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Up to 800,000 drug-dependent insomniacs can now get an app that helps them fall asleep more easily

Doctors should offer insomnia patients access to an app instead of sleeping pills, according to new guidance.

Around 800,000 people in England who struggle to sleep, who are normally offered pills such as zolpidem and zopiclone, will be recommended Sleepio.

The app provides people with a six-week self-help program, which includes 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 will prevent people from getting 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 prescribing fewer pills.

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 who struggle to sleep, who are normally offered pills such as zolpidem and zopiclone, will be recommended Sleepio.  The app provides people with a six-week self-help program, which includes a sleep test, weekly therapy sessions, and a diary for patients to record their sleep patterns.

Around 800,000 people in England who struggle to sleep, who are normally offered pills such as zolpidem and zopiclone, will be recommended Sleepio. The app provides people with a six-week self-help program, which includes a sleep test, weekly therapy sessions, and a diary for patients to record their sleep patterns.

What is insomnia?

People with insomnia have difficulty sleeping.

The problem, which affects one in six Britons, can usually improve if sufferers change their sleeping habits.

Symptoms include difficulty falling asleep, waking up multiple times during 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 too cold, an uncomfortable bed, shift work, alcohol, caffeine or nicotine, as well as recreational drugs.

Adults need seven to nine hours of sleep a night.

Insomnia can be short-term, lasting three months or less, or long-term, lasting more than 12 weeks.

Treatments include cognitive behavioral therapy (CBT) sessions with a therapist, which can help change the thoughts and behaviors that keep people from sleeping.

GPs rarely prescribe sleeping pills because of concerns about their side effects and drug dependency.

Sleepio uses an artificial intelligence algorithm to provide people with personalized digital cognitive behavioral therapy.

These sessions identify thoughts, feelings and behaviors that prevent people from sleeping and promote a healthy sleep routine.

Patients can also access e-articles, online tools, and talk to other users for help.

The program is designed to be completed in six weeks, but individuals 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 through a self-referral or through 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, costing as little as 9 pence per pill, is currently offered to insomnia patients.

But they often make patients feel tired during the day, have a dry mouth, or a metallic taste in their mouth. The drugs can also cause serious side effects, including falls, memory loss, and hallucinations.

And cost analysis in the practice of nine GPs in England, where the app was tested for a year, showed it saved the NHS £90 per patient over three years.

However the Nice orientation notes that GPs should complete a medical evaluation before referring pregnant patients and those with multiple underlying conditions to the app, in case they suffer from other complications that mimic insomnia.

One in six Britons suffer from sleep problems, and stress, anxiety and depression are often to blame.

And almost one in 10 suffer from anxiety, according to charities.

Sleepio, and its sister anxiety app Daylight, have been available on all 14 NHS trusts in Scotland since October, prompting warnings at the time of a UK-wide patient care ‘postcode lottery’.

Ms Kusel said: ‘Until now, people with insomnia have been offered sleeping pills and taught about sleep hygiene.

“So our committee’s Sleepio recommendation gives GPs and their patients a new treatment option.

‘Our rigorous, transparent and evidence-based analysis has found that Sleepio is a cost saver for the NHS compared to usual treatments in primary care.

“It will also reduce the dependency of people with insomnia on dependency-forming drugs such as zolpidem and zopiclone.

‘This is a good example of how digital health technology can help the NHS.

“Evidence has shown that use of Sleepio reduces the number of GP appointments needed by people with insomnia and will also reduce the number of sleeping pill prescriptions dispensed 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 of longer duration of effectiveness.”

“Also, you don’t run the risk of adverse effects like some medications do,” he said.

The app provides a “much broader scope and accessibility” than current therapy treatments, Professor Leschziner added.

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