The Effect of Virtual Reality in Older Adults

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.

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