Authors (including presenting author) :
YUEN K. C. (1), Y. S. CHOI (1), M. L. LEE (1), K. S. CHAN (1), W. K. LEE (1), Y. M. CHIN (1)
Introduction :
Individuals with mental illnesses frequently experience sleep disturbances, which harm their functioning and quality of life and lead to mood disturbances, fatigue, low energy, and reduced motivation (Faulkner & Bee, 2016; Sobieraj et al., 2013). Insomnia exacerbates mental health symptoms, causing negative emotions, emotional instability, and increased arousal (Freeman et al., 2020).
To investigate the potential of Virtual Reality (VR) in enhancing relaxation and stress reduction (Riches, Poole & Hughes, 2023), the Sleep Hygiene Exploration and Enrichment Programme (SHEEP) was developed. This 5-session course combined psychoeducation on sleep hygiene with an occupational lifestyle modification approach. VR was integrated into relaxation techniques to explore whether its immersive nature could provide a more effective method for promoting relaxation in the context of enhancing sleep quality.
Objectives :
This study explored the satisfaction of psychiatric inpatients with the use of virtual reality (VR) relaxation techniques in an occupational lifestyle modification programme. It also examined the changes in their daily routines and behaviours that affected their sleep quality, as well as any improvements in their sleep hygiene knowledge.
Methodology :
Participants were recruited from June 2023 to January 2024 from acute and sub-acute wards of both genders. They completed all five SHEEP sessions. Data from 26 participants were collected through the Sleep Hygiene Practice Scale (SHPS), pre- and post-programme quizzes, and an end-of-programme satisfaction survey.
Result & Outcome :
Results
A Wilcoxon Signed-Rank Test showed a significant change in participants' SHPS scores before and after completing SHEEP (z = -2.181, p = .029). The median SHPS score decreased to 78.00 after completing the programme, compared to a median of 83.00 before. Additionally, participants scored higher on the knowledge quiz post-SHEEP (median: 9.00) than pre-SHEEP (median: 7.00), with the improvement also supported by the Wilcoxon signed-rank test (z = -3.376, p = .001). Out of the 19 participants who completed the satisfaction survey, they reported a positive experience using VR for relaxation (mean score: 7.16/10). The overall satisfaction with the SHEEP programme was rated at 7.58/10.
Outcome
Participants of SHEEP were pleased with the use of immersive VR technology for practicing relaxation for promoting sleep. The improvements in SHPS and knowledge quiz scores indicate that the occupational lifestyle modification approach is effective in promoting sleep hygiene and knowledge. For future studies, it is suggested to include a control group to better compare the effectiveness of VR-assisted relaxation practice for improving sleep quality. Additionally, SHEEP could be adapted for outpatient settings to further enhance and maintain the gains achieved during the inpatient phase.
References
Faulkner, S., & Bee, P. (2016). Perspectives on sleep, sleep problems, and their treatment, in people with serious mental illnesses: A systematic review. PLOS ONE, 11(9), e0163486. https://doi.org/10.1371/journal.pone.0163486
Freeman, D., Sheaves, B., Waite, F., Harvey, A. G., & Harrison, P. J. (2020). Sleep disturbance and psychiatric disorders. The Lancet Psychiatry, 7(7), 628-637. https://doi.org/10.1016/S2215-0366(20)30136-X
Riches, S., Poole, H., & Hughes, S. (2023). Virtual reality relaxation for people with mental health conditions: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 58(1), 15-27. https://doi.org/10.1007/s00127-022-02212-9
Sobieraj, A., Fabin, K., Wilczy, K., & Krysta, K. (2013). Occurrence of sleep abnormalities among people with mental disorders—Questionnaire study. Psychiatria Danubina, 25, 203–206.
