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. 2024 Nov 26;13(23):7163.
doi: 10.3390/jcm13237163.

Virtual Reality to Improve Sleep Quality in Patients Suffering from Painful Diabetic Polyneuropathy: A Proof of Concept Study

Lisa Goudman  1   2   3   4   5 , Ann De Smedt  1   2   6 , Julie Jansen  1 , Maxime Billot  7 , Manuel Roulaud  7 , Philippe Rigoard  7   8   9 , Maarten Moens  1   2   3   4   5   10
Affiliations

Virtual Reality to Improve Sleep Quality in Patients Suffering from Painful Diabetic Polyneuropathy: A Proof of Concept Study

Lisa Goudman et al. J Clin Med. .

Abstract

Background/Objectives: Sleep disturbance is often observed in the context of chronic pain. We hypothesize that, by providing an immersive Virtual Reality (VR) experience with a serious game to chronic pain patients an hour before bedtime, attention can be diverted from the pain condition, consequently leading to improved sleep quality. The aim is to evaluate the efficacy of VR compared to usual care in reducing the number of awakenings during the night and increasing sleep efficiency in patients suffering from painful diabetic polyneuropathy (PDPN). Methods: Eight patients with PDPN were randomized to either two weeks of VR or two weeks of usual care, followed by a cross-over. The primary outcome measurements were sleep efficiency and number of awakenings during the night. As secondary outcomes, self-reported sleep quality, insomnia, pain catastrophizing, anxiety, depression, pain intensity, side effects and impression of change were evaluated. Results: Data of seven patients were analysed. Actigraphy data, self-reported sleep quality, insomnia, pain catastrophizing, anxiety, depression and pain intensity scores did not differ between usual care and VR. As for impression of change, more patients improved after VR compared to usual care (V = 21, p = 0.03). Conclusions: A 2-week period of pain neuroscience education through VR did not result in increased sleep efficiency or fewer awakenings compared to usual care in patients with PDPN. These pilot results indicate that patients subjectively experience an improvement, yet this is not substantiated by either self-reported or objective measurements.

Keywords: behavioral therapy; biopsychosocial treatment; chronic pain; diabetes; immersive technologies; patient education.

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Conflict of interest statement

Lisa Goudman is a postdoctoral research fellow funded by the Research Foundation Flanders (FWO), Belgium (project number 1211425N). Maarten Moens is funded by the Research Foundation Flanders (FWO), Belgium (project number 1801125N). Philippe Rigoard reports grants and consultant fees from Medtronic, Abbott and Boston Scientific, outside of the submitted work. Maarten Moens has received speaker fees from Medtronic. STIMULUS received independent research grants from Medtronic. There are no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Study protocol. One baseline visit was conducted after which patients were randomized to either a 2-week period of Virtual Reality or usual care. After this, a cross-over took place to the other intervention. Outcome measurements were collected immediately after each intervention. Abbreviations: PGIC: patient global impression of change; VAS: Visual Analogue Scale; VR: Virtual Reality.
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