The Effect of Virtual Reality in Older Adults

The Effect of Virtual Reality on Sleep Quality and Comfort in Older Adults

This research will be conducted to examine the effects of virtual reality on sleep quality and comfort in older adults. This research will be conducted as a single-blind, randomized controlled experimental study with a pre-test-post-test design, involving application and control groups, to examine the effect of virtual reality on sleep quality and comfort in elderly adult patients hospitalized in the internal medicine and surgical clinics of Kars Harakani State Hospital between December 15, 2025, and December 31, 2026. To inform older adults, and after obtaining informed consent, the study will be administered using a "Senior Adult Descriptive Information Form" containing demographic information about older adults, the Standardized Mini Mental Test which assesses the cognitive level of older adults, and a "Senior Adult Monitoring Form" to track any potential side effects of the intervention. The Senior Adult Descriptive Information Form, the Richards-Campbell Sleep Scale (RCSQ), and the VAS Comfort Scale (VCS) will be used to collect data for the study. Data will be collected from elderly adults hospitalized in the internal medicine and surgical clinics of Kars Harakani State Hospital who meet the research criteria. They will be shown 360-degree video images (Chitra and Eremita 2023; Eremita and Chitra 2024) for 20 minutes each night during their hospitalization hours using VR Shinecon virtual reality glasses.

Study Overview

• Status: Enrolling by invitation
• Conditions: Older Adults Without Any Specific Clinical Condition; Older Adults (65 Years and Older)
• Intervention / Treatment: Device: using virtual reality

Detailed Description

This research will be conducted to examine the effect of virtual reality on sleep quality and comfort in older adults hospitalized in internal medicine and surgical clinics. New technologies such as virtual reality are gaining interest as a non-pharmacological intervention in various clinical settings(Lee et al. 2019; D'Cunha et al. 2019; Kim et al. 2024; Szczepocka et al. 2024; Szczepocka, Mokros et al. 2024). Virtual reality offers a unique opportunity to expose individuals to various simulated natural and social environments that can be both calming and engaging(Appel et al. 2020; Appel et al. 2021; Chitra and Eremita 2023; Eremita and Chitra 2024). Virtual reality provides visual and auditory stimuly.(Appel et al. 2020; Hung et al. 2025; Liu et al. 2025). In their study, Lee and Kang(2020) stated that virtual reality could be beneficial as a nursing intervention method for providing a positive cognitive stimulus and blocking environmental stimuly. Although virtual reality is generally sometimes seen as a technology geared towards young people, research has shown that it is easily adopted by many older individuals and has the potential to improve participation and well-being in older adults.(Lee at al. 2019; Syed-Abdul et al. 2019; D'Cunha et al. 2019; Dermody et al. 2020; Cheng et al. 2020; Kalantari et al. 2023; Cinalioglu et al. 2023; Hung et al. 2025). Sleep is a fundamental physiological process for life(Yan et al. 2022; Kim et al. 2024). Sleep disorders are a common problem during the aging process(Sun et al. 2016; Çınar Yücel et al. 2016; Tseng et al. 2020; Martini et al. 2024) and can significantly affect comfort(Martini et al. 2024). With the progression of age, falling asleep becomes difficult, sleep is interrupted by frequent awakenings, the depth of sleep decreases, and the time spent sleeping in bed increases, and as a result, sleep gradually moves away from being satisfying(Çınar Yücel et al. 2016). Insufficient sleep can lead to problems such as memory loss, lack of concentration, as well as heart disease, hypertension, arrhythmia, stroke and impairment of the immune system(Huang et al. 2022; Wan et al. 2024; Sharma and Dhaka 2025), may also lead to fatigue and excessive daytime sleepiness(Tseng et al. 2020; Chitra and Eremita 2023; Eremita and Chitra 2024).The use of virtual reality may also positively affect sleep quality(Lee and Kang 2020; Eremita and Chitra 2024; Martini et al. 2024; Liu et al. 2025; Sharma and Dhaka 2025). Virtual reality helps alleviate difficulties in falling asleep by targeting pre-sleep arousal(Zambotti et al. 2020; Sharma and Dhaka 2025). Virtual reality 360-degree video nature images can release Gamma-aminobutyric acid, which is necessary to support sleep(Chitra and Eremita 2023; Eremita and Chitra 2024) and increase relaxation(Zambotti et al. 2020; Cinalioglu et al. 2023; Martini et al. 2024; Wan et al. 2024; Sharma and Dhaka 2025). It was found that a 30-minute virtual reality meditation session on the evening of hospital admission positively affected the sleep quality of intensive care unit patients(Lee and Kang 2020). Chitra and Eremita(2023) and Kim et al.(2024)'s studies indicate that virtual reality can be used to improve the sleep quality of students experiencing sleep problems. In a study conducted to investigate the effectiveness of virtual reality therapy administered at home once daily in the evening for 6 weeks in chronic imsomnia patients, it was reported that virtual reality therapy improved sleep quality(Wan et al. 2024). Virtual reality is increasingly being used in elderly care settings, including long-term care(Lee at al. 2019; Hung et al. 2025). Older patients require regular sleep to live their lives in the best possible way and maintain their bodily functions(Çınar Yücel et al. 2016). Information regarding virtual reality for older adults is limited, and the research literature is still quite insufficient(Zambotti et al. 2020; Kalantari et al. 2023; Martini et al. 2024; Szczepocka, Mokros et al.2024; Sharma and Dhaka 2025). When examining the national and international literature; Virtual Reality Guided Imagery has been found to improve sleep quality among older adults(Martini et al. 2024; Sharma and Dhaka 2025-meta analysis study), Virtual Reality Exercise Games(Peng et al. 2024-meta analysis study ) and virtual reality combined with aromatherapy to improve comfort (Hung et al. 2025) it has been seen that there are studies in which it is used. It is believed that the virtual reality goggle application will enable elderly adults to relax their minds and bodies by blocking external stimuly, provide an innovative, effective, safe, and comfortable nursing care method that can be implemented without a doctor's prescription for the management of elderly adults' sleep problems, and contribute to the literature.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kars, Turkey (Türkiye), 36100
    • Kafkas University, Faculty of Health Sciences Department of Nursing

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Older adults willing to participate in the study
• Being 60 years of age or older
• Not having been diagnosed with Parkinson's disease or a psychiatric disorder, not having cognitive impairment, and being able to communicate
• Absence of a sleep apnea diagnosis
• Scoring 24 or higher on the Standardized Mini Mental Test
• The participant stated that her average nightly sleep duration is less than 5 hours
• Avoid using medications that may affect sleep (acetylcholinesterase inhibitors, beta-blockers, diuretics, phenytoin, theophylline, benzodiazepines, etc.)
• Hospital stay must be at least 3 days
• Avoid smoking in the last 15 minutes before a session and avoid using caffeine stimulants (tea/coffee/chocolate/cola etc.) exceeding 1.4 mg/kg in the 10 hours prior.
• Lack of photosensitivity
• Eye disease and absence of contact lenses

Exclusion Criteria:

• Those unwilling to participate in the study
• Those who are not 60 years of age or older
• Patients diagnosed with Parkinson's disease and psychiatric disorders, who have cognitive impairment and are unable to communicate
• Having a diagnosis of sleep apnea
• Those who score below 24 on the Standardized Mini Mental Test
• Those who stated that their average nightly sleep duration is more than 5 hours
• Those who use medication (acetylcholinesterase inhibitor, beta blocker, diuretic, phenytoin, theophylline, benzodiazepine etc.) that can affect sleep
• Hospital stay of 3 days or less
• Smoking a cigarette in the last 15 minutes before a session and using caffeine stimulants (tea/coffee/chocolate/cola etc.) above 1.4 mg/kg 10 hours prior
• Having photosensitivity
• Older adults with eye disease and contact lenses

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Virtual reality; Older adults with insomnia in the experimental group will undergo a 20-minute virtual reality session. The study group, consisting of elderly adults meeting the inclusion criteria, will be given an Elderly Adult Identifier Form, after which the VR SHINECON GO4EA virtual reality headset will be applied by the researcher for 20 minutes at bedtime (routinely at 10:30 PM) for three nights. Before the first night's virtual reality headset application, sleep quality and comfort levels will be assessed. These assessments will be repeated in the morning after the virtual reality headset application.	Device: using virtual reality; Older adults with insomnia in the experimental group will undergo a 20-minute virtual reality session. Data will be collected from elderly adults hospitalized in the internal medicine and surgical clinics of Kars Harakani State Hospital who meet the research criteria. They will be shown 360-degree video images (Chitra and Eremita 2023; Eremita and Chitra 2024) for 20 minutes each night during their hospitalization hours using VR Shinecon virtual reality glasses. One of two 1-hour videos - one with a starry night sky and one with night rain sound - will be selected according to the elderly adults' preference. After each participant's use, the headphone jack of the virtual reality glasses will be wiped with an antiseptic solution. The "Richards-Campbell Sleep Scale (RCSQ)" and the "VAS Comfort Scale (VCS)" will be used to collect data.
No Intervention: Control group; Older adults in the control group will not receive any intervention aimed at improving sleep quality and comfort. During the study period, no interventions aimed at improving sleep quality and comfort will be performed on the older adults in this group. Routine clinical care will be applied. After administering the Older Adult Identifier Form, the older adults will have their sleep quality and comfort assessed on the first night. Their sleep quality and comfort will be assessed again after they wake up in the morning.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sleep quality	Richards-Campbell Sleep Questionnaire: Developed by Richards in 1987, the Richards-Campbell Sleep Questionnaire (RCSQ) is a six-item scale that assesses the depth of nighttime sleep, time to fall asleep, frequency of awakenings, duration of wakefulness, quality of sleep, and ambient noise level. Each item is evaluated on a visual analog scale ranging from 0 to 100. A score of 0-25 indicates very poor sleep, while a score of 76-100 indicates very good sleep. Higher scores indicate improved sleep quality. The Cronbach's α value for the scale developed by Richards is 0.82.	1st midterm test: second day, 2nd midterm test: third day, final test: fourth day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comfort	VAS Comfort Scale: The comfort level of older adults will be assessed using the Visual Analog Scale (VAS). A previous validity and reliability study of a comfort scale (Karabey and Karagözoğlu 2021) used VAS to conduct similar scale validity assessments, determining that VAS can be used to assess comfort levels. Furthermore, other studies have also evaluated patients' comfort levels using VAS (Kütük and Arıkan 2019; Karabey and Karagözoğlu 2021). The scale ranges from 0 to 10, indicating the lowest level of comfort, with higher scores representing a higher comfort level. Additionally, an Inter-Rate Rating Reliability analysis will be conducted on the VAS comfort scale scores.	8 month (A final test will be performed after 4 days of treatment for each patient, a total of 240 days for 60 patients)

Collaborators and Investigators

• Sponsor: Kafkas University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: March 4, 2026
• First Submitted That Met QC Criteria: March 23, 2026
• First Posted (Actual): March 30, 2026

Study Record Updates

• Last Update Posted (Actual): March 30, 2026
• Last Update Submitted That Met QC Criteria: March 23, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: older adults; comfort; virtual reality; sleep quality; care
• Additional Relevant MeSH Terms: Nervous System Diseases; Mental Disorders; Sleep Wake Disorders; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Initiation and Maintenance Disorders
• Other Study ID Numbers: 81829502.903/109

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No