In many adventure games the puzzles seem to be bolted on to the story in haphazard fashion. Such is not the case in Sanitarium . It does an admirable job of weaving the puzzles into the fabric of the story, such that each one seems to be appropriate. And, while this is certainly helped by the surreal plot and surroundings in some cases, it is nonetheless an extraordinary accomplishment. So despite the relatively abbreviated length of the game, it works precisely because it is such a well integrated whole.
Puzzles take on several varieties.
These require you to manipulate complex gadgets. None of the puzzles is particularly difficult. Indeed, for the most part they are fairly easy as adventure game puzzles go. Partly that's because they make sense, and partly that's because the game is so story driven. The only exceptions to the difficulty rule are that at times it can be hard to notice where an item you need to pick up is located.