0482 Virtual Reality Guided Imagery for Insomnia (iVR): Preliminary Feasibility and Outcomes

Abstract

Abstract Introduction Chronic insomnia affects approximately 10% of adults and is associated with reduced quality of life, fatigue, impaired cognition, and increased risk for illness. Cognitive behavioral therapy for insomnia (CBT-I) is a recommended frontline treatment for chronic insomnia, but is not widely accessible as the number of trained CBT-I clinicians (<500) falls significantly short of the number of patients needing treatment. Digital delivery holds great potential for increasing access to CBT-I as well as other behavioral treatment approaches. Our team recently developed and conducted preliminary testing of a novel, brief virtual reality guided imagery for insomnia (iVR) in adults with chronic insomnia. Methods 12 adults (Mage=38.2 years, SD=20.7, 50% female) with chronic insomnia completed 4-weeks of iVR delivered via Oculus Go headsets equipped with blue light blocking lenses and pre-loaded with a guided relaxation application, sleep hygiene instructions, and modified stimulus control instructions. Participants completed a Satisfaction Survey at post-treatment and the following outcome assessments at baseline, post-treatment, and 1-month follow-up: Insomnia Severity Index, State-Trait Anxiety Inventory, Fatigue Severity Scale, and 1-week of sleep diaries (sleep onset latency, wake time after sleep onset, total sleep time, sleep quality [1-poor, 5-excellent]). [KM1] Paired one-tailed t-tests were used to examine preliminary outcomes. Effect sizes (ES) are reported as Hedges G. Results Adherence (#treatment weeks completed, M=3.5, SD=0.78) and Satisfaction (greater >8.8/10 on average for overall experience and likelihood of recommending to a friend) were high. Insomnia severity (7/28, ES=1.13, p<0.01), wake time after sleep onset (12 mins, ES=0.40, p=0.03), sleep onset latency (10 mins, ES = 0.36, p=0.04), and sleep quality (0.5/5, ES=1.08, p<0.01) improved following treatment. Gains were maintained at 1-month along with additional improvements in total sleep time (36 mins, ES=0.67, p=0.03) and trending improvement in fatigue (9/100, ES=0.46, p=0.05). State Trait Anxiety Inventory and Fatigue Severity Scale scores did not improve. Conclusion Our pilot findings suggest iVR is feasible and promising treatment for chronic insomnia. Because the intervention can be pre-installed, iVR may be particularly useful for individuals with limited internet access (e.g., rural populations, military). Future research with a larger sample, randomized controlled design, and longer-term follow-up appears warranted. Support (If Any) Healium, Inc-PI McCrae