Need Your Sleep: DTx for Treating Comorbid Insomnia and Psychiatric Disorders


Digital therapeutics may be poised to step up as the next CBT.




“You absolutely need to have your sleep. Many patients with psychiatric disorders will tell us that sleep needs to be addressed,” said Colin A. Espie, PhD, Professor of Sleep Medicine in the Nuffield Department of Clinical Neurosciences at University of Oxford, Clinical Director of the Oxford Online Programme in Sleep Medicine, and Cofounder and Chief Scientist of Big Health.

At DTx West, Psychiatric TimesTM Associate Editorial Director, Heidi Anne Duerr, MPH, teamed up with Espie to discuss sleep issues and mental health in the session, “How Big Health Are Tackling Wider Mental Health Issues by Addressing Sleep.” Together, they looked at the prevalence of mental health and insomnia across multiple populations.

“Research has shown that it really is important to address both sleep and psychiatric disorders. If sleep is not addressed in patients with depression or anxiety, then it could very well exacerbate their psychiatric condition and vice versa,” Duerr shared.

Psychopharmacological options are very important to treat sleep disorders, the pair discussed, but so is cognitive behavioral therapy (CBT) that is associated with addressing sleep issues.

“CBT is not a treatment, but a family of treatments,” said Espie. “It contains bits that deal with the racing mind, the cognitive element of CBT, and addresses our approach to sleep.”

“In the headlines and in the news, we hear that there are shortages of mental health care professionals who can treat patients, including offering CBT to help patients,” continued Duerr.

The potential solution to such shortages? Digital therapeutics (DTx) may be poised to step in, so long as they are utilized by empathetic doctors who are ready to be there for their patients. According to Espie, mental health treatment must be given the same respect and be held accountable as any other health care, and DTx are no exception.

“We must give them [our patients] treatments that work,” said Espie. He believes DTx must (1) work correctly, and (2) be provided only after they are validated via randomized, placebo controlled trials.

“Digital therapeutics need to be skillfully made, they cannot just be translations,” said Espie. “We need evidence-based treatments that are sophisticated enough to really help people to implement things in their life that make a difference.”

Something investigators should be aware of, Espie noted, is potential placebo effects of DTx. Just as with regular medications, DTx will not be regarded as effective treatments unless they produce benefit beyond placebo.

From the discussion, it is clear that DTx have the potential to improve patient care—and increase the number of patients receiving care. With more evidence-based research, the availability is likely to increase in the near future.

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