Big Health FAQ

Sleepio is an NHS-recommended, six-week digital treatment that uses Cognitive Behavioural Therapy (CBT) techniques to help improve insomnia symptoms. It is clinically proven to help a person fall asleep faster, stay asleep through the night and feel better during the day – whether they’ve had poor sleep for weeks, months or even years. The whole course takes place online via a computer, tablet or mobile app. It is available at no cost to residents in Scotland and some parts of England thanks to our partnerships with NHS England and NHS Scotland.

No, Sleepio is completely free for you as a patient, and you will never be charged to use it. There are no premium features or additional chargeable resources – the entire programme is available at no cost.

Sleepio meets the NHS’s standards for clinical safety, data protection, technical security, interoperability and usability and accessibility (DTAC). Sleepio is GDPR compliant, and Cyber Essentials and HITRUST certified.

Yes, you can complete the course at your own pace, at any time that suits you. A new session unlocks each week, so the fastest you can complete the course is 6 weeks, but you can take longer if you wish – taking some time off in the middle is no problem!

Yes! Sleepio has been designed to be as user friendly as possible, and you will be guided through all tools and techniques. Plus, you can re-watch any course topics in your Library on the Sleepio website.

Daylight is a clinically proven digital treatment that uses Cognitive Behavioural Therapy (CBT) techniques to help people gain control over their anxiety. After a few short questions, individuals receive techniques tailored to them, to help manage it. The whole course takes place via the Daylight mobile app. It is available at no cost to residents in Scotland and South Yorkshire thanks to our partnerships with NHS Scotland and the South Yorkshire ICS.

At the start of the Daylight programme, you will be asked to provide information about your worry and anxiety, mood, sleep, and goals. These are measured against clinical scales GAD-2 for anxiety, PHQ-2 for mood, and SCI for sleep. Each week you will complete a check in on your worry, anxiety, mood, and sleep, and Daylight will provide you with information and guidance regarding your progress.

It is up to you how long you use Daylight - it is there for you whenever and wherever you need it. Daylight users will receive weekly feedback on their progress. When they have achieved their desired goals, they can keep using the app, either as a way to practise techniques daily, or as a way to check in on their worry and anxiety weekly. In our research, we have seen that users who use Daylight frequently (approximately daily) can start to notice benefits in as little as 3-4 weeks, and that using the app frequently for up to 6 weeks may result in more benefit. 

We recommend using Daylight daily. Individuals tend to see the most benefit from utilising cognitive behavioural techniques when they are practiced regularly, and in daily life situations. 

Sleepio meets the NHS’s standards for clinical safety, data protection, technical security, interoperability and usability and accessibility (DTAC). Sleepio is GDPR compliant, and Cyber Essentials and HITRUST certified.

Equity is often confused with equality, which refers to the idea of equal treatment. While equality is important, it also often carries the assumption that equal treatment always results in equal outcomes. Because some people start at a disadvantage, giving the same treatment to all people can result in certain groups making progress, but not as much progress as those who benefit from more privilege. When it comes to mental health conditions and mental health care, different populations have different needs and face unique challenges when accessing care. Striving for mental health equity means giving the level of support each person or group needs instead of equal levels across all groups. Read how Big Health is prioritising mental health equity.

“Barriers to care” refers to obstacles that limit or prevent people from receiving care. Common barriers to care primarily fall into two categories: systemic barriers and cultural barriers. Systemic barriers are policies and procedures that disproportionately impact specific communities. These can include access to certain treatments due to lack of local funding. Systemic barriers can also include experiences of racism in the healthcare system, lack of culturally responsive treatment, and a shortage of culturally informed mental health care providers. Cultural barriers include lack of awareness about mental health conditions and treatments, negative emotions such as fear, stigma, and shame, and a preference for cultural interventions such as community and spiritual leaders or holistic interventions.

​​The term “stigma” refers to feelings of shame due to widespread misconceptions about mental health. These misconceptions often shape people’s attitudes and behaviours toward those with mental health struggles. Stigma is destructive because it can lead people to dismiss or ignore their symptoms, or someone else’s, which typically leads to the individual in need not getting care. Stigma can come in three forms: public, which includes the societal perception that people with mental health conditions are dangerous, unpredictable, or to be blamed for their own struggles; self, which is an individual’s belief that they as an individual may be dangerous or to blame for their own mental health struggles; and institutional stigma which involves stereotypes embodied in laws and institutions that reduce access to mental health care.

Wellness refers to pursuits to improve one’s overall well-being through lifestyle choices regarding physical, emotional, social, mental, spiritual, and environmental aspects of life. Examples of activities one might pursue to increase wellness could include changing diet and exercise, joining a volunteer organisation, or practising mindfulness (discussed below). There are many wellness tools that can come in the form of apps, including popular medication and weight loss programmes you may have heard of. There is an important distinction between wellness and the treatment methods outlined above (talk therapy, medication, etc.). Wellness can be used to prevent illness, and to increase overall well-being. However only treatment is designed to address symptoms of a diagnosed mental health condition and reduce the symptoms of conditions to sub-clinical thresholds.

In short, mindfulness is the practice of becoming more aware of the present moment, our surroundings, and our own emotions. Mindfulness has origins in eastern and Buddhist philosophies and is integrated into many modern types of meditation practice. Mindfulness also has therapeutic applications within psychotherapy — providers might recommend that patients engage in gratitude journals, daily meditation, or other mindfulness activities — but these alone are not sufficient to treat conditions. Learn more about the need to prioritise evidence-based platforms over wellness apps for treating clinical conditions.

An RCT is a type of study in which participants (the individuals being observed) are randomly assigned to separate groups. The thing being tested — often a drug, or some kind of medical device — is then administered to one group, while another group has a different experience. Often, they will receive no treatment, or get a placebo. Because the groups are randomly divided, the groups will be similar in terms of characteristics which could affect the outcomes such as gender and age.

This term simply refers to a standard that the scientific community has agreed is the best way to do things. In mental health, the gold standard of evidence is the randomised controlled trial, or RCT, because it has proven to be the most accurate in measuring efficacy and safety.
Read more about the studies Sleepio and Daylight have been involved in and the impact they’ve had on the people that use them.

Generally speaking, when people say “therapy,” they’re referring to psychotherapy: talk-based treatment provided by a therapist in an office setting. This could be in an individual, family, or group setting, and be administered by a psychologist, licensed therapist, or social worker. Psychotherapy uses various techniques to help you overcome challenges, change your behaviour, improve your overall wellbeing, or work towards an identified goal. Talk therapy can help with a wide range of concerns and conditions, including but not limited to: depression, stress, grief, substance abuse and addiction, anxiety disorders, insomnia, and trauma.

CBT is an action-oriented type of structured therapy that gives people tangible skills to identify and change unhelpful thoughts and behaviours that harm their mental health. CBT is useful for a variety of conditions, and is particularly helpful with anxiety disorders and insomnia. It helps you learn and practise skills directly related to your individual needs. For example, someone suffering from social anxiety that involves fear in social settings might work on taking small steps towards getting comfortable with small talk. Someone with insomnia might learn how to structure their night time routine to facilitate better sleep.

Digital health is a broad category that covers the many ways technology can be used to deliver healthcare. Treatments like Sleepio and Daylight, and wellness apps qualify as digital health, as do wearables that track things like heart rate and steps.

Digital therapeutics (DTx) are a class within digital health, defined as devices that “deliver medical interventions directly to patients using evidence-based, clinically evaluated software to treat, manage, and prevent a broad spectrum of diseases and disorders.” For example, Big Health makes two digital therapeutics — Daylight for anxiety and Sleepio for insomnia disorder. Daylight and Sleepio are non-drug treatments that have been evaluated like a medical device or medication making them clinical-grade treatments. The best digital therapeutics are the ones that are tested and shown to be safe and effective — like Sleepio and Daylight — which have been tested in clinical trials and have been shown to deliver consistent clinical outcomes.

For mental health, most medications are taken for depression, anxiety, and insomnia. The medications that address those conditions are called SSRIs, benzodiazepines, and hypnotics. Some of the brand names these go by are prozac, ativan, and ambien. Medications to treat mental health disorders are usually prescription only. They typically have psychoactive effects, which the World Health Organisation (WHO) defines as having “significant effects on mental processes, e.g. perception, consciousness, cognition or mood and emotions. ” Antidepressants, sedatives, antipsychotics, and mood stabilisers are all examples of psychoactive drugs.