Insomnia, a sleeping disorder that causes habitual sleeplessness or the inability to sleep, poses a threat to most adults due to its common occurrence.
A sleep app that offers a digital six-week treatment program could be used to replace sleeping pills for people suffering from insomnia.
The proposed Sleepio app uses an artificial intelligence (AI) algorithm to provide individuals with tailored cognitive behavioral therapy for insomnia (CBT-I).
The National Institute for Health and Care Excellence (NICE) said it would save Britain's National Health Service (NHS) money as well as reduce prescriptions of medicines such as zolpidem and zopiclone, which can be dependency forming.
Their economic analysis found that the health care costs were lower after one year of using Sleepio, mostly because of fewer general physician (GP) appointments and sleeping pills prescribed.
The app provides a digital six-week self-help program involving a sleep test, weekly interactive CBT-I sessions, and keeping a diary about their sleeping patterns. The sessions focus on identifying thoughts, feelings, and behaviors that contribute to the symptoms of insomnia.
Cognitive interventions aim to improve the way a person thinks about sleep and behavioral interventions aim to promote a healthy sleep routine.
The NICE predicts that up to 800,000 people could benefit from using Sleepio in England. The program is designed to be completed in six weeks but people have full access to the program for 12 months from registration. This allows people to complete the sessions at their own pace and revisit sessions.
Participants can also access electronic library articles and online tools and join the online Sleepio user community for support. A daily sleep diary helps users track their progress and the program 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 randomized controlled trials showed that Sleepio is more effective at reducing insomnia 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."
The cost of Sleepio is £45 ($56) (excluding VAT) per person, however, NICE says that Sleepio is cost-saving compared with usual treatment in primary care. This is based on primary care resource use data analysis before and after Sleepio was introduced in nine GP practices.
The independent NICE committee has recommended a medical assessment should be done 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.
They have also recommended more research or data collection to show how effective Sleepio is compared with face-to-face CBT-I.
