While I will never play it either way because I'm a gigantic wimp when it comes to horror games...i could see a capacity in which it would work...if, say, you had a surround-sound setup. It's a game that warrants one of those nightmare-inducing playthroughs where you have headphones on, the volume up, and the lights off. Which would work with surround-sound...just not standard stereo because it loses some atmosphere