Strictly speaking, I don't know if this game is… good.
I'm definitely not sure if it's good porn, for that matter.
But what this game definitely is… is fascinating. It's in many ways an old-school RPG Maker horror game, in the vein of Yume Nikki or The Crooked Man, but with its own bizarre, idiosyncratic tendencies that give it an ambiance I've never quite felt in a game before. Once I started playing, I was utterly captivated, and just had to keep going to see the madness unfold to the very end.
I can't put my finger on exactly what it is, but there's something about this game that makes it unmistakably Russian. There's a general atmosphere of weary, resigned misery that perfuses the entire work.
Every sex scene in the game has this stilted quality to it that walks the fine line between seeming incompetent and seeming intentionally off-putting. If the goal was to make a sexy game, I think it undeniably fails; nevertheless, this game would also somehow be incomplete without the sexual content. At many points, the sex doesn't even seem like it's enjoyed by either party, more like… an obligation, either for the sake of the plot, or maybe for the sake of the player. It adds to the overall ennui on display.
I'd go so far as to characterize Agony of the Healthy Sleep as a kind of… outsider art. The creator is undeniably a talented artist and developer, and I think this game is worth seeing through to the end just to see an utterly unrestrained creative vision on display.