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Updated: Aug 24, 2026

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
Published on: November 12, 2009
Virtual reality combined with biofeedback improves sleep quality and daytime function in patients with chronic
Xiaofeng Xu1,2, Xiaomin Kou1,2, Jianying Yu1,2
1Mental Health Center, National Center for Mental Disorders, West China Hospital, Sichuan University Chengdu 610041, Sichuan, China.
Objective:
To explore the effect of virtual reality (VR) combined with biofeedback on sleep quality and daytime function in patients with chronic insomnia.
Methods:
Data from 83 patients with chronic insomnia admitted to the sleep department of our hospital were retrospectively analyzed and divided into a control group and an observation group according to the treatment method. The control group received routine biofeedback therapy, and the observation group received VR combined with biofeedback therapy. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Multidimensional Fatigue Scale (MFI) and Daytime Function Scale (DFSS) were compared between the two groups before and after treatment, and the changes of sleep latency, total sleep time and awakening times in polysomnography (PSG) were analyzed.
Results:
After the above treatment, the PSQI and ISI scores of the observation group were significantly lower than those of the control group (P < 0.01). PSG showed that the sleep latency was shortened, the total sleep time was prolonged, and the number of awakenings was reduced (P < 0.05). In addition, in terms of daytime function, the MFI fatigue score of the observation group decreased and the DFSS score increased, and the differences were statistically significant (P < 0.05). Finally, after 1 month of follow-up, there was no significant difference in the incidence of adverse reactions between the two groups (P=0.071).
Conclusion:
VR combined with biofeedback can effectively improve the sleep quality of patients with chronic insomnia, reduce nocturnal awakening, and improve daytime functional status, without increasing the incidence of adverse reactions.
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