Doctors should offer insomnia patients access to an app rather than sleeping pills, according to new guidance.
Around 800,000 people in England struggling to sleep, who would usually be offered pills such as zolpidem and zopiclone, are set to be recommended Sleepio.
The app provides people with a six-week self-help programme, including a sleep test, weekly therapy sessions and a diary for patients to log their sleeping patterns.
The National Institute for Health and Care Excellence (NICE), which produces guidelines for medics, said the move will prevent people becoming hooked on 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 for 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 struggling to sleep, who would usually be offered pills such as zolpidem and zopiclone, are set to be recommended Sleepio. The app provides people with a six-week self-help programme, including a sleep test, weekly therapy sessions and a diary for patients to log their sleeping patterns
What is insomnia?
People with insomnia have difficulty sleeping.
The problem, which affects one in six Britons, can usually get better if sufferers change their sleeping habits.
Symptoms include finding it hard to sleep, waking up several times in the night, waking up early and struggling to get back to sleep.
It can be triggered by stress, anxiety or depression, noise, a room that is too hot or cold, an uncomfortable bed, shift work, alcohol, caffeine or nicotine, as well as recreational drugs.
Adults need seven to nine hours of sleep per night.
Insomnia a can be short term – lasting three months or less or long-term if it persists for more than 12 weeks.
Treatments include cognitive behavioural therapy (CBT) sessions with a therapist, which can help change thoughts and behaviours that stop people from sleeping.
GPs rarely prescribe sleeping pills over concerns about their side effects and drug dependency.
Sleepio uses an artificial intelligence algorithm to provide people with tailored digital cognitive behavioural therapy.
These sessions identify thoughts, feelings and behaviours that stop people from sleeping and promotes a healthy sleep routine.
Patients can also access electronic articles, online tools and talk to other users for support.
The programme is designed to be completed in six weeks but people have full access to the programme for 12 months from registration, so they can complete it at their own pace and revisit sessions.
Patients can access Sleepio through a self-referral or their GP.
The app was crafted by Big Health, a firm co-founded by Oxford University sleep expert Professor Colin Espie.
Evidence from 12 randomised trials, examined by NICE, showed that the app is more effective at reducing insomnia than sleeping pills.
A two to four-week course of prescription-only tablet zolpidem or zopiclone, which cost as little as 9p per pill, is currently offered to insomnia patients.
But they often make patients tired in 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 analysis of costs at nine GP practice in England, where the app was trialled for one year, showed it saved the NHS £90 per patient over three years.
However, the NICE guidance notes that GPs should complete a medical assessment before referring pregnant patients and those with multiple underlying conditions to the app, in case they are suffering from other complications that mimic 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 app for anxiety Daylight, have been available at all 14 NHS trusts in Scotland since October, prompting warnings at the time of a ‘postcode lottery’ of care for patients across the UK.
Ms Kusel 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.
‘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.’
Professor Guy Leschziner, consultant neurologist at King’s College London, said cognitive behavioural therapy for insomnia ‘has been shown as being as effective as drugs, with some evidence that duration of effectiveness is longer’.
‘Additionally it does not risk adverse effects as some drugs do,’ he said.
The app provides a ‘much broader reach and accessibility’ than current therapy treatments, Professor Leschziner added.