There are many reasons people do not get enough sleep, but it is often related to lifestyle. So many of us have difficulty switching off before we go to sleep, and modern technology doesn’t help.

Finishing a movie or binge-watching one more episode of a series can mean staying up later than we planned. Checking our mobile phones just before we go to sleep—and even checking for phone messages in the middle of the night–all contribute to preventing us from switching off and winding down ready for bed.

But it is hoped that digital technology can now help people sleep in the form of an App called Sleepio. That will now be prescribed by GPs and it is hoped it will replace sleeping pills and other medication.

Often, when people are having difficulty sleeping, they are first advised to implement sound sleep hygiene—this means changing their night-time routine to aid sleep.

Typically, this will involve making sure you wind down at night and making your bedroom a more conducive place to fall asleep. For example, the NHS website recommends the following: Caffeine, alcohol, and nicotine should be limited or avoided before bedtime; avoid eating too close to bedtime; keep the bedroom quiet, dark, and at a comfortable temperature; and only use the bedroom for sleeping.

Other advice includes keeping electronic devices such as computers, tablets, and TVs out of the bedroom and decluttering, so the bedroom is peaceful and calm. Have a wind-down routine you follow each night to prepare your body and mind for bed—this could be a hot drink peaceful reading a book for 30 minutes or gentle stretching. Many people find improving their night-time routine helps sleep, but for those with insomnia, who still cannot sleep, the options become more limited.

For more severe insomnia, sedative tablets are an option, but they come with their own issues. Sleeping tablets may help you sleep, but it is not quite the same as natural sleep, and they can have a drowsy effect on you the next day. In general, most doctors feel they should not be used long term. Coming off sleeping tablets can also be an issue, and many people can become dependent on them and develop an addiction.

For insomniacs, advice about sleep hygiene and sleeping tablets has been the mainstay of treatment for decades. Now the mobile phone might help sleep rather than hinder it. The National Institute for Health and Care Excellence (NICE) which reviews medical treatments in the UK has announced it is recommending a £45 App-based treatment programme (Sleepio) on the NHS instead of sleeping tablets.

Trials showed the App was more effective at reducing insomnia than sleep hygiene and sleeping pills and that it reduced reliance on dependence-forming sleeping pills and GP visits, meaning it also has cost-saving benefits for the NHS.

Sleepio is a 6-week digital self-help programme that uses an AI algorithm that provides tailored cognitive behavioural therapy for insomnia (CBT-I). The App provides a self-help programme involving a weekly sleep test, interactive CBT-I sessions that focus on identifying thoughts and feelings that contribute to insomnia, and a sleep diary.

Cognitive interventions are designed to improve how a person thinks about sleep, and behavioural interventions aim to promote a beneficial sleep routine. The programme is designed to be used over a 6-week period, but patients will have access to it for 12 months.
The effectiveness of Sleepio in treating insomnia will continue to be monitored.

However, NICE is recommending that GPs prescribe it for sleeping issues in patients whom they feel it could benefit. This App represents a major change in the treatment of insomnia and is part of a growing trend of using digital technology to monitor and improve health.

(Photo: Sleepio App)
Rachel Kayani