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Sleepio to treat insomnia symptoms

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1 Recommendations

1.1 Sleepio shows promise for treating insomnia symptoms in primary care for people who would have usual treatment (sleep hygiene or sleeping pills). But there is uncertainty about whether it will be cost saving for the NHS.

1.2 Clinical evidence shows that Sleepio reduces insomnia symptoms compared with usual treatment. But cost models show that Sleepio is £16 more expensive than usual treatment at 1 year. This could result in a high total cost to the NHS. But Sleepio could be cost saving over a 3-year period if the longer-term benefits of using the technology can be shown.

1.3 Real-world evidence collection is recommended to show that the patient benefits and resource savings observed at 65 weeks also apply at 3 years. Find out more in the section on further research.

1.4 Sleepio is not recommended for people with insomnia symptoms who would be eligible for face-to-face cognitive behavioural therapy for insomnia (CBT-I) in primary care. This is because there is not enough clinical evidence to show how effective Sleepio is compared with face-to-face CBT-I.

Why the committee made these recommendations

Usual treatment for insomnia symptoms is sleep hygiene and sleeping pills. People with insomnia that persists after usual treatment are referred for face-to-face CBT-I.

Sleepio is a digital self-help programme that includes CBT-I. It could increase patient access to CBT-I. It also increases the options available to primary care practitioners when treating insomnia.

Clinical evidence shows that Sleepio reduces insomnia symptoms compared with usual treatment. But because there is no direct evidence about its effectiveness compared with CBT-I, it is not supported for people who would be eligible for CBT-I.

Cost modelling shows reduced healthcare costs at 65 weeks, mostly because of reduced GP appointments and sleeping pills prescribed. But there is an overall cost to the NHS at this point because of the price of the technology. To be cost saving, Sleepio would need to reduce healthcare costs for at least 3 years. So, evidence collection for at least 3 years is recommended.