Effective Digital Cognitive Behavioural therapy for Insomnia and Anxiety
Chronic insomnia, defined as difficulty sleeping for 3 nights a week for 3 months or more, affects one in ten adults and a significantly greater proportion of those with long-term health conditions. Cognitive Behavioural Therapy (CBT) is recommended as the first-line treatment for insomnia in adults, by helping people to develop coping strategies and change unhelpful thought patterns and behaviours. However, insufficient numbers of trained therapists, intervention costs and perceived stigma limit access to CBT. Digital CBTs (dCBT) overcome such barriers because digital devices are widespread, enabling effective therapy to be accessed discreetly, immediately and at low cost. ‘Sleepio’ is a fully automated, interactive web-based dCBT to address insomnia that was initially developed by Professor Colin Espie before he moved to the University of Oxford at the start of 2013. Since then, Colin and colleagues in Oxford have further developed the content of Sleepio and have demonstrated its wide-ranging beneficial effects in randomised controlled trials.
Generalised anxiety disorder is a condition involving excessive anxiety and worry, affecting 5-8% of the population. CBT is the recommended treatment for GAD, but is limited by the same stigma and access challenges as CBT for insomnia. The University of Oxford team conducted the first RCT of Daylight, a new web and mobile dCBT, developed to treat moderate-to-severe symptoms of GAD at scale. To meet this scale of adoption, Both Sleepio and Daylight have been developed for market by Big Health, a company that Colin Espie co-founded.
Research has shown that Sleepio and Daylight are effective and can be used as scalable interventions with wide ranging effects on mental health, wellbeing and workplace productivity. These digital CBTs have been widely used across the UK since October 2018 to help more than 21,000 people, including NHS and social care staff during the COVID-19 pandemic, improve their sleep, wellbeing and mental health. Since June 2019 and July 2020 respectively, Sleepio and Daylight have been made available through health insurers and occupational health programmes in the US and used by thousands of employees across 42 employers to improve workforce health and productivity.