OBJECTIVES

Access to non-pharmacological interventions for insomnia is limited, despite evidence for their effectiveness. This is due in part to a shortage of trained providers. Digital cognitive behavioural therapy for insomnia (dCBT-I), which requires less input per session, is therefore an attractive complement or substitute to face-to-face cognitive behavioural therapy. Sleepio is a self-help programme for sleep improvement, which has been shown to improve sleep quality. However, there is little evidence available regarding its impact on health care use. In this study, we sought to identify whether providing access to Sleepio results in a change in the trend of patients' primary care costs.

METHODS

The study adopted a before and after quasi-experimental design alongside population-wide rollout of Sleepio in a region of England. A segmented regression analysis of the interrupted time series data was used to estimate the change in trend of the average primary care costs per patient per week. Data were collected from two sources: i) primary care providers, and ii) Sleepio user data collected through the app. Interim results are presented, based on data from 12 months pre-intervention (October 2017) to 6 months post-intervention (May 2019).

RESULTS

More than 6,000 individuals used the Sleepio service, with around a third converting to dCBT-I and gaining 30 minutes extra sleep per night, on average. Of dCBT-I users within the clinical range on the Sleep Condition Indicator, 42% moved to a non-clinical range. Preliminary results show that people with a diagnosis of insomnia who were referred to Sleepio had a lower rate of hospital referrals and hypnotics prescriptions.

CONCLUSIONS

Interim findings show that population rollout of Sleepio may be effective in improving sleep for people with clinically significant sleep problems, and that this is associated with changes in health service use that may be cost-saving.