195Joined Feb 2020


I'm not an expert here / don't have much capacity to invest right now, but other commenters expressed interest and pointed to experts - you should reach out to both!  :)

I'm not an expert / don't have much capacity to invest in this right now, but other commenters here might! You should reach out

I don't have expertise here, I'm mostly just a concerned bystander lol. Other comments mention relevant people, you should reach out to them perhaps?

This analysis accurately frames my starting point in working on Dozy. It convinced me to commit full-time to the project on the merits of its potential impact. Some of the awareness the post generated led to me raising a small pre-seed round from EAs, which has been invaluable. The problem size and treatment claims have been largely substantiated by studies that came out since, but I underestimated the challenges of getting users through the complete treatment program. Also, there are a few direct-to-consumer CBT-i options coming out as of now, so the counterfactual impact is more limited than I initially suggested.

That said, I still think startups / new projects represent one of the best ways to rapidly explore solutions in problem spaces like this.

Re: followup work, I'd love to see more problem analyses - especially in the mental health space - as it provides inspiration and launch support for new projects. Large-scale interventions in sleep health could be incredibly worthwhile if we can find them - insomnia continues to get more prevalent, along with other mental health related suffering. I don't know how to reverse this trend and am looking for ideas.  :)

This is a great analysis!

I'm working on an EA-aligned public benefit corporation ( with similar ambitions as Mind Ease, but for insomnia treatment. My funding up to this point has predominantly been from EA-driven investors, implicitly based on a model like this. Having a more formalized analysis for the approach I'm taking will be helpful.  :)

Have fixed! Thanks for pointing that out, I should really check EA forum notifications more

I fall under this category - have applied.  :)

Thanks for your reply! I agree, CBT-i is super promising and I'm all about finding effective ways to spread it.

Almost got confused as to which Overcoming Insomnia book before I added the author title - first result is a $50 therapist manual lol.

I think it's possible to treat yourself this way if you're decently analytical (as I suspect most visitors in this forum to be), but quite difficult to stick to otherwise. E.g. I can't really imagine telling my aunt with insomnia to read the book and apply the techniques to herself, both from a comprehension perspective and a habit maintenance perspective. It's kinda similar to how there's a lot of high-quality books out there on fitness, but classes or personal trainers provide more value to most people.

Regarding the CBT-i guidelines, different techniques are more or less useful in different circumstances. For instance, what you describe in the first bullet point is known as Sleep Compression Therapy - a useful technique, but it takes longer and has less empirical support than Sleep Restriction Therapy (SRT, where you immediately restrict time in bed based on a baseline of time sleeping). The slower Compression edition is helpful in cases where patients have trouble with the sudden schedule shift, so it's quite useful, but not always ideal.

Similarly, sleep hygiene education is actually significantly less impactful than other core CBT-i techniques such as Stimulus Control Therapy (SCT), which is all about turning the bedroom into a strong environmental trigger for sleep. And sometimes the above doesn't click without additional help from relaxation training (usually Progressive Muscle Relaxation) or some cognitive interventions (such as Paradoxical Intention Therapy).

It looks like Espie addresses much of these in his book, which is great, but it's harder to distill into core techniques. If one did distill into core techniques, sleep hygiene probably wouldn't be mentioned due to that being the first advice anyone with insomnia gets. The sleep therapists I've talked to usually emphasize SRT, SCT, and relaxation training where necessary (covering other bases like hygiene over time).

tl;dr: There are many potentially helpful techniques and a lot of information to consider, but it's cognitively demanding to do so and manage your own treatment. The app will take away that cognitive strain by customizing treatment and offering behavioral support along the way, so the user only sees the information they need and can reach out for support when necessary. We've all seen research on how much convenience affects behavior - I want to take this therapy and make it extremely convenient, thus improving treatment outcomes and reaching a larger audience.

Does that make sense / illustrate the value I think the app provides?

(am definitely on board with convincing more doctors to push CBT-i instead of sleeping pills - the book would be a far better option than the pills (though with more cognitive effort required)).

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