The way the Schoolday 9 theme warps as your sanity drops is genuinely unsettling and so well done. Yandere Simulator's 2020 OST leans into that reactive music design where the same track exists in multiple states. The normal version is this bright, peppy school tune.
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Low sanity version? Distorted, off-key, like the melody is falling apart in real time. Low atmosphere takes it somewhere cold and hollow instead. Then there's a vaporwave edition that just exists because why not. Sakura Love Confessions is surprisingly sweet for a game about, well, you know.
If you've ever wondered what a school sim soundtrack sounds like when it's slowly losing its mind, here you go.