Insomnia disorder (also known as chronic insomnia) is a sleep-wake disorder that involves a difficulty falling asleep, waking up too early and being unable to go back to sleep, or a complaint with sleep quality. Studies found that about 30-35% of the general population presents with at least one insomnia symptom, making it the most common sleep difficulty. One article reviewing the literature on the consequences of sleep disruption found that, in the short term, sleep disruption can contribute to psychological distress, including depression and anxiety symptoms. In the long term, individuals with disrupted sleep are at greater risk of having conditions such as type 2 diabetes, cardiovascular disease, high blood pressure, and colorectal cancer. Thus, it is necessary to explore options for accessible and effective treatments.

Sleepio is a digital program, available on desktop and mobile devices, designed by Big Health as a treatment for insomnia disorder in English-speaking adults. The program is based on cognitive behavioral therapy for insomnia (CBT-I). CBT-I involves concrete strategies such as sleep restriction, reinforcing the association between the bed and sleep, sleep hygiene, addressing dysfunctional beliefs about sleep, and relaxation techniques. Sleepio includes six weekly sessions, each taking about 20 minutes to complete, with skill practicing between the sessions and a short sleep diary to complete daily. The program is tailored to the user’s characteristics. For individuals diagnosed with an insomnia disorder, it is recommended to have medical supervision during program use. On the other hand, people with self-identified sleeping difficulty can use the program without supervision. Regarding availability, their website only specifies that “Sleepio is available at no cost as a covered benefit by many employers and health plans.” Clicking on the “Am I covered?” button gives you three choices: “USA”, “UK”, and “Another Country”. After contacting the company, they confirmed that there is no out-of-pocket option for purchasing the Sleepio program (the communication took place in October 2023).

Multiple clinical trials have been conducted to evaluate the effectiveness of Sleepio in reducing insomnia symptoms and in improving other health-related areas. A 2019 randomized clinical trial conducted with 1711 participants found that Sleepio was successful in gradually reducing insomnia symptoms, which in turn led to improvements in functional health, well-being, and sleep-related quality of life. More recently, a 2021 observational study found that Sleepio was efficacious in reducing anxiety and depressive symptoms, while also improving social and work functioning. Overall, research supports the effectiveness and safety of the Sleepio digitized CBT-I program for relieving users of insomnia while also enhancing their overall health.

Using sleep restriction, meaning limiting the number of hours spent in bed to only those spent sleeping, could potentially result in less hours slept per night. For this reason, Sleepio’s website warns of a risk of excessive daytime sleepiness, which could especially affect certain groups of people, such as those working night shifts or diagnosed with narcolepsy. The website also points to the need for pregnant users to be mindful of maintaining a minimum of 6 hours of sleep per night. Two clinical trials, authored by Felder et al. (2020) and Kalmbach et al. (2020), have confirmed Sleepio’s safety and effectiveness for pregnant users. Furthermore, due to its use of sleep restriction, Sleepio is not recommended for minors since their continual development requires them to upkeep a higher number of hours slept per night. Since childhood insomnia has shown trends of continuing into adulthood, further research could explore how Sleepio might be adapted into a treatment for children.