Combining Big Health’s digital therapeutic for insomnia and IAPT therapy improves mental health

Big Health, a digital therapeutics company dedicated to helping millions back to good mental health, and the Oxford Health NHS Foundation Trust today announced a joint study published in the Behavior Research and Therapy journal showing almost two-thirds [65 percent] of people seeking treatment for anxiety or depression and who had sleep difficulty saw their mental health improve substantially more by combining enrollment in Sleepio, Big Health’s digital therapeutic for insomnia, with NHS Improving Access to Psychological Therapies programme (IAPT) care, when compared to IAPT care alone. Additionally, participants using Sleepio reduced their utilization of high-intensity IAPT treatment, including personalized therapy delivered by mental health professionals.

The study was a key part of a wider population mental health programme enabling any adult in the Thames Valley to access Sleepio through self-referral, general practitioner (GP) prescription, and mental health services. It was funded by a UK Research and Innovation grant, delivered with the Oxford Academic Health Science Network, and was hosted through NHS services, specifically Healthy Minds Bucks, the Buckinghamshire, England IAPT service.

To better understand the impact of incorporating Sleepio into a psychological therapies stepped-care model, researchers tracked more than 1,000 IAPT patients who had sleep and mental health issues. Half enrolled in Sleepio alongside NHS IAPT services. The control group did not access Sleepio. After 12 months, Sleepio users experienced significantly better outcomes in mood, anxiety, and social functioning. Recovery rates from standardized IAPT measures used to capture symptoms of anxiety (GAD-7) and depression (PHQ-9) were 65 percent for Sleepio users, versus 58 percent in the control group who received IAPT alone.

“We are proud to collaborate with Big Health on this innovative study, which shows the opportunity to further improve clinical outcomes through integration of a digital therapeutic for insomnia and evidence based psychological therapy for anxiety and depression,” said Dr. John Pimm, Clinical lead of Healthy Minds Bucks, the Buckinghamshire IAPT service, provided by Oxford Health NHS Foundation Trust. “Recovery rates for people with anxiety and depression receiving IAPT care in England are already good - however, we have found that we can improve them further with this additional digital intervention. Reflecting on the pandemic, increasingly we'll need more scalable, evidenced digital interventions to augment our services, making care more efficient and effective.”

Poor sleep is rarely specifically addressed in primary care or mental health services, but clinical evidence shows that insomnia significantly impacts comorbid mental health conditions including depression and anxiety. According to leading treatment guidelines, including the National Institute for Health and Care Excellence(NICE), cognitive behavioral therapy (CBT) is recommended as the first line treatment for insomnia; however, the vast majority of patients are given medications or a long waiting list for therapy. Leading programmes, including Big Health’s Sleepio, deliver CBT in a digital format, providing 24/7 access to gold-standard treatment regardless of clinical setting. Sleepio’s approach is validated through industry-leading clinical evidence, including 12 randomized controlled trials, and NICE accreditation. Through the study, the Healthy Minds Bucks IAPT service sought to understand how integrating Sleepio into a psychological therapies stepped-care model would impact mental health outcomes within the service.

“This study represents Big Health’s unique ability to reach users across the clinical care pathway,” said Dr. Colin Espie, Big Health Co-Founder and Chief Scientist, and Professor of Sleep Medicine at the University of Oxford.

By supplementing existing clinical care with access to personalized and evidenced-based digital therapeutics, we can reach people with the right approach and at the right time to maximize outcomes.

Dr. Colin Espie, Co-Founder and Chief Scientist, Big Health

The IAPT programme in England assesses approximately one million people each year and offers evidence-based psychological interventions, primarily for diagnoses of anxiety and depression. These services utilize a stepped-care model whereby most patients begin with a low-intensity intervention, such as a psychoeducation group. People with greater needs can be ‘stepped up’ to individual weekly therapy sessions or more intensive interventions. The NHS Long Term Plan is focused on expanding mental health services so that 1.9 million adults access treatment each year, integrating physical and mental health care, improving employment outcomes, and improving equitable access to care.

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