Effect of a Virtual Reality–Based Relaxation Program on Sleep Disturbance Among Male Inpatients With Substance Use Disorders
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Objective: This study aimed to evaluate the short-term effect of a virtual reality (VR)–based relaxation program on sleep disturbance among male inpatients with substance use disorders.
Methods and Materials: This quasi-experimental study employed a nonequivalent control group pretest–posttest design with follow-up. Sixty male inpatients with substance use disorders were recruited consecutively from Al-Shifaa Hospital/Al-Mosul National Addiction Rehabilitation Center in Mosul, Iraq, and allocated to a VR intervention group (n = 30) or a comparison group (n = 30) using a non-random alternating approach. The VR group received a 4-week relaxation program consisting of 12 sessions of immersive guided relaxation, mindfulness, and calming virtual exposure to nature. The comparison group received routine care plus standardized non-immersive sleep education and audio relaxation. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) global score measured at baseline, post-intervention, and 1-month follow-up. Data were analyzed using linear mixed-effects models and risk differences with 95% confidence intervals.
Findings: The VR group showed greater improvement in subjective sleep quality than the comparison group at post-intervention and follow-up. Adjusted mean differences in PSQI global score favored the VR group at posttest (−3.1, 95% CI: −4.6 to −1.6, p < 0.001) and follow-up (−2.9, 95% CI: −4.3 to −1.4, p < 0.001). Responder and remission rates were also higher in the VR group. Diary-based sleep parameters, including sleep onset latency, total sleep time, and wake after sleep onset, improved significantly over time. No VR-related adverse events leading to discontinuation were reported.
Conclusion: A VR-based relaxation program was associated with short-term improvements in sleep disturbance among male inpatients with substance use disorders. This intervention may represent a feasible non-pharmacological adjunct in addiction treatment settings, although larger randomized studies are needed.
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