Is a mobile app the future for insomnia treatment?

Is a mobile app the future for insomnia treatment?
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Say goodbye to sleeping pills! NICE recommends offering a new form of insomnia treatment using a mobile app.

Sleepio could soon be deployed as an effective alternative to insomnia treatments like sleeping pills. The app uses an artificial intelligence (AI) algorithm that provides people with tailored digital cognitive behavioural therapy for insomnia (CBT-I). The self-help format will guide patients for six weeks and includes a sleep test, weekly interactive CBT-I and a sleep pattern diary.

The implementation of this app would save the NHS money and reduce prescriptions of medications that can be dependency forming. An economic analysis strengthened this finding as healthcare costs were lower at one year when using Sleepio.

Sleepio: the alternative insomnia treatment

CBT-I focuses on identifying thoughts, feelings and behaviours that contribute to the symptoms of insomnia. These interventions can positively shape the way a person thinks about sleep and the behavioural interventions aim to promote a healthy sleep routine.

The six-week programme will be fully accessible for 12 months following registration, allowing this insomnia treatment to be revisited when necessary. The app also has a bank of helpful articles, tools and an online community function.

The daily sleep diary function can support insomnia treatment by progress tracking and through tailored advice. The diary can be filled out manually, or data can be pulled from wearable devices such as a FitBit.

Clinical evidence presented to NICE’s medical technologies advisory committee from 12 randomised controlled trials showed that Sleepio is an effective form of insomnia treatment and reduced the condition more than sleep hygiene and sleeping pills.

Jeanette Kusel, acting director for MedTech and digital at NICE, said: “Until now, people with insomnia have been offered sleeping pills and taught about sleep hygiene, so our committee’s recommendation of Sleepio provides GPs and their patients with a new treatment option.

“Our rigorous, transparent and evidence-based analysis has found that Sleepio is cost saving for the NHS compared with usual treatments in primary care. It will also reduce people with insomnia’s reliance on dependence forming drugs such as zolpidem and zopiclone.

Cost-saving for the NHS

Sleepio costs £45 (excluding VAT) per person who starts session one of the insomnia treatment. The app is cost-effective when compared to usual insomnia treatment in primary care. This is based on an analysis of primary care resource use data before and after Sleepio was introduced in nine GP practices.

NICE recommends a medical assessment should be carried out before a referral to Sleepio during pregnancy and in people with comorbidities. Pregnant women should undergo further assessment as insomnia can mimic conditions such as restless legs.

Furthermore, the committee recommends additional research or data collection to show how effective Sleepio is compared with face-to-face CBT-I.

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