Okay, now I'll just write down anything that comes to my mind, so I apologize for this wall of text~
About the size of the real world.. I think it should just be one room, with one or maybe two beds. Perhaps a curtain that can separate them from each other? In my opinion, the fact that Kazenori can't fall asleep in the other bed can add to some speculation.
The random Get Well Soon-balloons and stuff sound awesome, but.. maybe not balloons. Perhaps just a small card on a nightstand, and if you walk up to it and press Z, maybe you could see the front of the card where it actually says "Get well soon"? Except that's probably too... revealing, or something. Maybe just a card and a balloon that you can't interact with. Or maybe you can pop the balloon? I dunno, discuss.
One important thing though, is to make sure they don't appear too often. They're proof that there actually are people outside of the hospital that care about Kazenori, but if they're there too often it gets kinda weird that Kazenori's always asleep when he has visitors.
Regarding NPCs in the real world, I think it would ruin pretty much the Yume Nikki-feeling. Sometimes when I play Yume Nikki, I'm creeped out even before I go to the dream world, just by the fact that you're in a small room with neither exits nor people. But if you really want something else than Kazenori alive, how about a cute but useless puppy jumping around? Or maybe an "uninteractable" patient in the other bed?
EDIT:
I also think >>757 sound good. But what about in the dream world it's more or less open, but in the real world it's closed - until you find a certain effect to open it with. Inside could be something completely unrelated to the dreams - again, puppy?
Last edited 09/11/24(Tue)09:00.