Virtual Reality for Dual Relief of Pain and Sleep Disturbance in Burn Patients: A Randomized Clinical Trial.

Abstract

Purpose: Pain during dressing changes and sleep disturbances are among the most distressing challenges faced by burn patients, profoundly affecting recovery and quality of life. This randomized controlled trial examined the efficacy of virtual reality (VR) as a nonpharmacological intervention for alleviating procedural pain and improving sleep quality in patients with 25%-60% total body surface area burns.

Design: Single-center, parallel-group, randomized controlled trial.

Methods: Sixty patients admitted to Taleghani Burn and Trauma Hospital in Ahvaz were randomly assigned to a VR group (n = 30) or a control group (n = 30). The VR group received immersive virtual reality distraction during dressing changes, while the control group received standard care. Pain intensity was measured using the visual analog scale (VAS) before and immediately after the procedure, and sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI) at baseline and 24 hours postintervention.

Results: The VR group showed dramatic improvement in sleep quality (PSQI: 18.63 ± 1.25 → 11.37 ± 1.59; Δ = -7.27 ± 1.68) and significant pain reduction (VAS: 8.73 ± 0.64 → 7.33 ± 0.71; Δ= -1.40 ± 0.86). In contrast, the control group showed no meaningful improvement. Between-group differences in change scores were highly significant (p < .001 for both outcomes).

Conclusions: VR is a highly effective, nonpharmacological intervention that concurrently alleviates procedural pain and improves global sleep quality in burn patients.

Clinical implications: The magnitude of sleep improvement exceeds the minimal clinically important difference (MCID = 2-3), supporting VR's integration into standard burn care protocols as a safe, nonpharmacological adjunct.