Nature-based virtual reality relaxation to improve mental health and sleep in undergraduate students: A randomized controlled trial

Junggeun Ahn · Jiu Kim · Youngeun Park · Riah Kim · Heeseung Choi

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Digital Mental Health Interventions Sleep and related disorders Urban Green Space and Health

Abstract

Background Undergraduate students are particularly vulnerable to mental health problems due to academic pressure, financial concerns, and interpersonal stressors. Nature-based virtual reality (VR) technologies, which replicate natural settings, may offer psychological benefits by compensating for limited access to real-world natural environments in urban contexts. Purpose This study aimed to evaluate the effectiveness of a nature-based VR relaxation program in improving mental health and sleep outcomes among Korean undergraduate students. Method Participants from five Korean universities were randomly assigned to one of three groups: VR relaxation, progressive muscle relaxation (PMR), or wait-list control. Self-reported measures of depression, anxiety, perceived stress, and sleep patterns were collected at baseline, post-intervention, and follow-up. Objective sleep efficiency was assessed using wrist-worn actigraphy devices. Data were analyzed using generalized estimating equations to examine changes over time and between groups. Results A total of 41 participants completed the study. The VR intervention group showed significant reductions in perceived stress levels ( p = .001) and improvements in subjective sleep patterns ( p = .046), with these effects sustained at follow-up. Notably, sleep efficiency measured via actigraphy improved significantly in the PMR group compared to the other groups ( p = .033). Conclusions A nature-based VR relaxation program appears to be an effective digital intervention for reducing stress and enhancing subjective sleep quality among undergraduate students. These findings highlight the potential of nature-simulating digital environments to support mental health and wellness in settings with limited access to natural spaces.

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References

1983A Global Measure of Perceived Stress 2010The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008 2011The role and validity of actigraphy in sleep medicine: An update 2013Measuring Sleep: Accuracy, Sensitivity, and Specificity of Wrist Actigraphy Compared to Polysomnography 2021Prevalence and risk factors for mental health problems in university undergraduate students: A systematic review with meta-analysis 2011Wrist Actigraphy 1992Self-Reported Sleep Disturbances in Employed Women 1994Managing Stress: Principles and Strategies for Health and Wellbeing

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2026Virtual Reality Interventions for Stress Reduction in the General Population: Systematic Review and Meta-Analysis of Randomized Controlled Trials

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