We’ve been following the development of wearables with considerable interest. From Imogen Heap’s musical gloves to wristbands such as the UP system by Jawbone, there’s a fascination in the idea of clothes or jewellery that can help us to live better or healthier lives. And while some are still in the very early stages of development, where the potential is perhaps more obvious than the results, there are a few systems that have made it well beyond the drawing board, and are starting to show serious success. One of these is Big Health’s Sleepio programme.
Born from personal need
Like some of the other early wearables, Big Health was born from personal need, in this case co-founder Peter Hames’ insomnia. He realised that there was potential to use Cognitive Behavioural Therapy (CBT) to resolve the problem, but found it difficult to get access via his GP. Online, he found a self-help book written by Professor Colin Espie, who has been researching sleep and insomnia for over 30 years, and is based at the Nuffield Department for Clinical Neuroscience at the University of Oxford. Hames found the book a revelation, and started to work with Espie to develop Sleepio, an automated sleep improvement programme.
Sleepio uses data provided by users, and is also able to draw on big data from wearables such as Jawbone’s UP wristband. The wristband is able to share data about sleep patterns automatically, without users having to worry about self-monitoring. This both decreases worry, which obviously affects sleep patterns, and also removes any kind of self-reporting bias or exaggeration, known to be an issue in such programmes.
Applying the science
Sleepio works by training people to apply proven CBT techniques to address the mental issues that lead to insomnia, such as the inability to settle because of worrying about work or the future. It helps to break the negative cycle of poor sleep, where sufferers start to worry that they can’t sleep, so they’ll be feeling bad in the morning, making it harder to fall asleep. The usual course of six to eight weekly face to face sessions with a therapist is replaced in Sleepio by an online expert, ‘the Prof’, and a tailored sleep programme. Users are provided with a toolkit to help them resolve their own sleep problems.
The Sleepio team is committed to evidence-based medicine. Not only is CBT proven to work for insomnia, but Sleepio itself has been submitted to a randomised controlled trial, the ‘gold standard’ of evidence-based medicine. Admittedly the study numbers were fairly small, just 164 people, but a recent trial found that Sleepio helped around three quarters of people with persistent insomnia to improve their sleep patterns. It also gave an average reduction of around 50% in the time taken to fall asleep, and of around 60% in the time spent awake at night. Perhaps even more promisingly, the effects lasted well beyond the duration of the programme.
It’s hard to fully randomise a trial of a therapy such as Sleepio, because it is likely to be pretty clear to the participants whether they are part of the control group or not. However, the team set up a placebo course, delivered via the same online system, but not CBT-based, as well as a group that received no therapy. This enabled them to evaluate the placebo effect, and demonstrate as far as possible, the genuine effects of Sleepio. We await with interest the outcomes of larger clinical trials, which we hope will follow.
The start of a wider movement?
Big Health is going from strength to strength, having announced back in April that it has been successful in raising $3.3m from venture capital to help break into the US market. But it may also be part of a wider pattern. Also in April, the mayor of London announced funding to support development of London as a MedCity, with the aim of increasing the importance of medical science to London’s economy, with the precise boundaries of London being considered flexible enough to take in Oxford and Cambridge.
Like the TechCity initiative before it, MedCity aims to decrease London’s reliance on the financial sector. And with Big Health’s roots firmly set in academic expertise at Oxford University, its success in winning financial backing for its US expansion is great news for the future well-being of the new MedCity, as well as for the growth of wearables and big data in improving well-being.