min read
September 7, 2023

Improving member outcomes for mental health conditions with evidence-based digital treatments

Rooted in cognitive behavioral therapy, clinically validated, proprietary treatments offer members proven alternatives to achieve remission.

This week, the New York Times ran a story on the well-established clinical evidence showing cognitive behavioral therapy for insomnia (CBT-I) is a proven alternative for people hesitant to try insomnia medication — noting studies find that CBT-I is as effective as sleep medications in the short term — and more effective over the long term. Behavioral sleep psychologist and CBT-I expert Dr. Shelby Harris recommended our flagship treatment for insomnia, Sleepio, as a reputable alternative to improve sleep.

For many insomnia patients who struggle with the negative impacts and downstream mental health challenges, this is a revelation.

In fact, reversing this downward spiral in patients is why we developed a proprietary formulation of CBT to create Sleepio. By combining the clinical rigor of well-established CBT principles with a modern, digital, and customized patient experience, we’re transforming mental health care delivery beyond traditional treatment modalities to improve access and outcomes.

How does traditional CBT work?

Traditionally, CBT is delivered via manualized protocols that offer guidelines for how to effectively provide a specific treatment, such as treatment for panic, obsessive-compulsive, or binge-eating disorders. This “one-size-fits-all” approach has a large upside in that it helps providers deliver treatments with fidelity to the science and evidence, which in turn improves patient outcomes. Just like it is well-established that surgical checklists reduce mistakes and improve surgery outcomes, CBT protocols do the same.

However, these manualized treatments are designed for clinicians to deliver them to patients in person, enabling clinicians to use their professional judgment to make the treatment effective for patients. In a digital treatment context, no therapist is present to adapt the treatment nor suggest alternative ways to motivate and re-engage patients in their own care. We wanted our programs to address this inherent need for customization to ensure that every patient can be successful.

Another challenge of traditional CBT is pacing the treatment to achieve sustained success. In a typical once-a-week session, the therapist and patient discuss CBT techniques for use in hypothetical scenarios, yet the real work is done outside the therapist setting, as patients practice unsupported in myriad, day-to-day situations. We designed our digital treatments to enable real-time prompting and practice, expediting outcomes. This approach reinvents the patient experience and leverages technology to make our treatments more accessible, engagement more intuitive and results more achievable.

Pioneering a digital CBT modality

When it comes to digital CBT, a virtual interface is a much different experience from visiting a therapist’s office. To center our design on the patient experience, our world-leading clinical team tapped renowned sleep experts and psychologists to define the behaviors we wanted patients to adopt to achieve remission.

We first distilled well-evidenced CBT treatments into their underlying mechanisms of action, things like operant conditioning, extinction, or sleep drive, for example Next, we developed novel treatment designs that addressed these mechanisms while increasing usability, accessibility, speed to skill acquisition, real-world practice, and habit formation. The result was a platform rooted in the well-established science of  CBT with an engaging experience that facilitates the adoption of new thought patterns and beliefs.

A reimagined experience in practice

It’s one thing to tell people to think differently — our approach is to ensure they have the skills to both learn how to actually change their own thinking and to maintain adaptive thinking patterns over time. We designed our programs to enable patients to truly embed these improved thinking habits in their daily lives through a short and engaging format that shows long-term results. If people are more likely to adhere to a treatment regimen over time, these cognitive and behavioral processes become automatic — so they can overcome insomnia for good.

Our proprietary software helps guide members on a path back to healthy sleep and focuses on giving them the tools they need to create new perspectives. Sleepio can be used whenever and wherever members have time, with techniques taught in as little as 10 minutes. When the goal is to make a new behavior automatic, repetition and practice are key to success.

Improved outcomes with lasting results

This digitally-delivered approach to CBT has been shown to be clinically effective. In fact, Sleepio’s positive outcomes are well-evidenced, with nearly 70 peer-reviewed publications, 14 randomized controlled trials, and a meta-analysis demonstrating its efficacy. In addition, Sleepio has been referenced in four clinical guidelines by the American College of Physicians, the National Institute for Health and Care Excellence, the British Association for Psychopharmacology, and the European Sleep Research Society.

In a placebo-controlled trial, 76% of Sleepio participants achieved significant clinical improvement in insomnia. And in real-world patients, 86% have shown at least 25% clinical improvement, with 66% reaching remission in as little as six weeks. 1 This speed to remission not only improves health outcomes for members but also means cost savings for health plans and large employers — with Sleepio, we have shown that organizations can anticipate savings of $6,412 per member in health care costs.2

The secret sauce behind our digital treatments at Big Health is adhering to the scientific underpinnings that make traditional CBT clinically effective while delivering a unique, easy-to-use experience that resonates with people and empowers them to heal themselves. We’re determined to continue evolving and expanding our treatments to help members overcome their mental health challenges. And we know that our proven and proprietary treatment formulation is the path to continued engagement, adherence, and remission.

Take a closer look at Sleepio by requesting a demo.

1. Internal Data. (2023).

2. Internal Data. (2023).

During the COVID-19 public health emergency, Sleepio is temporarily being made available as a treatment for insomnia disorder without a prescription. Sleepio has not been cleared by the U.S. Food and Drug Administration (FDA) for the treatment of insomnia disorder.

DOC-3242 Effective 11/2023

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During the COVID-19 public health emergency, Sleepio and Daylight are being made available as treatments for insomnia disorder and generalized anxiety disorder (GAD), respectively, without a prescription. Sleepio and Daylight have not been cleared by the U.S. Food and Drug Administration (FDA) for the treatment of insomnia disorder and GAD, respectively.

1. Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165(2), 125-133.2. Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., … & Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675-700.3. Wilson, S., Anderson, K., Baldwin, D., Dijk, D. J., Espie, A., Espie, C., … & Sharpley, A. (2019). British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update. Journal of Psychopharmacology, 33(8), 923-947.4. King’s Technology Evaluation Centre. (2017, November 9). Overview: Health app: SLEEPIO for adults with poor Sleep: Advice. NICE. Espie, C. A., Kyle, S. D., Williams, C., Ong, J. C., Douglas, N. J., Hames, P., & Brown, J. S. (2012). A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application. Sleep, 35(6), 769-781.6. Carl, J. R., Miller, C. B., Henry, A. L., Davis, M. L., Stott, R., Smits, J. A., … & Espie, C. A. (2020). Efficacy of digital cognitive behavioral therapy for moderate‐to‐severe symptoms of generalized anxiety disorder: A randomized controlled trial. Depression and Anxiety, 37(12), 1168-1178.

DOC-3046 Effective 11/2023