NICE recommends app-based Sleepio for insomnia instead of sleeping pills
In 2022 guidance, NICE (National Institute for Health and Care Excellence) recommended that the 100s of 1000s of people who experience insomnia should be offered an App-based treatment costing £45 rather than the commonly prescribed sleeping pills.
Sleepio is seen by NICE as an effective alternative to sleeping pills. The benefits would both save the NHS money as well as reduce the use of habit-forming medications such as zolpidem and Zopiclone. At one year, Sleepio saved money both due to lower prescriptions and also due to few GP appointments.
Sleepio uses an artificial intelligence (AI) algorithm to provide people with tailored digital cognitive behavioural therapy for insomnia (CBT-I). Up to 800,000 people could benefit from using Sleepio in England.
The app is a digital six-week self-help programme involving a sleep test, weekly interactive CBT-I sessions and keeping a sleeping pattern diary. Users have access to the programme for 12 months from registration. This allows people to complete the sessions at their own pace and revisit sessions. There are also electronic library articles, online tools and the online Sleepio user community for support.
The programme tailors advice to individuals. Users can fill in the diary manually or the data can be automatically uploaded from a compatible wearable tracking device, like an Apple watch or Fitbit.
Clinical evidence presented to NICE’s medical technologies advisory committee from 12 randomised controlled trials showed that Sleepio is more effective at reducing insomnia than sleep hygiene and sleeping pills.
“This is a good example of where a digital health technology can help the NHS. The evidence has shown using Sleepio reduces the number of GP appointments people with insomnia need and will also cut the number of prescriptions for sleeping pills delivered by pharmacists” says Jeannette Kusoo, NICE’s acting director for MedTech and digital
NICE recommends medical assessment before referral to Sleepio during pregnancy and in people with comorbidities. Pregnant women should undergo an assessment because insomnia can mimic other conditions like restless legs, or it could be a consequence of undiagnosed sleep apnoea.
NICE also recommend more research or data collection to show how effective Sleepio is compared with face-to-face CBT-I. In 2015, research from Northumbria University suggested that a one hour session of CBT were cured after a one hour session withing three months (https://www.northumbria.ac.uk/about-us/news-events/news/2015/06/73-of-insomniacs-cured-after-1-hour-therapy-session/0)
See https://www.nice.org.uk/guidance/mtg70 for the full medical guidance