by Rose de Mendonca – 11th June, 2019

I’ve struggled with sleep for a long time. Lying in bed, watching the minutes go by as my brain wriggles around and fails to get comfortable, followed by a day of baggy eyes and sleep-deprived misery has been my rhythm for at least the last three years.

I spend the day after a poor night of sleep propped up on sugary snacks and caffeine (which of course doesn’t make for a good sleep later), lacking concentration, and praying for it to be over quickly. When I get home from work, without the energy and mindset to do much else, I scroll mindlessly through Instagram or watch TV until it’s time to go to bed and repeat the cycle. And so the days go by.

“I didn’t sleep last night” 101

Until recently, I never saw my poor sleep as a health problem, but as a par-for-the-course side issue which I didn’t have any control over. But when I came across a video of the CEO of Pzizz talking about sleep, I discovered that I could do something about it, and in fact there was a whole subset of the healthtech industry dedicating effort to just that.

Almost a third of us suffer from poor sleep – whether it be insomnia or something else – on a regular basis[1]. This is a big number, and the impacts go beyond feeling a bit (or a lot) crabby. Persistent sleep deprivation can affect how sufferers feel about their life, their work, and their relationships, and their mental health state can subsequently suffer. We might not talk about it much, but poor mental health is closely related to poor physical health[2], so sleep issues can actually be quite a big problem for society as a whole.

Eventually, on the recommendation of a colleague, I decided to download the Sleepio app. Poor sleep seemed too trivial to visit my GP about, I didn’t want to take medication, and, quite frankly, living in central London meant I didn’t have spare cash to throw at psychologists, so an app that I could access at my own convenience seemed perfect.

For those of you not familiar with it, Sleepio is a free (bingo!) NHS approved (double bingo!) app, that helps users improve their sleep through a six-week programme of Cognitive Beheavioral Therapy (CBT).

 

How can an app possibly unseat a years-long sleep problem?

“CBT works on the basis that how we think (cognitions), how we feel (emotion) and how we act (behaviour) are all interconnected,” says Zabair Hussain, Cognitive Behavioural Psychotherapist at Dr Julian, an online therapy provider working with the NHS. “It looks at how negative thoughts and feelings can trap you in a vicious cycle and unhelpful behaviours. Although CBT is a talking therapy it’s also very much a ‘doing’ therapy. There are weekly homework tasks which focus on practical ways to deal with your problems, and the techniques can also be used in other parts of your life.” Ultimately, CBT can help people challenge unhelpful thoughts and behaviours and reduce psychological distress around a particular issue or issues.

During the Sleepio course, every week you watch a short film from Sleepio’s sleep expert, “The Prof”, who talks you through some facts about sleep and techniques to help you improve yours. Every film guides you to make small changes in your sleep routine and schedule, which add up to a bigger change overall. 

Professor Colin Espie, Co-Founder and Chief Medical Officer at Big Health, which developed the Sleepio app explains that Sleepio is all about “getting a good natural connection with your sleep once again.” He says that “once you’ve learnt those techniques in CBT, they can last a lifetime.” The app has been clinically proven to work and has been tested using placebo-controlled clinical trials, which Professor Espie says show that 75% of even the poorest sleepers make very significant improvements.

I’m not going to lie, I was initially sceptical, and following the course was tough going at times. Trying sleeping with one less pillow? Not such a hardship. Engaging in elaborate imaginings about my dream holiday to displace anxious thoughts? Fine! But getting up and out of bed at 2am because I couldn’t sleep and having to stay up until I felt sleepy again? No thanks (for your info, it took 1.5 hours). Having to get out of bed at a much earlier time every day, even on weekends? Sigh. My poor colleagues got a blow-by-blow account of my previous night’s sleep every morning over a cup of tea, until after just two weeks, with a little backup guidance from the Headspace app, it started to work.

 

I liked the fictional “Prof” character, and how he even addressed me by name

The verdict

For me, the pros of Sleepio being convenient and actually making a difference far outweigh the minor cons of a slightly buggy app, and the assumption that you will hold yourself accountable for visiting The Prof each week. I honestly do feel that my sleep has improved and is much more consistent now that I’ve completed the course. 

I did struggle the first few days of getting up at the crack of dawn, and it took me well over the prescribed six weeks to complete the programme because I didn’t have a physical appointment to ensure I toed the line. But in the end, the commitment to myself, my slightly weird desire to please the fictional Prof, and my guilt when I lay in, outweighed the temporary desire to hit snooze and snuggle down when the alarm went off.

 

Pros

  • It worked!
  • It’s NHS approved, and free if you live in London
  • Anyone can use it from anywhere, so it’s super convenient
  • Because it uses pre-recorded, standard formats, it doesn’t require extra staff-power on the NHS side to run it

 

Cons

  • The app is a bit buggy
  • Some functionality is only accessible through a browser
  • It’s not available on the NHS in all parts of the country yet
  • I found it hard to hold myself accountable for doing each session on time

I finally started to break the cycle of poor sleep using cognitive behavioural therapy techniques I learnt through the Sleepio app

If I can get help to solve an ongoing problem I’ve had with my sleep, I can’t help but think “why can’t it work for other areas of my life?” The fact is, it can. The behavioural change techniques used by Sleepio are already being used by other platforms designed to help us look after ourselves better. Changing Health for example, helps people with or at risk of type 2 diabetes to change their behaviour around food. My Possible Self helps people suffering from anxiety to challenge negative thoughts and could potentially prevent a decline in mental health. Smoke Free helps people who want to quit smoking quit for good. The list goes on: our health is in the palm of our hands, if we want it.

Accessing health services is something all of us need to do at some point in our lives. But not all of our problems need an in-person interaction to solve them – there are many cases where we can look after ourselves and improve our health and wellbeing, given the right tools. Perhaps this is something we can all play our part in, and help ourselves before the NHS needs to.

Follow Rose on Twitter and Instagram @deMenRo

 

Useful information

  • The Sleepio programme is based on Cognitive Behavioural Therapy (CBT) and is backed by gold-standard research evidence. It involves working on four key areas: your thoughts and worries about sleep, your night time sleep schedule, your lifestyle, and your bedroom: sleepio.com/nhs
  • Pzizz uses “psychoacoustic” principles to create soundscapes that it claims help you fall asleep, stay asleep, and wake up feeling refreshed: pzizz.com 
  • Headspace provides guided meditation and mindfulness so more people can experience the benefits anytime, anywhere. It is currently working on producing clinically-validated research on the product: headspace.com
  • Dr Julian, Changing Health, My Possible Self, and Smoke Free are all graduates of, or current participants in, the DigitalHealth.London Accelerator. The programme supports digital health innovators over a 12 month period, supporting them to understand and navigate the NHS more effectively, so that patients can benefit from digital technologies more quickly: digitalhealth.london/accelerator
  • The NHS Apps Library is one place to find health apps that could help you manage your health better: nhs.uk/apps-library

References

[1] https://www.sleepcouncil.org.uk/wp-content/uploads/2013/02/The-Great-British-Bedtime-Report.pdf

[2] https://www.mentalhealth.org.uk/a-to-z/p/physical-health-and-mental-health

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