From step counts and sleep scores to protein intake and microplastic exposure, Americans have more access to personal health data than ever before. But when does healthy self-awareness become unhealthy self-monitoring? To understand what that access is actually doing, Naturepedic partnered with North Star Inbound to survey 2,009 adults across the U.S. about the metrics they track, how often they track them, and what that tracking is doing to their mental well-being and sleep. The results point to something the study calls "optimization anxiety" — and sleep, it turns out, may be where it shows up the most.

What the Survey Found

Across respondents, the pattern was consistent: More tracking doesn't always mean less worry. Some people use the data to build genuinely better habits. Others end up watching a number so closely that the number itself becomes the problem, which those suffering from orthosomnia (aka, disrupted sleep due to sleep tracking) can confirm.

Health and Sleep Tracking: Key Findings

• 64% of Americans track at least one aspect of their health every day.
• 58% feel overwhelmed by the sheer volume of health and wellness advice online.
• More than 1 in 3 Americans have stopped tracking a health metric because it made them feel worse mentally.
• More than half of U.S. adults are tracking their sleep, and 2 of the top 5 tracked metrics relate to sleep.
• Dallas and Austin, Texas, rank highest in the country for optimization anxiety.
• Weight (81.5%) and steps (71.9%) are the two most commonly tracked health metrics.

What Is Optimization Anxiety?

Optimization anxiety is the stress, overwhelm, and/or self-doubt that builds when health tracking starts working against the goal it was meant to serve. Also referred to as health optimization anxiety, it describes what happens when the pressure to monitor, improve and optimize becomes its own mental health burden.

Is America Becoming Obsessed With Wellness Tracking?

Across the board, Americans are watching their numbers: 64% of people say they track at least one aspect of their health daily, whether that's logging steps, weighing in, or checking a sleep score before they've even gotten out of bed.

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Health Metrics Americans Are Monitoring

Weight tops the list, with 81.5% of people saying they track it in some form, whether that's a daily scale check-in or a long-term trend on an app. Steps and physical activity come in second at 71.9%, followed by water intake (63.8%), sleep duration (60.3%), and sleep quality (47.4%). Calories, protein, and heart rate round out the top eight, each tracked by close to half of respondents.

What Is the Top Health Metric People Track?

Weight, steps, and water lead the list, but sleep isn't far behind — sleep duration and sleep quality both rank in the top five most-tracked metrics in the country.

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What Environmental Factors Do Americans Monitor?

The data shows that it's not just personal health metrics people are tracking. Americans are also keeping tabs on what's around them. Sun exposure is the most-monitored environmental factor (45.5%), followed by air quality (42.8%), food additives (40.2%), and water quality (39%). Roughly a quarter of people track chemicals like PFAS (27.3%) and microplastics (26.6%) specifically — a sign that concern about everyday chemical exposure has moved well beyond food and skincare and into how people think about their homes.

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Which US Cities Have the Highest Health Optimization Anxiety?

The survey scored 40 U.S. cities on an optimization anxiety scale from 0 to 100, factoring in which metrics residents track, how often they track them, and how frequently that tracking produces stress or worry. Here's how the most health-anxious cities in America stack up.

Dallas, Texas — 99.74

Dallas ranks first in the country for health optimization anxiety, with 90% of residents tracking at least one health metric every week and the highest rates of protein, hormone, and mindful-minutes tracking in the nation.

Austin, Texas — 97.06

Austin comes in second, with 3 in 4 residents tracking something about their health every single day — one of the highest daily tracking rates of any city surveyed.

Phoenix, Arizona — 95.24

Phoenix ranks third and leads all cities in social influence on tracking: Nearly 1 in 4 residents say family and friends are most likely to influence their motivation for monitoring their health.

Houston, Texas — 95.08

Houston ranks fourth and is the city most likely to produce an unwanted discovery — residents here are more likely than those anywhere else to say tracking revealed something about their health they wish they hadn't known.

Washington, D.C. — 93.85

D.C. ranks fifth and leads the country in one category that matters most: Residents are more likely than those in any other city to feel anxious, stressed, or worried as a direct result of tracking their health.

San Jose, CA — 93.45

San Jose ranks sixth nationally and first for sleep tracking, with residents more likely than those in any other city to monitor both sleep duration and sleep quality.

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The Downside of Doing Too Much: Wellness Burnout

Tracking more doesn't always mean feeling better: 58% of Americans say they feel overwhelmed by the sheer volume of health advice and optimization trends circulating online, and that overwhelm has a breaking point.

More than 1 in 3 Americans stopped tracking a health metric because it made them feel worse, according to the survey.

If optimization anxiety is the process — the slow build of pressure that comes with constant monitoring — wellness burnout or wellness fatigue is the outcome. It's the point where tracking stops feeling useful, and people opt out entirely, even when the original goal was a healthier life.

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Does Tracking Sleep Help or Hurt?

Sleep is one of the most heavily tracked areas of health in the country: 60% of Americans track sleep duration and 47% track sleep quality, putting sleep among the top five most-monitored metrics overall. With that much attention on a single number, it's worth asking: Is checking your sleep score every morning actually helping you rest — or is it doing the opposite?

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What Is Orthosomnia?

Orthosomnia is a condition in which anxiety about achieving a perfect sleep score disrupts the very sleep a person is trying to optimize. The term was coined by sleep medicine researchers in 2017 to describe people whose pursuit of a "perfect" sleep score was, ironically, making their sleep worse.

Can Sleep Tracking Actually Make Sleep Worse?

Yes, in people who develop orthosomnia. Whether someone is using an Oura Ring, Apple Watch, Fitbit, or another wearable, sleep researchers describe the same feedback loop: Someone becomes so focused on hitting a "good" score that the anxiety about the score itself raises stress and makes it harder to fall or stay asleep, which can then lower the very score they're chasing. The preoccupation with what the tracker says is the problem.

How Common Is Orthosomnia?

A 2024 study in the journal Brain Sciences surveyed 523 adults and found that, depending on how strictly the condition was defined, somewhere between 3% and 14% of the general population may show signs of orthosomnia. Roughly 36% of that study's participants used a sleep-tracking wearable regularly, and those who did showed measurably higher sleep-related anxiety than non-trackers. Pair that with Naturepedic's data showing 60% of Americans tracking sleep duration and 47% tracking sleep quality, and the overlap between sleep tracking and sleep-related anxiety becomes hard to ignore.

What to Do When Wellness Becomes a Source of Stress

Sleep tracking works well for plenty of people — it can highlight real patterns and help people make genuinely useful changes. The issue is when the data becomes the goal instead of a tool. For many people, the better question isn't how to track more precisely but whether tracking is the right tool for them at all.

Here are a few evidence-based ways to step back without giving up on better sleep:

• Limit checking your score, especially right before bed or first thing in the morning.
• Prioritize sleep hygiene fundamentals — a consistent bedtime, reduced screen time, and a dark, cool room — over chasing a specific number.
• Try a tracker-free week to see how you feel without the data.
• Optimize what you can control in your environment, rather than the data you can't fully control.

That last point is where a clean sleep environment comes in. Remove the variables you can control, like reducing screen exposure before bed. If anxiety around sleep is a recurring pattern for you, take steps to ease sleep-related anxiety, such as keeping a consistent sleep schedule and a predictable wind-down routine.

Less tracking doesn't have to mean less intentional.

Methodology

In this study, Naturepedic set out to learn how Americans view health optimization. To do this, they surveyed 2,009 people across the U.S. and asked a variety of questions about the areas of health they track, how frequently they track, what concerns worry them most, what concerns they feel most pressured to optimize and more.

Points were awarded for each metric tracked as well as responses that represented anxiety related to health optimization. Next, the average score was calculated by city and adjusted on a scale of 0 to 100, with 100 representing the most optimization anxiety.

FAQs

What is optimization anxiety?

Optimization anxiety is the stress, overwhelm or self-doubt that builds when health tracking, which is meant to help, becomes a source of pressure instead. According to a 2026 Naturepedic/North Star Inbound survey, 58% of Americans feel overwhelmed by the volume of health and wellness advice online.

Is wearable health tracking making us healthier or more anxious?

It depends on the person. Tracking genuinely helps some people build healthier habits, but for others, it adds pressure rather than relief. More than 1 in 3 Americans have stopped tracking a health metric specifically because it was making them feel worse mentally.

How many Americans track their health daily?

Sixty-four percent of Americans track at least one aspect of their health every day, whether that's weight, steps, sleep, or another metric.

What health metrics do Americans track most?

Weight is the most commonly tracked metric (81.5%), followed by steps or physical activity (71.9%), water intake (63.8%), and sleep duration (60.3%).

Can tracking your sleep make your sleep worse?

Yes, for some people. When someone becomes preoccupied with hitting a perfect sleep score, the anxiety around that goal can itself disrupt sleep — a pattern sleep researchers call orthosomnia.

How can I improve my sleep without tracking it?

Focus on the fundamentals a tracker can't measure: a consistent bedtime, less screen time before bed, and a sleep environment built for rest.

What environmental factors do Americans monitor?

Beyond personal health metrics, Americans track environmental exposures, too. Sun exposure is most monitored (45.5%), followed by air quality (42.8%), food additives (40.2%), and water quality (39%).

Which U.S. cities have the highest health optimization anxiety?

Dallas, Texas, ranks highest in the country for optimization anxiety (99.74 out of 100), followed by Austin, Texas (97.06) and Phoenix, Arizona (95.24).

This story was produced by Naturepedic and reviewed and distributed by Stacker.