Doctors should offer insomniac patients access to an app rather than sleeping pills, according to new guidelines.
Around 800,000 people in England with difficulty sleeping, who would typically be offered pills such as zolpidem and zopiclone, should be recommended Sleepio.
The app offers users a six-week self-help program, including a sleep test, weekly therapy sessions, and a diary for patients to record their sleep patterns.
The National Institute for Health and Care Excellence (NICE), which produces guidelines for doctors, said the move would prevent people from becoming addicted to powerful drugs.
The app, which has been described as a digital sleeping pill, is expected to save the NHS money due to fewer GP appointments and fewer pills being prescribed.
Jeanette Kusel, acting director of MedTech and digital at NICE, said Sleepio, which costs £45 per patient, is a “good example” of how digital health technology can help the NHS.
Around 800,000 people in England with difficulty sleeping, who would typically be offered pills such as zolpidem and zopiclone, should be recommended Sleepio. The app offers users a six-week self-help program, including a sleep test, weekly therapy sessions, and a diary for patients to record their sleep patterns.
What is insomnia?
People with insomnia have trouble sleeping.
The problem, which affects one in six Britons, can usually improve if sufferers change their sleep habits.
Symptoms include difficulty sleeping, waking up multiple times in the night, waking up in the morning, and difficulty going back to sleep.
It can be triggered by stress, anxiety or depression, noise, a room that is too hot or too cold, an uncomfortable bed, shift work, alcohol, caffeine or nicotine, and recreational drugs.
Adults need seven to nine hours of sleep per night.
Insomnia may be short term – lasting three months or less, or long term if it persists for more than 12 weeks.
Treatments include cognitive behavioral therapy (CBT) sessions with a therapist, which can help change thoughts and behaviors that keep people up at night.
General practitioners rarely prescribe sleeping pills due to their side effects and drug addiction.
Sleepio uses an artificial intelligence algorithm to provide people with tailored digital cognitive behavioral therapy.
These sessions identify the thoughts, feelings and behaviors that keep people up at night and promote a healthy sleep routine.
Patients can also access electronic articles, online tools, and talk to other users for help.
The program is designed to be completed in six weeks, but people have full access to the program for 12 months from registration, so they can complete it at their own pace and revisit sessions.
Patients can access Sleepio via self-referral or their GP.
The app was designed by Big Health, a company co-founded by Oxford University sleep expert Professor Colin Espie.
Evidence from 12 randomized trials, reviewed by NICE, showed that the app is more effective at reducing insomnia than sleeping pills.
A two to four week course of prescription-only zolpidem or zopiclone tablets, which cost just 9p per tablet, is currently offered to patients with insomnia.
But they often tire patients during the day, have a dry mouth or a metallic taste in the mouth. The drugs can also cause serious side effects, including falls, memory loss, and hallucinations.
And cost analysis at nine GP practices in England, where the app was tested for a year, showed it saved the NHS £90 per patient over three years.
However, NICE guidelines state that GPs should conduct a medical assessment before referring pregnant patients and those with multiple underlying conditions to the app, in case they suffer from other complications mimicking insomnia. .
One in six Britons suffer from sleep problems, with stress, anxiety and depression often to blame.
And nearly one in 10 suffer from anxiety, according to charities.
Sleepio and its sister anxiety app Daylight have been available in all 14 NHS trusts in Scotland since October, triggering warnings amid a care ‘postcode lottery’ for patients across the UK .
Ms Kusel said: ‘So far people with insomnia have been offered sleeping pills and told about sleep hygiene.
“Thus, the recommendation of Sleepio by our committee offers GPs and their patients a new treatment option.
“Our rigorous, transparent and evidence-based analysis found that Sleepio is a cost saver for the NHS compared to standard primary care treatments.
“It will also reduce the reliance of people with insomnia on addictive drugs such as zolpidem and zopiclone.
“It’s a great example of how digital health technology can help the NHS.
“Evidence has shown that using Sleepio reduces the number of GP appointments for people with insomnia and will also reduce the number of prescriptions for sleeping pills issued by pharmacists.”
Professor Guy Leschziner, a consultant neurologist at King’s College London, said cognitive behavioral therapy for insomnia “has been shown to be as effective as medication, with some evidence that the duration of effectiveness is longer”.
“Plus, it doesn’t risk side effects like some medications do,” he said.
The app offers a “much wider reach and accessibility” than current therapeutic treatments, Professor Leschziner added.