Virtual Reality-based Relaxation Program on Mental Health and Sleep Patterns for Undergraduate Students: A Randomized Controlled Repeated-Measures Design (Preprint)

Abstract

BACKGROUND Undergraduate students have vulnerable mental health due to problems related to academics, finances, and interpersonal relationships, and the prevalence of sleep disorders among Korean undergraduate students is higher than other countries. Virtual reality (VR) provides an immersive experience that can reduce negative emotions and induce relaxation and positive emotions. OBJECTIVE This study aimed to evaluate the effects of an immersive VR relaxation program (VRelax) that simulates a natural environment on the mental health and sleep patterns of Korean undergraduate students. METHODS Participants were recruited from five universities in Korea. They were randomly assigned to three groups: (1) VR relaxation program (VRelax) for intervention, (2) progressive muscle relaxation (PMR) for attention control (AC), and (3) wait-list control (WLC). VRelax and PMR were conducted six times over two weeks. Self-report surveys on depression, anxiety, perceived stress, and sleep patterns were obtained at baseline and twice after the intervention (immediately and four weeks after). Additionally, objective sleep patterns using actigraphy were assessed before and after the intervention. We used analysis of variance and generalized estimating equation model to analyze the data. RESULTS In total, 41 undergraduate students (13 in VRelax, 13 in AC, and 15 in WLC) participated in the program, and all completed the 4-week follow-up test. The VRelax group demonstrated significant improvement on perceived stress levels (p=.001) and subjective sleep patterns (p=.046); these effects were maintained for 4 weeks. However, sleep efficiency measured through actigraphy was significantly improved in the AC group compared to the other groups (p=.033). CONCLUSIONS Our study suggests that an immersive VR-based relaxation program plays an important role in improving perceived stress and subjective sleep patterns. Based on this, we expect that the immersive VR relaxation programs will be actively used as a self-management intervention to improve mental health and sleep patterns among undergraduate students. CLINICALTRIAL Clinical Research Information Service (CRIS) in Republic of Korea (KCT0009185), which is a member of the WHO International Clinical Trials Registry Platform (ICTRP)

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