach upset, which then feel like more proof something is wrong.

With a wearable, the same pattern takes new shapes:

• opening the app many times a day, or right after any sensation;

• feeling you can't start the day until the overnight score "clears" you;

• re-running ECG or HRV measurements until you get a result that feels safe;

• searching the meaning of single readings;

• cancelling exercise, plans or work because one number looks off;

• a jolt of dread before a notification or before opening the app;

• feeling more anxious on days you don't wear the device.

Health anxiety runs on reassurance-seeking. Your brain senses a threat, a check brings quick relief, and then doubt comes back ("but what if…"), so you check again. Over time the brain learns the wrong lesson: I'm only safe because I checked. A wearable makes this loop frictionless. It's always on your wrist, always refreshing, always ready to offer one more small hit of certainty.

The evidence-based point is narrower: tracking tends to backfire when checking becomes repetitive, reassurance-driven and hard to stop.

When smartwatch alerts trigger anxiety

Heart alerts are where tracking and health anxiety collide most clearly.

A case that named the problem. In 2020, cardiologists and a cardiac psychologist described a 70-year-old woman with occasional atrial fibrillation (AF, an irregular heart rhythm). She was on the right treatment, and her arrhythmia was present less than 1% of the time. Over one year, she recorded 916 ECGs on her smartwatch. Only 55 flagged possible AF; 701 showed a normal rhythm and 130 were "inconclusive." Her checking spiked after notifications, including harmless ones such as exercise-related heart rate rises and inconclusive readings. She had 12 clinic and emergency visits, none of which changed her treatment. She was diagnosed with illness anxiety disorder, completed 6 sessions of cognitive behavioral therapy, and her symptoms fully remitted (doi.org).

Beyond one case. A 2024 study compared 172 AF patients, 83 of whom used a wearable. Wearable users reported more symptom monitoring and preoccupation, and more worry about their AF treatment. 20% of wearable users felt anxious and always contacted their doctor after an irregular rhythm notification. Wearable users also had more AF-related health care use, including ECGs, heart ultrasounds and ablation procedures (doi.org). Because this was an observational study, it can't show that the devices caused the extra worry.

In a Michigan study where 6,765 people were given an Apple Watch, 86 received irregular heart rate notifications and met the study criteria. Of the 76 assessed by the study team, 42.1% reported anxiety about the notifications. Among the 59 who sent watch ECGs, 88.1% were in normal sinus rhythm (doi.org).

Alerts are rare, and not every alert means disease. In the Apple Heart Study of 419,297 people, only 0.52% received an irregular pulse notification over a median of 117 days. Among notified participants who later wore an ECG patch, AF was found in 34%. And 57% of notified people who returned a survey contacted a health care provider outside the study (doi.org). A review at Mayo Clinic of 264 patients evaluated after Apple Watch abnormal pulse readings found that a clinically actionable heart diagnosis was made in only 11.4%, after many tests (doi.org).

This doesn't mean you should ignore alerts. An alert can catch real AF, and AF matters because it raises stroke risk. It means an alert is a prompt to get a proper check, once, with a doctor, not a reason to take 20 more ECGs at home.

The trap nobody warns you about: false reassurance

A "bad" number can cause anxiety. A "good" number can cause a different problem: it can talk you out of real symptoms.

Smartwatch rhythm features are built and validated mainly to spot AF. In a 2026 case report, a 70-year-old man with recurring palpitations took an Apple Watch ECG that read normal sinus rhythm at 75 beats per minute. A 12-lead ECG the same day showed atrial flutter, a different rhythm problem that needed treatment. The authors stress that persistent symptoms need a standard 12-lead ECG, even when the watch looks reassuring (doi.org).

The rule works both ways: a wearable is a prompt, not a verdict. A worrying reading is a reason to pay attention. A reassuring reading is not a reason to override your body. If you have chest pain, fainting, trouble breathing, one-sided weakness, confusion or severe palpitations, get urgent medical care. Your symptoms outrank your gadget.

Why a single reading can mislead you

Wearable metrics are real physiological signals, but they are noisy. That noise is where a lot of tracking anxiety starts.

Take HRV (heart rate variability, the small beat-to-beat changes in your heart rhythm). In a within-session study, two short HRV readings taken 20 to 30 minutes apart, with no intervention in between, differed by a typical error of about 21% for rMSSD, the HRV measure most apps use. When readings were repeated in ten back-to-back intervals without a break, the typical error for rMSSD fell to about 10% (PMC). So a drop from 50 to 42 ms can happen in the same person, in the same chair, within half an hour. It isn't necessarily a sign you're getting worse. Sleep, alcohol, caffeine, illness, your menstrual cycle, training, posture, breathing and timing all move it too. We explain the everyday reasons in why HRV fluctuates day to day.

"Stress" scores need the same care. In a real-world study of 657 people wearing fitness trackers for 8 weeks, HRV was significantly linked to how stressed people said they felt, but the link was weak: models explained only about 1% to 2% of the variation. The authors cautioned against using wearable HRV alone as a stand-in for stress (doi.org). So if your watch says "high stress" and you feel fine, or the reverse, that's normal. We explore this in why your wearable and your feelings disagree, and compare how different devices score stress in stress monitoring devices compared.

The unit of meaning is usually the trend over days and weeks, not a single reading. If you treat every dip as a diagnosis, your brain will do what threat systems do: find danger, connect dots, build a story. That's how a normal, noisy signal turns into a worry generator. For how recovery scores from different brands are built, see overnight recovery metrics compared.

Who is most at risk

Based on the studies above, tracking is most likely to backfire if you:

• already have health anxiety or illness anxiety disorder, or have had it before;

• have panic attacks triggered by body sensations such as a racing heart;

• have obsessive-compulsive symptoms, especially checking;

• tend toward perfectionism, particularly about sleep;

• have insomnia or strong worry about sleep;

• have a heart rhythm condition like AF and feel anxious about it;

• have a history of disordered eating or compulsive exercise.

That last point has its own evidence. A 2025 systematic review of 38 studies found that young adults who use diet and fitness apps, especially those who use them more often, report more disordered eating symptoms than non-users, and cross-sectional studies link app use with body image concerns and compulsive exercise. Qualitative studies described pressure to hit goals and guilt when missing them. The evidence is mostly cross-sectional, so it doesn't prove the apps cause these problems (doi.org).

If you recognize yourself in this list, tracking isn't forbidden. It just deserves stronger guardrails, and ideally a conversation with a professional.

How to track calmly: practical rules

You don't have to quit. You have to change the how. The safest version is slower, more personal and less reactive.

Look at trends, not single nights. Decide to judge sleep, HRV and resting heart rate over a week or more. One short night or one low reading is weather, not climate. If your app lets you view weekly averages or ranges, make that your default screen.

Compare yourself to yourself. A resting heart rate or HRV that looks "low" next to a population chart may be completely normal for you. The meaningful question is "Is this unusual for me, and has it stayed that way?" not "Am I in the green?"

Set check times, and stick to them. For example: one glance after waking, one weekly review. Don't open the app in response to a sensation. If you feel an urge to check, wait 30 minutes and notice whether the urge fades on its own.

Cut notifications to the essentials. Keep only the alerts you'd actually act on. Mute nonessential nudges, badges and "your stress is high" pings that make you hypervigilant.

Ask: "What would I do differently today?" If the honest answer is "nothing, I just want reassurance," skip the check. Data is worth looking at when it can change a decision: go to bed earlier, take a lighter workout, drink more water.

Hide the sleep score if it runs your mornings. Judge your night by how you feel first. Then, if you want, look at broad patterns such as bedtime and total time asleep, not the stage breakdown.

Don't try to "earn" sleep. Staying in bed longer, going to bed before you're sleepy, or napping to fix a score usually makes insomnia worse. CBT-I works partly by doing the opposite (doi.org).

Never search a single reading. Write it down instead. If a pattern persists or you feel unwell, bring your notes to a doctor.

Add context. A note like "coffee at 4 p.m.", "argument", "first day of period" or "started a cold" turns a scary number into an explained one.

Let symptoms lead, data follow. If you feel fine and the number is odd, the number is context, not a command. If you feel unwell, your symptoms matter even if the dashboard looks calm.

Should I stop wearing my smartwatch?

Not necessarily. For many people, a watch is a useful nudge. A meta-analysis of 12 randomized trials in 1,693 healthy adults found that wearable trackers were linked to modest short-term increases in physical activity (doi.org). That's a real, if small, benefit.

But a tool is only worth keeping if the net effect on your life is positive. Consider taking it off, at least for a while, if:

• you check it many times a day and feel unable to stop;

• a score regularly decides whether you exercise, work or see people;

• you've had repeated doctor or emergency visits driven by readings rather than symptoms;

• you sleep worse on nights you wear it, or dread your morning score;

• tracking has started to shape your eating or exercise in a rigid way.

A simple experiment: take a one- to two-week break. Notice whether your baseline anxiety drops once the feedback loop is gone. If it does, that tells you something important. When you go back, if you go back, start with fewer metrics, no nonessential notifications and set check times.

If you have a diagnosed heart rhythm problem and your doctor wants you to use the watch for monitoring, don't just stop. Talk with them about a plan: which alerts to act on, when to take an ECG, and when not to. The Pulsewatch trial suggests that monitoring with a clear medical purpose need not raise anxiety (doi.org).

Taking the device off is not failure. It's a valid health choice.

How to stop health anxiety: what treatment works

The good news: health anxiety responds well to treatment, and the strongest evidence is for cognitive behavioral therapy (CBT). CBT helps you spot catastrophic interpretations, gradually cut back checking and reassurance-seeking, and practice tolerating uncertainty until the alarm settles on its own.

• A 2019 meta-analysis of 19 randomized trials found a moderate to large effect of CBT on health anxiety compared with non-CBT controls (g = 0.79; 0.62 after adjusting for publication bias). About 66% of people responded and 48% reached remission, and benefits largely lasted 12 to 18 months (doi.org).

• In a randomized trial of 204 people with health anxiety in Sweden, 12 weeks of therapist-guided internet CBT worked as well as face-to-face CBT. Therapists spent about 10 minutes per patient per week online versus about 46 minutes in person (doi.org).

• In the UK CHAMP trial of 444 hospital outpatients with health anxiety, adapted CBT beat standard care, with benefits lasting two years. At one year, twice as many people in the CBT group reached normal health anxiety levels (13.9% vs 7.3%) (doi.org).

For tracking-driven health anxiety, therapy often includes an explicit plan for the device: fewer checks, planned review times, no re-measuring, no symptom searching. In the smartwatch case above, six CBT sessions were enough for full remission (doi.org). If the main issue is sleep, CBT-I is the first-line treatment (doi.org).

Things you can start today, before or alongside therapy:

1. Count your checks for three days. Just notice how often you check the app, your pulse or search engines. Awareness alone often reduces it.

2. Cut back gradually. Reduce checks step by step over a week or two, rather than all at once.

3. Delay the urge. When you want to check or search, wait 30 minutes. Anxiety usually peaks and then falls on its own.

4. Stop asking others for reassurance. Tell family you're working on it, and agree on a kind response like "I know this feels scary. What would you tell a friend?"

5. Get one proper medical check. If a symptom is new, see a doctor once, then let the result stand rather than repeating tests.

If health anxiety comes with low mood, panic attacks or thoughts of self-harm, get professional help promptly. If you're prescribed medication for anxiety, don't stop or change it without talking to your doctor.

When to see a doctor

Get urgent care, whatever your device says, for:

• chest pain or pressure;

• fainting or near-fainting;

• severe shortness of breath;

• sudden weakness, numbness, drooping face or trouble speaking;

• sudden confusion;

• severe or prolonged palpitations, especially with dizziness.

Book a regular appointment if:

• you got an irregular rhythm alert that repeats, or persistent symptoms like palpitations, even if a watch ECG looks normal;

• a change in your data has lasted weeks and comes with how you feel (for example, a resting heart rate that stays well above your usual together with fatigue);

• worry about your health has lasted months and takes up a lot of your day;

• you've had several doctor or emergency visits driven by readings, and reassurance never sticks;

• tracking is shaping your eating or exercise in a rigid way;

• you have insomnia three or more nights a week for three months or longer, which is how doctors define chronic insomnia (doi.org).

How to bring this up with your doctor — and what to ask for

Say it plainly. "I think my health tracking is making my anxiety worse. I check my watch many times a day, and normal results don't reassure me for long." That's a complete, useful sentence. Doctors see this often, and naming it helps them help you.

Bring context, not just screenshots. Instead of a single scary reading, bring a few weeks of trends plus notes: when you checked, what you were feeling, what happened around the reading (caffeine, poor sleep, stress, illness). Mention any real symptoms separately, clearly and specifically.

Ask these specifically. Is there a medical reason to monitor this metric at all? Which alerts should I act on, and which can I ignore? Given my results, how often should I check, if ever? Could this be health anxiety, and would CBT, including internet-delivered CBT, help? If sleep is the issue, can I be referred for CBT-I?

If you are dismissed. "I understand my tests are normal. I'm asking for help with the worry and the checking, because they're affecting my life. Can we note this and discuss a referral to a psychologist?" A documented concern is much more likely to be followed up.

How Welltory helps

Welltory is built around the principle this article keeps returning to: trends and your own baseline matter more than any single reading.

Welltory measures your stress load, HRV, resting heart rate, sleep, activity and morning energy (body battery), and shows them against your personal ranges rather than a one-size-fits-all chart. That makes it easier to see whether today is actually unusual for you, or just ordinary day-to-day noise. It's the reason a single measurement is better read as a nervous system snapshot than as a verdict.

With My Patterns, you can add notes and tags such as "late coffee", "bad news", "period day 1", "checked app a lot" or "skipped the check today." Over a few weeks, you can see what tends to come before your harder days, and whether cutting back on checking goes with calmer ones. Welltory also offers guided breathing and calming measurements when you want to settle your nervous system rather than analyze it.

Honestly: Welltory can't diagnose health anxiety, insomnia or heart rhythm problems, and it can't replace a doctor or therapist. If you notice it's feeding a checking loop, use it less: once in the morning and a weekly look at trends is plenty. Used that way, it can turn "Am I okay right now?" into "What does my body usually do, and what helps?" and give you and your doctor a clear timeline instead of a pile of screenshots.

How we made it

This article updates and expands an earlier version of this page. Every factual claim was re-checked against primary sources, and each DOI was verified. It draws on the original orthosomnia case series (Baron et al. 2017) and newer orthosomnia research (Jahrami et al. 2024; Guldbrandsen et al. 2025); sleep-wearable surveys and validation studies (Dion et al. 2025; Chinoy et al. 2021); an experiment on sham sleep feedback (Gavriloff et al. 2018); the AASM insomnia treatment guideline (Edinger et al. 2021); cyberchondria research (Doherty-Torstrick et al. 2016; McMullan et al. 2019; Miezah et al. 2026); health anxiety epidemiology and diagnostic criteria (Sunderland et al. 2013; Tyrer et al. 2011; Kosic et al. 2020; American Psychiatric Association 2022); studies on tracker use and anxiety (Li et al. 2026; Altmannshofer et al. 2026; Anderberg et al. 2025; Tang et al. 2020); smartwatch heart alerts (Rosman et al. 2020, 2024; Pastapur et al. 2023; Paul et al. 2023; Perez et al. 2019; Wyatt et al. 2020; Ratti et al. 2026); HRV measurement variability (Cipryan 2016; Martinez et al. 2022); and CBT trials and meta-analyses for health anxiety (Axelsson & Hedman-Lagerlöf 2019; Axelsson et al. 2020; Tyrer et al. 2014). This article does not use Welltory user data. It was drafted with AI tools, then edited, fact-checked and medically reviewed by the Welltory team.

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