NICE guidance on insomnia backs app to replace sleeping pills

Hundreds of thousands of people with insomnia could be offered treatment via a mobile phone app instead of prescriptions for sleeping pills under updated guidance from NICE.

Man sleeping
(Photo: Tom Merton/Getty Images)

NICE's medical technology advisory committee backed use of an app to treat insomnia after evidence from 12 randomised controlled trials found it was more effective than treatment with 'sleep hygiene' - addressing habits and environmental factors that can prevent sleep - and sleeping pills.

As many as 800,000 people in England with insomnia could be offered a treatment programme via the Sleepio app, in a move NICE says could save the NHS money as well as improving treatment.

NICE's guidance said the app's cost of £45 plus VAT per person who starts session one of the programme meant it was 'cost saving for the NHS compared with usual treatments in primary care'.

Sleeping pills

Reducing prescriptions for sleeping pills will also reduce numbers of patients who come into contact with 'dependence forming' drugs such as zolpidem and zopiclone, the institute said.

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.

'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.'

Analysis carried out in the assessment of the app found that healthcare costs were lower at one year when using Sleepio compared with other treatments, 'mostly because of fewer GP appointments and sleeping pills prescribed'.

Digital CBT

The app uses an algorithm to provide users with 'tailored digital cognitive behavioural therapy for insomnia (CBT-I)' in a six-week programme that includes 'a sleep test, weekly interactive CBT-I sessions and keeping a diary' about sleep patterns.

NICE has warned that people who are pregnant and those with comorbidities should be medically assessed before being advised to use the app to rule out conditions other than insomnia or undiagnosed sleep apnoea.

The NICE committee has also called for more research or data collection to compare use of an app with face-to-face CBT-I.

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