Badre et al. (2015)
J Sleep Med Disord 2(3): 1022 (2015) 6/7
effectiveness of a weighted blanket has been found to relate to
the mass of a person, where a blanket that weighs more than 10%
in the current study had a weight of blanket/participant
ratio of more than 12% (see Table 1). The longitudinal chain
construction of the present weighted blanket may adjust well to
the participant’s body, where an even weight is delivered over
the body from the whole blanket surface, with the longitudinal
with minor movements producing a stroking-like effect.
There are limitations to the current study design, which
include a lack of a control group, the long duration of the study,
some missing data, and the inability to provide a placebo weighted
blanket. The participants represented their own control (pre-
and post-test measures) in our cross-over design and a control
group would only have been necessary if the goal was to compare
different types of blankets. However, in some tests, we had
reduced numbers of participants (e.g. in the PSG), particularly
due to technical issues with this equipment-intensive technique.
As we calculated that we needed at least 26 participants for
participants, which allowed for some issues and participant drop-
out (which occurred mainly at the week 4 post-test stage).Giving
a weighted blanket to control participants without insomnia
would have been less meaningful, unless we were interested in
looking at a possible negative impact of the blanket. However, the
strengths of our design include the use of combined objective and
subjective assessments using different, independent methods,
and the use of a pre- and post-test baseline.
PSG is the golden standard to study sleep, but it can be
cumbersome, disturbing and is limited to a few nights, hence not
representative of the subject’s habitual night sleep. The PSG did
reporting a subjective positive impact of the blanket. Regarding
responsiveness of the brain to stimuli, where a decreased amount
suggests a ‘loss of contact’ with the external environment, hence
movement (U-sleep) analysis was based on recordings from the
PSG. Hence, we used the ‘next to last hour’ measure to assess
sleep, since the last hour is often characterized by a shallow
sleep. The participants showed a decrease of movements this
next to last hour, which represented a quieter, more restful sleep.
Therefore the combination with actigraphy made for a more
comprehensive evaluation of the effects of using the weighted
blanket over time. The actigraphy showed a number of objective
improvements in sleep, including a decrease in movements and
an increase in the length of sleep bouts.
Overall, these measures suggest the additional pressure
stimulation from the weighted blanket provided a calming effect
on the participants, by decreasing agitation and increasing the
quality of their sleep. This was demonstrated through a decrease
in movements during sleep with the weighted blanket, which
were increased in the pre- and post-test periods, and also the
subjective increased in sleep quality (measured by the VAS)
and KSS (which is a validated instrumental scale). Although
these subjective measures are possibly less clinically relevant,
it is important to consider the psychological effects of using the
weighted blanket (cf. ), for example, having a positive attitude.
Weighted blankets and deep pressure touch may work well for
insomniacs, both through psychological means (e.g. calming and
‘cocooning’, releasing anxiety ) and physiological means (e.g.
tactile input that decreases activity of the sympathetic nervous
system ).As increased sympathetic arousal likely affects
sleep quality negatively, reducing it may aid sleep.
The weighted chain blanket used in the present study had
a positive impact on sleep, both objectively and subjectively,
where a number of physiological and behavioral measures were
improved during weighted blanket use. When the participants
used the weighted blanket, they had a calmer night’s sleep,
with a decrease in movements. Subjectively, they believed that
using the blanket provided them with a more comfortable,
better quality, and more secure sleep. In conclusion, a weighted
blanket may aid in reducing insomnia through increased tactile
and proprioceptive inputs, may provide an innovative, non-
pharmacological approach and complementary tool to improve
CONFLICT OF INTEREST
The study was supported by a grant from Somna AB. GB is
the Medical Director of SDS Clinic, where the study was overseen.
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