I come by my love of wearables naturally, via my beloved late father, who was an early adopter of everything. In the last few days of his life, he was not afraid of dying, nor was he trying to live longer. But much to our amusement, he still checked his sleep quality each morning and kept an eye on his heart rate. He was simply curious, to the end, about what his body was doing.

Like father, like daughter; I wouldn’t be surprised if I, too, am checking my Oura Ring data on my deathbed. I’m super curious about what’s going on inside me, though I don’t believe my wearables are an irrefutable source of truth.

When to ignore your wearables

I’ve spent many mornings checking multiple sleep apps before my feet hit the floor, flipping through them until I find the one that gives me the most positive feedback. They rarely agree; one device announces I got more deep sleep than usual and congratulates me; another mourns my fragmented, insufficient rest and predicts a hard day ahead; a third splits the difference and blames my late dinner.

The underlying hardware has gotten genuinely good at capturing raw signals like heart rate, movement, and temperature. But each app’s composite sleep, stress, and recovery scores are determined by proprietary algorithms that may or may not be accurate for you in a given 24-hour period.

So many people worry when their sleep scores aren’t good that researchers gave the phenomenon a name: orthosomnia.

If you’re not careful, these devices can mess with you. Researchers found this out by randomly telling study participants they’d gotten either above-average or below-average sleep quality the night before. These sleep grades weren’t based on real measurements, but people told they’d slept badly performed worse on cognitive tests the next day, and people told they’d slept well performed better, regardless of the actual quality of their sleep or how well the participants thought they’d slept going in.

Wearables are an important part of Annosa Health, my lifestyle medicine program. But I think there are many times when we should ignore them entirely.

For example: Ignore anything that makes you anxious, especially about sleep or food. Ignore any score that contradicts your own felt sense; if the thing says you slept terribly and you feel terrific, trust yourself, not the algorithm. Ignore the stress scores altogether; I don’t think they’re that accurate yet.

Most of all, ignore what you can’t control.

If your tracker is regularly handing you bad grades for things you can’t fix in a few days or nights, like illness, night sweats caused by menopause, or a massive time zone change, take the damn thing off.

Even if it means leaving it in the drawer for an entire season.

Worth tracking

After all these years and all these devices, I focus on what’s within my control (which is why I built an app with a dashboard that suppresses proprietary scores). Self-monitoring is incredibly effective for helping us stick to behaviors that drive well-being. Here’s what I look at:

Sleep Timing Consistency. How consistent we are with our bedtime and wake-up times significantly impacts sleep quality. Of the two, a consistent wake time is more important. Along with morning sunlight, wake time is a primary circadian anchor that sets your body clock and supports stable energy, mood, and sleep.
Nighttime Heart Rate Variability (HRV) is the natural beat-to-beat variation in our heart rate while we sleep, and it’s a clear signal of nervous system recovery. A rising HRV usually reflects greater recovery and resilience. Because HRV varies enormously between people, your HRV trend matters more than the absolute value. When mine drops for several days in a row, I know it’s a signal to take it easy and give myself some extra rest.
Weekly Exercise. I track the type, time, and intensity of my exercise as it accumulates over the week, gauging it against a target amount that research shows will decrease my risk of breast cancer recurrence. Regular exercise is one of the most reliable ways to support energy, mood, sleep, and long-term health.
Time in Bed. We can’t force ourselves to fall asleep or directly control our sleep quality, but we can protect the window in which sleep is possible. An eight-hour window in bed increases the odds we get enough sleep.
High-impact behaviors that influence my well-being, including meditation and breathwork sessions, time spent in nature or making art, and gratitude practices. I also track meaningful conversations, kindness towards others, participation in social activities, morning light, effortful learning, spiritual practices, activities that bring me a sense of purpose, and hydration.
Subjective signals, like mood, energy, and stress, matter enough that I log them directly. Self-reported wellbeing isn’t a soft substitute for hard data: research has repeatedly linked how people rate their own mood and stress to real, measurable, long-term health outcomes. Self-awareness is a superpower.

Glucose Variability and Time-in-Range. The extent to which our blood sugar swings throughout the day is associated with mood and energy instability, insulin resistance, and cardiovascular risk. I don’t chase a flat line: I look for patterns in the way that my exercise, stress, sleep, and what I eat affect blood sugar spikes.

Let’s remember what we’re living for

The song these instruments are all playing is the same: Stay young, or at least become a Super Ager. Optimize everything so that you don’t die.

But illness and death are inevitable. No matter how well you sleep, eat, and exercise, everything and everyone passes away.

I know this all too well. In 2023, a dear college friend in his early 50s, an active, happy, grateful, Labrador-loving GI doctor just home from a ski trip, had a massive heart attack and died. My extremely health-conscious and seemingly super-fit mom had just been diagnosed with ovarian cancer; four months later she was gone. A week before her memorial, I was diagnosed with invasive breast cancer. Then a close cousin died suddenly, just after his 50th birthday. In the middle of all of this, we had to put our beloved dog Buster down. A few months later, my sweet brother-in-law Brian was diagnosed with terminal brain cancer. Not 9 months later, both Brian and my spry 84-year-old dad, who was in truly fantastic shape his entire life, passed away.

This season of epic loss reminded me that the aim of all our self-improvement is not to stay alive as long as possible. The goal is to feel fully alive for the unknown time we do have. We feel most alive when we are out in the world making it better, focused on something bigger than ourselves.

You can have the highest sleep scores, VO2 max, and HRV in your friend group, and you’re still going to die. This is an important fact to keep track of; when we are aware of how fleeting life is, we’re more likely to live vibrant, meaningful lives. Reflecting on our own mortality is linked to a stronger sense of connectedness and appreciation for life; people who hold more accepting attitudes toward death report higher well-being and lower depression.

So ask yourself what will make you feel most vital and alive. What behavior gives you energy for the people and the work that you love? Track that, because that’s worth doing.

Tomorrow morning, I’ll check my sleep data. But I’ll also remember what my dad always knew: the point isn’t to live to 150; it’s just to stay curious, engaged, and unafraid of what’s ahead.