Positive effects of a weighted blanket on insomnia

Article (PDF Available) · May 2015with 2,564 Reads
Cite this publication
Abstract
Insomnia is a common occurrence and can have a negative impact on physiological, psychological and social well-being. There is a need for simple, effective solutions to increase sleep quality. It has been suggested that weighted blankets and vests can provide a beneficial calming effect, especially in clinical disorders. Hence, we aimed to investigate the effects of a chain weighted blanket on insomnia, using objective and subjective measures. Objectively, we found that sleep bout time increased, as well as a decrease in movements of the participants, during weighted blanket use. Subjectively, the participants liked sleeping with the blanket, found it easier to settle down to sleep and had an improved sleep, where they felt more refreshed in the morning. Overall, we found that when the participants used the weighted blanket, they had a calmer night's sleep. A weighted blanket may aid in reducing insomnia through altered tactile inputs, thus may provide an innovative, non-pharmacological approach and complementary tool to improve sleep quality.
Journal of Sleep Medicine & Disorders
Cite this article: Ackerley R, Badre G, Olausson H (2015) Positive Effects of a Weighted Blanket on Insomnia. J Sleep Med Disord 2(3): 1022.
Central
*Corresponding author
Gaby Badre, SDS Kliniken, Vasaplatsen 8, 411 34
Gothenburg, Sweden, Tel: 46-31-107-780; Fax: 46-31-107-
781; Email:
Submitted: 09 May 2015
Accepted: 22 May 2015
Published: 25 May 2015
Copyright
© 2015 Badre et al.
OPEN ACCESS
Keywords
•Sleep
•Insomnia
•Treatment
•Pressure
•Touch
•Blanket
Research Article
Positive Effects of a Weighted
Blanket on Insomnia
Ackerley R1,2, Badre G1,2* and Olausson H1,2,3
1Institute of Neuroscience and Physiology, University of Gothenburg, Sweden
2SDS Clinic, ESRS accredited Sleep Research Laboratory, Gothenburg, Sweden
3Clinical and Experimental Medicine, University of Linköping, Sweden
Abstract
Insomnia is a common occurrence and can have a negative impact on physiological,
psychological and social well-being. There is a need for simple, effective solutions to
increase sleep quality. It has been suggested that weighted blankets and vests can
provide a benecial calming effect, especially in clinical disorders. Hence, we aimed
to investigate the effects of a chain weighted blanket on insomnia, using objective and
subjective measures. Objectively, we found that sleep bout time increased, as well as a
decrease in movements of the participants, during weighted blanket use. Subjectively,
the participants liked sleeping with the blanket, found it easier to settle down to sleep
and had an improved sleep, where they felt more refreshed in the morning. Overall, we
found that when the participants used the weighted blanket, they had a calmer night’s
sleep. A weighted blanket may aid in reducing insomnia through altered tactile inputs,
thus may provide an innovative, non-pharmacological approach and complementary
tool to improve sleep quality.
ABBREVIATIONS
ANOVA: Analysis of Variance; ASD: Autism Spectrum
Disorders; BMI: Body Mass Index; ISI: Insomnia Severity Index;
KSS: Karolinska Sleepiness Scale; PSG: Polysomnography; REM:
Rapid Eye Movements; Karolinska Sleepiness Scale; TST: Total
Sleep Time; VAS: Visual Analog Scale; WASO: Wake after Sleep
Onset
INTRODUCTION
According to most epidemiological studies, up to a third of the
population in industrialized countries suffers from poor sleep [1-
5]. This problem affects all categories of people from teenagers
to the elderly, and is increasing due to modern lifestyles and
the associated stressors, especially in cities. The impairment of
sleep has short- and long-term effects. It can lead to depression,
burn-out, psychosomatic disorders and addictions, as well as
other serious health problems (e.g. metabolic, cardiovascular)
[3,4,6,7]. It can affect professional lives (e.g. loss in productivity,
poor judgments, accidents, inadequate emotional reactions),
with great economic consequences. It can also have a negative
impact on social and family life. Pharmacological and behavioral
(e.g. cognitive, relaxation) methods are commonly used to treat
sleep disorders. However, drugs are often addictive or have
side effects, and psychological/behavioral methods require long
treatment sessions and it may take time to achieve satisfactory
results. Hence, there is a need for additional, simpler methods to
promote and maintain better sleep.
The application of deep pressure, through for example
weighted vests and blankets, has been reported to produce a
calming and relaxing effect in clinical conditions such as autism
    
disorder, and pervasive developmental disorders [8-15]. Applying

high levels of anxiety or arousal [16] and deep pressure touch may
also alleviate anxiety (e.g. in dental environments and bipolar
disorder [17,18]). There are also anecdotal reports suggesting

relief from deep pressure touch and many nursing homes are
experimenting with weighted blankets.
A weighted blanket that is more than 10% of a person’s body

Most of the research on weighted blankets has focused on their
use in children with clinical disorders, such as ASD. However, the
majority of these studies do not probe sleep objectively. To our
knowledge only one study has systematically investigated the
use of a weighted blanket during bedtime and this was in children
with ASD and severe sleep problems, using some objective
measures. The study found no increase in the total sleep time;
however, the blanket was favored by both the children and their
parents [20].
There is a need for systematic studies into the potential

those with insomnia. Hence, the aim of the present study was to
investigate whether the use of a weighted blanket may have a
Badre et al. (2015)
Email:
J Sleep Med Disord 2(3): 1022 (2015) 2/7
Central
positive impact on adults with sleeping problems, mainly chronic
insomnia.
MATERIALS AND METHODS
Intervention
There are several weighted blankets on the market. For this
study we used a new type of chain-weighted blanket (Somna AB,
Stenkullen, Sweden), currently used both in nursing homes for
the elderly and in patients with ASD. The weight is provided by a
metal chain construction, which is evenly distributed throughout
the blanket and provides constant tactile stimulation across the
body. The participant can choose to sleep with the chain or the
padding side of the blanket closest to their body (hence provide a
different sensation). They can also use an additional quilt, either
over or under the blanket. The blanket is weighted without being
thick, and the fabric is such that the blanket does not particularly
provide additional warmth. Three weights were available (6, 8
or 10 kg) and the participants could select the most comfortable
one. The majority of the participants in the present study selected
the 8 kg blanket.
Study design
A repeated-measures study was undertaken in two clinical
sites in Sweden, over the course of a year. For each participant,
the study lasted 4 weeks. There was no control group, as the
participants were their own control, with baseline pre-test and
post-test measures. The study was approved by the Ethical
Committee of the Sahlgrenska Academy in Gothenburg and was
conducted according to the Declaration of Helsinki. Written,
informed consent was obtained from all the participants before
taking part and they were paid for their time. Prior to undertaking
the study, an effect size analysis was conducted to ascertain the
      
effects. This was based on statistical analyses from objective
and subjective results of a previous pilot study on 5 participants.
Cohen’s d was used to calculate an effect size of 0.75, with a power
of 0.8 (ratio 4:1 between type 1: type 2 errors); a minimum of 26
participants was required to gain statistical differences. Hence,
we aimed to recruit 30 participants to account for drop-out and
technical failures, due to the complexity of the study and its
design.
Study population
The inclusion criteria were: participants’ of\genders, aged
        
  
nights a week (> 3 days) for more than 3 months, and having
feelings of not being refreshed when waking up in the morning.
If they were on medication upon entering the study, this was
continued throughout the trial period. Otherwise they had to
be healthy. The exclusion criteria were presence of illnesses
or newly discovered problems (<6 months), for example, sleep
apnea, untreated metabolic disorders or high blood pressure.
The participants should not have changed any medication in the
prior 4 weeks to commencing the study.
Participants were selected by advertising at the sleep clinics
lthy participants
complaining of chronic insomnia were recruited for the study;
31 completed the protocol (11 men, 20 women). For further
details about the participants, see Table 1. Prior to the study,
the participants also completed various questionnaires covering
environmental and lifestyle factors, including their health status,
irregularity in sleep-wake patterns and life style, variability of
sleep during the weekend, the presence of any sleep phase delay
or advance, their perception of sleep quality, and if they used any
medication.
The level of insomnia per participant was determined
according to the 7-item Insomnia Severity Index (ISI) [21], which
assesses the nature, severity, and impact of insomnia in their
life. Each question is rated from 0 (no problem) to 4 (severe
problem), with the total possible score being 28. A score of less

threshold insomnia, while 15-21 represents moderate insomnia
and a score greater than 22 indicate severe insomnia. The
         
daytime consequences of insomnia (i.e. daytime sleepiness). This
consisted of a questionnaire with answers ranging from 0 (no
chance of dozing) to 3 (high chance of dozing) to give a total out
of 24 points.
Procedures
After screening and consent, the eligible participants slept
for a week in their habitual environment, which consisted the
pre-test baseline period. The following test period followed
consisted of two consecutive weeks during which the participant
used the weighted blanket every night. They pre-selected a
blanket weight, but if they felt that it was too light or heavy, they
could change it after no more than two nights into the test. The
participant returned the blanket after these two test weeks and
slept for one more week in their ordinary, habitual conditions
(post-test period).
Methods for studying sleep patterns
The trial design included both objective (physiological) and
subjective (self-report) measures.
OBJECTIVE MEASURES
Continuous actigraphy (Actiwatch; Cambridge
Neurotechnology Ltd, Cambridge, UK) and comprehensive
polysomnography (PSG) recordings, in the participants’ own
home, were obtained.
The actigraphy watch consisted of an accelerometer that was
worn on the same wrist continuously during the 4 week period.
Data were stored in the watch unit. Analyses of patterns and
frequencies of movements were done by validated algorithms for
the recognition of basic sleep-wake patterns. The participants’
time-to-bed and waking-up time were reported in their sleep
        
were conducted on these sleep periods. The variables analyzed
included sleep latency, assumed sleep, total wake time, sleep
fragmentation index, number of bouts of immobile time and
their frequency, as well as the number of sleep bouts and their
duration. We did not want to interfere with the ordinary lifestyle
and activities of the participants, though we recommended that
Badre et al. (2015)
Email:
J Sleep Med Disord 2(3): 1022 (2015) 3/7
Central
Characteristic Number Mean ± SD Range
Age (all)
Males
Females
31
11
20
47 ± 14 years

43 ± 13 years
21-66 years
25-60 years
21-66 years
BMI (all)
Males
Females
31
11
20
25.8 ± 5.2

25.4 ± 5.8



ISI(all)
Males
Females
31
11
20
20 ± 5

20 ± 6
5-28
11-23
5-28
Epworth(all)
Males
Females
31
11
20
6 ± 4
6 ± 3
6 ± 4
0-12
2-12
0-11
Weight of blanket/weight of participant 31  12% -38%
Question No Occasionally/Yes Often
Do you take sleep medication? 66% 21% 14%
Do you have an irregular sleep cycle? 66% 21% 14%
Is your sleep different at the weekend? 48% 34% 17%
Do you have a phase delay with sleep?  10%
Do you do shift work?  7%
Table 1: Details about the participants.
Abbreviations: BMI: Body Mass Index; ISI: Insomnia Severity Index
they avoid major irregularities, if it meant a large variation in
their sleep-wake pattern e.g. going to bed late and getting up
late during the weekend. For participants that showed these

deviation for 2 or more days), we restricted the analysis to 5
continuous days/nights for both the pre-test and the test period,
which typically did not include weekends where the larger
sleeping deviations tended to occur.
The PSG was measured using a 23 channel ambulatory
polygraph that recorded electroencephalography (electrical brain
activity), electromyography (muscle activity), electrooculography
(eye movements), electrocardiography (heart beat), respiratory
activity and oxygen content in the blood (pulse oximetry), while
a sensor pad, placed under the sheets, recorded body movements
and positions during the night (Biosaca; Swedsleep AB,
Gothenburg, Sweden). Two comprehensive PSG recordings were

test (no weighted blanket) week and one at the end of the third
week (test period, with the weighted blanket). PSG analysis was
done using the REM Logic software (Embla Systems LLC).
Further to conventional PSG analysis a validated automatic
system for analyzing body movements [23] was used (U-sleep;
Swedsleep AB, Gothenburg, Sweden). Based on the sensor pad it

according to their duration(from < 5 s to >15 s), representing
jerks or twitches, minor or major adjustments, and turns in the
bed. The total number and duration of each of these measures
were calculated, as well as the distribution per recording hour,
with an emphasis on the next-to-last hour prior to waking up.
The following measures were gained: wake after sleep onset
         
latency, latency to deep sleep and rapid eye movements (REM),
number of awakenings, amount of deep sleep and REM, arousal
index, number of stage shifts, of sleep cycles, deep and REM sleep,
average deep sleep period, and sleep spindles index.
Subjective measures
During the whole experimental period, the participants
 
perception together, with any comments about their night’s sleep
and any environmental changes of importance. Each morning,
they also reported their ‘sleep quality’ in a visual analog scale
(VAS; with the end-anchors ‘Very good’ and ‘Very bad’), as well
      
very sleepy) [24].
At the end of the study the participants reported their
subjective feelings about using the weighted blanket in an 8-item

with the blanket (Table 2), where lower scores indicated more
favorable feelings towards the weighted blanket. Two further
questions were asked: (i) ‘Which side of the blanket is closest to
your body most of the time?’ and (ii) ‘Did you use something else
as a cover, in addition to the weighted blanket?’ These were to
assess how the participants used the weighted blanket.
Data analysis
Statistical studies were made using SPSS (version 22; IBM,
Armonk, NY) and Prism (version 6; Graph Pad, La Jolla, CA)
        
analyses have been conducted on normalized data, as most of
the variables were not normally distributed. Hence, parametric,
interval statistics were carried out on the actigraphy, PSG and
U-sleep measures and repeated-measures analysis of variance
(ANOVA) tests were used. We compared the pre- and post-
test data with the weighted blanket data for each variable
     
controlled for multiple comparisons. It was not always possible
Badre et al. (2015)
Email:
J Sleep Med Disord 2(3): 1022 (2015) 4/7
Central
Score between 1 10
1 Comfortable Uncomfortable
2 How is your experienced sleep quality, as compared to having no weighted blanket? Better Worse
3  Awkward
4 Not at all Very
5 Does the blanket affect your temperature in bed? Not at all Very
6 Is it easier to settle down to sleep with the blanket? Very Not at all
7 Does the blanket give you a sense of security? Very Not at all
8 How do you feel in the morning with the blanket? More rested More tired
Table 2: The participants rated their subjective feelings about sleep with the weighted blanket using a visual analog scale for questions 1-8.
to include all of the participants per measure due to issues such
as technical problems. The effects of confounding variables,
such as the participant’s gender, age, use of medication, were
tested as covariates. As the behavioral measures were based on
questionnaires, non-parametric, ordinal tests were used for the
analysis.
Additional analyses were conducted on a sub-set of
participants who rated the weighted blanket favorably, which
was based on their subjective assessment scores, where lower
scores indicated a higher liking. The criteria for exclusion
         
score on questions 1-8 of more than 5, a maximum score of 8 or
more, and scores of 8 or more on more than two questions.
RESULTS
          
SD), which indicated insomnia of moderate severity (see Table
1 for further details).The mean Epworth score was 6.1 (±3.7 SD)
indicating that the participants had minor issues with sleepiness
in the daytime, with further details in Table 1.
OBJECTIVE MEASURES
Actigraphy
The actigraphy was used to determine variables about sleep
metrics; therefore only the sleep period was analyzed, with the
time-in-bed adjusted according to each participant’s sleep diary.
Actigraphy was obtained from 27 participants, from a total of
26 different measures, although some of these measures were
seemingly redundant (e.g. immobility expressed in minutes
        
differences were found in comparing the pre-test period to the
        
         
when using the weighted blanket. Furthermore, the total activity
score during the time in bed (p < 0.001) and the average dark
        
decreased, during weighted blanket use. These measures are
shown in Figure 1.
There was an effect on the results from one of the covariates,
        

blanket, if the participant used medication. The further analysis
    
(A)
(B)
(C)
Pre-Test Blanket Post-Test
0
5
10
15
20
25
30
35
Mean sleep bout time (mins)
* **
Pre-Test Blanket Post-Test
0
50
100
150
200
250
Mean dark activity (mins)
*
Pre-Test Blanket Post-Test
0
5000
10000
15000
20000
25000
Total activ ity score
*** *
Figure 1       
sleep periods from actigraphy measurements.

actigraphy measures, where there was (A) an increase in the mean
sleep bout time, and decreases in (B) the total activity score and (C)
         
where * p < 0.05 and *** p < 0.001.

the results.
The post-test actigraphy period was compared to both the
pre-test and weighted blanket periods. Due to participant drop-
out, only 22 participants completed the post-test, as compared to
the 27 who completed the pre-test and weighted blanket periods.
 differences between the pre- and post-
Badre et al. (2015)
Email:
J Sleep Med Disord 2(3): 1022 (2015) 5/7
Central

weighted blanket and the post-test periods for the mean sleep

activity score (p = 0.018) and mean activity score (p = 0.015).
PSG
A total of 25 participants completed both PSG tests during
the pre-test stage and while using the weighted blanket. PSG is
a state-of-the-art measure for sleep studies, but the participants
often reported that it was disturbing, due to the equipment

weighted blanket test, as compared to the pre-test: the spindles
      
only the 21 participants (out of the 25 who completed the PSG, i.e.
    
         
=0.016).The effect of confounding variables on the PSG measures
was sought, where an effect of gender was found, but this was
only for the sleep spindles measure. Here, females had a higher
spindles index during use of the weighted blanket, as compared
to males (p = 0.024).
Movement analysis
The U-sleep data consisted of 6 measures collected from
23 of the 25 participants who completed the PSG (in 2 subjects
there were technical problems with the sensor pad). The mean
movements decreased in the next-to-last hour prior to waking
up, both in duration (p =0.001) and in number (p = 0.075).No
        
the U-sleep measures. A further analysis was run using only the
subjects that liked using the weighted blanket (n = 15). Here, the
number of movements in the next-to-last hour prior to waking
      
blanket use.
Subjective measures
   
participants. There were decreases in both of these measures,
meaning a better subjective sleep quality (sleep quality:
          
0.005; KSS decreased from 5.8 (pre-test) to 5.5 (during blanket
         
differences with either the pre-test or weighted blanket periods
    
were found for the confounding variables on the KSS or sleep
quality measures, nor were any further differences found when
only the participants that liked using the blanket (n = 20) were
analyzed.
In Figure 2, the subjective assessment of using the weighted
blanket showed that overall, the participants liked sleeping with
the blanket (p =0.035), found easier to settle down to sleep (p =
0.032) and reported a much better quality of sleep (p = 0.004),
feeling more refreshed in the morning (p = 0.045). They were
not disturbed by the weight of the blanket (p =0.012) and in fact,
felt a sense of security (p = 0.042). Furthermore, the weighted
blanket did not affect their temperature in bed. The majority of
participants (63%) preferred the padding side of the blanket to
be closest to their body during sleep. The majority also just used
the weighted blanket (63%), as compared to 30% who used an
additional quilt under the blanket and 7% who used a quilt over
the blanket.
DISCUSSION
In the present study, a chain weighted blanket was found to
be effective at improving sleep quality in recognized insomniacs,
both in parameters measured objectively and subjectively. The
impact was more pronounced objectively when the participants
reported having a positive experience of using the weighted
blanket and if they used sleep medication. No adverse effects of
using the weighted blanket were found.
Weighted blankets providing a ‘cocooning’ feeling and are
often recommended for young patients with ASD and in the
care of agitated elderly people. However, to our knowledge this
     
insomniacs. The ISI results validated that the selected group had
mild-to-moderate insomnia and their Epworth scores, expected
to be low in this group of subject, though within the normal
range, were also a little elevated (mean = 6, indicating some
tendency for daytime consequences), meaning that the blanket
 
mild sleep problems. Based on sensory integration, it has been
suggested that deep pressure and consistent sensory input,
such as provided by a heavy weight on the body, can reduce
physiological levels of arousal [25].A crucial point is that the
weight should not be too light or heavy, and the weight must
be evenly distributed throughout the fabric to provide constant
tactile stimulation distributed across the body, which the current
weighted blanket design provided.
There are many weighted blankets and vests on the market
with different designs, for example, those with metal chains
          
and ball quilts may provide different sensations (e.g. tactile,
thermal insulation) and have different weights, which need to
be adapted individually, as some patients may be more sensitive
to stimulation, thus requiring a lesser-weighted blanket. The
1
. Sleeping
2. Quality
3. Weight
4. Movement
5. Temperature
6. Settling
7. Security
8. Morning
0
2
4
6
8
10
Rating
* ** * * * *
Figure 2 Ratings of subjective feelings about sleep with the weighted
blanket. Each participant rated their feelings on VASs for eight items
(numbered 1-8, see questions in Table1), where lower numbers are
more favorable ratings towards the weighted blanket. The dotted line
indicates the level between liking and disliking. The asterisks indicate
        

Badre et al. (2015)
Email:
J Sleep Med Disord 2(3): 1022 (2015) 6/7
Central
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. [20]), 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 [27]) and physiological means (e.g.
tactile input that decreases activity of the sympathetic nervous
system [28]).As increased sympathetic arousal likely affects
sleep quality negatively, reducing it may aid sleep.
CONCLUSION
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
sleep quality.
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.
REFERENCES
1. Léger D, Guilleminault C, Bader G, Lévy E, Paillard M. Medical and
socio-professional impact 
2. Ohayon MM, Bader G. Prevalence and correlates of insomnia in the

3. Hillman DR, Lack LC. Public health implications of sleep loss: the

4. Riemann D, Nissen C, Palagini L, Otte A, Perlis ML, Spiegel Alder K.
The neurobiology, investigation, and treatment of chronic insomnia.
Lancet Neurol. 2015; 14: 547-558.
5. National Center on Sleep Disorders Research. National Institutes of
Health.
6. Colten HR, Altevogt BM. Committee on Sleep Medicine and Research
-Sleep Disorders and Sleep Deprivation: An Unmet Public Health
Problem. The National Academies Press Washington, DC, National
Academy of Sciences. 2006; 404.
7. Asplund R, Aberg H. Sleep and cardiac symptoms amongst women

8.        

 Collins A, Dworkin RJ. Pilot study of the effectiveness of weighted

10. Fertel-Daly D, Bedell G, Hinojosa J. Effects of a weighted vest on
attention to task and self-stimulatory behaviors in preschoolers with
 
640.
11. Grandin T. Calming effects of deep touch pressure in patients with
Badre et al. (2015)
Email:
J Sleep Med Disord 2(3): 1022 (2015) 7/7
Central
autistic disorder, college students, and animals. J Child Adolesc

12.          
hyperactivity disorder sleeping problems. Nord J Psychiatry. 2011;

13. Morrison AP. A review of research on the use of weighted vests with
children on the autism spectrum. Education. 2007; 127: 323–327.
14. Olson LJ, Moulton HJ. Use of weighted vests in pediatric occupational
therapy practice. Phys Occup Ther Pediatr. 2004; 24: 45-60.
15. Stephenson J, Carter M. The use of weighted vests with children with
autism spectrum disorders and other disabilities. J Autism Dev Disord.

16. Edelson SM, Edelson MG, Kerr DC, Grandin T. Behavioral and
physiological effects of deep pressure on children with autism: a pilot
      

17. Chen H-Y, Yang H, Chi H-J, Chen H-M. Physiological effects of deep
touch pressure on anxiety alleviation: The weighted blanket approach.
J Med Biol Eng. 2013; 33: 463-470.
18. Sylvia LG, Shesler LW, Peckham AD, Grandin T, Kahn DA. Adjunctive
deep touch pressure for comorbid anxiety in bipolar disorder:
mediated by control of sensory input? J Psychiatr Pract. 2014; 20: 71-
77.
Mullen B, Champagne T, Krishnamurty S, Dickson D, Gao RX. Exploring
the safety and therapeutic effects of deep pressure stimulation using a

20. Gringras P, Green D, Wright B, Rush C, Sparrowhawk M, Pratt K, et
al. Weighted blankets and sleep in autistic children--a randomized

21. Morin CM. Insomnia: psychological assessment and management.

22. Johns MW. A new method for measuring daytime sleepiness: the

23. Bader G, Almersjö B. A Comparison of sleep analysis according to

22: C074N.
24. Akerstedt T, Gillberg M. Subjective and objective sleepiness in the

25. Ayres AJ. Sensory integration and learning disorders. Western

26. Dang-Vu TT, McKinney SM, Buxton OM, Solet JM, Ellenbogen JM.
Spontaneous brain rhythms predict sleep stability in the face of noise.
Curr Biol. 2010; 20: R626-627.
27. Krauss KE. The effects of deep pressure touch on anxiety. Am J Occup

28. Bundy AC, Lane SJ, Murray EA. Sensory integration: Theory and
Practice, 2nd ed., Philadelphia: F.A. Davis Company, 2002.
Ackerley R, Badre G, Olausson H (2015) Positive Effects of a Weighted Blanket on Insomnia. J Sleep Med Disord 2(3): 1022.
Cite this article
This research hasn't been cited in any other publications.
  • Article
    • H.-Y. Chen
    • Hsiang Yang
    • H.-J. Chi
    • H.-M. Chen
    The application of deep touch pressure (DTP) has been suggested to provide positive effects on anxiety modulation. However, empirical and theoretical evidence linked to the clinical effects of DTP are relatively rare. This study conducts a quantitative analysis of behavioral assessments and performs physiological measurements, including those of electrodermal activity and heart rate variability, to understand the modulation of the autonomic nervous system (ANS), and the orchestration of sympathetic (SNS) and parasympathetic nervous systems (PsNS). The results suggest that the activation of PsNS plays a critical role in ANS modulation. This study provides physiological evidence to support the positive clinical effects of DTP for reducing anxiety in dental environments.
  • Article
    • Dieter Riemann
      Dieter Riemann
    • Christoph Nissen
      Christoph Nissen
    • Laura Palagini
      Laura Palagini
    • Kai Spiegelhalder
      Kai Spiegelhalder
    Chronic insomnia is defined by difficulties in falling asleep, maintaining sleep, and early morning awakening, and is coupled with daytime consequences such as fatigue, attention deficits, and mood instability. These symptoms persist over a period of at least 3 months (Diagnostic and Statistical Manual 5 criteria). Chronic insomnia can be a symptom of many medical, neurological, and mental disorders. As a disorder, it incurs substantial health-care and occupational costs, and poses substantial risks for the development of cardiovascular and mental disorders, including cognitive deficits. Family and twin studies confirm that chronic insomnia can have a genetic component (heritability coefficients between 42% and 57%), whereas the investigation of autonomous and central nervous system parameters has identified hyperarousal as a final common pathway of the pathophysiology, implicating an imbalance of sleep-wake regulation consisting of either overactivity of the arousal systems, hypoactivity of the sleep-inducing systems, or both. Insomnia treatments include benzodiazepines, benzodiazepine-receptor agonists, and cognitive behavioural therapy. Treatments currently under investigation include transcranial magnetic or electrical brain stimulation, and novel methods to deliver psychological interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.
  • Article
    Full-text available
    • Paul Gringras
      Paul Gringras
    • Dido Green
      Dido Green
    • Barry Wright
      Barry Wright
    • Luci Wiggs
      Luci Wiggs
    Objective: To assess the effectiveness of a weighted-blanket intervention in treating severe sleep problems in children with autism spectrum disorder (ASD). Methods: This phase III trial was a randomized, placebo-controlled crossover design. Participants were aged between 5 years and 16 years 10 months, with a confirmed ASD diagnosis and severe sleep problems, refractory to community-based interventions. The interventions were either a commercially available weighted blanket or otherwise identical usual weight blanket (control), introduced at bedtime; each was used for a 2-week period before crossover to the other blanket. Primary outcome was total sleep time (TST) recorded by actigraphy over each 2-week period. Secondary outcomes included actigraphically recorded sleep-onset latency, sleep efficiency, assessments of child behavior, family functioning, and adverse events. Sleep was also measured by using parent-report diaries. Results: Seventy-three children were randomized and analysis conducted on 67 children who completed the study. Using objective measures, the weighted blanket, compared with the control blanket, did not increase TST as measured by actigraphy and adjusted for baseline TST. There were no group differences in any other objective or subjective measure of sleep, including behavioral outcomes. On subjective preference measures, parents and children favored the weighted blanket. Conclusions: The use of a weighted blanket did not help children with ASD sleep for a longer period of time, fall asleep significantly faster, or wake less often. However, the weighted blanket was favored by children and parents, and blankets were well tolerated over this period.
  • Article
    • L. G. Sylvia
    • Leah W Shesler
    • Andrew D. Peckham
      Andrew D. Peckham
    • David A Kahn
    Previous studies have shown that individuals with autism spectrum disorders and attention- deficit/hyperactivity disorder (ADHD) experience sensory over-responsivity (SOR) in which a heightened response is evoked by stimuli in the environment. These individuals also display symptoms of anxiety such as irritability, avoidance, and sweating. Deep touch pressure, a technique in which firm touch is applied to the body either by the self or by a machine, has been shown to improve functioning and reduce symptoms of anxiety in these populations. A patient presenting with bipolar I disorder and comorbid anxiety, ADHD, and dyslexia was taught deep touch pressure strategies to alleviate severe symptoms of sensory over-responsivity and anxiety. The patient reported that the techniques were helpful as they allowed her to cope with potentially overwhelming situations in her environment. Clinician-rated functioning also improved over the course of treatment. This case study suggests that deep touch pressure may be useful in patients with bipolar disorder who have SOR and anxiety as comorbid conditions. (Journal of Psychiatric Practice 2014; 20:71-77).
  • Article
    Full-text available
    • David Hillman
      David Hillman
    • Leon Lack
      Leon Lack
    Poor sleep imparts a significant personal and societal burden. Therefore, it is important to have accurate estimates of its causes, prevalence and costs to inform health policy. A recent evaluation of the sleep habits of Australians demonstrates that frequent (daily or near daily) sleep difficulties (initiating and maintaining sleep, and experiencing inadequate sleep), daytime fatigue, sleepiness and irritability are highly prevalent (20%-35%). These difficulties are generally more prevalent among females, with the exception of snoring and related difficulties. While about half of these problems are likely to be attributable to specific sleep disorders, the balance appears attributable to poor sleep habits or choices to limit sleep opportunity. Study of the economic impact of sleep disorders demonstrates financial costs to Australia of $5.1 billion per year. This comprises $270 million for health care costs for the conditions themselves, $540 million for care of associated medical conditions attributable to sleep disorders, and about $4.3 billion largely attributable to associated productivity losses and non-medical costs resulting from sleep loss-related accidents. Loss of life quality added a substantial further non-financial cost. While large, these costs were for sleep disorders alone. Additional costs relating to inadequate sleep from poor sleep habits in people without sleep disorders were not considered. Based on the high prevalence of such problems and the known impacts of sleep loss in all its forms on health, productivity and safety, it is likely that these poor sleep habits would add substantially to the costs from sleep disorders alone.
  • Article
    • Erin E. Morrison
    Occupational therapists working in the school system setting report using weighted vests as a technique to improve attention and sensory processing for students who have an autism spectrum disorder. Some critics, however, contend that this technique is used without evidence of effectiveness. This study examines the overall research available on the use of weighted vest with children on the autism spectrum to see what, if any, consensus concerning effectiveness exist regarding this practice.
  • Article
    Full-text available
    • Brian Mullen BS
    • Tina Tessier Champagne
      Tina Tessier Champagne
    • Sundar Krishnamurty
      Sundar Krishnamurty
    • Robert X. Gao
      Robert X. Gao
    This paper presents the results of a concurrent, nested, mixed methods exploratory study on the safety and effectiveness of the use of a 30 lb weighted blanket with a convenience sample of 32 adults. Safety is investigated measuring blood pressure, pulse rate, and pulse oximetry, and effectiveness by electrodermal activity (EDA), the State Trait Anxiety Inventory-10 and an exit survey. The results reveal that the use of the 30 lb weighted blanket, in the lying down position, is safe as evidenced by the vital sign metrics. Data obtained on effectiveness reveal 33% demonstrated lowering in EDA when using the weighted blanket, 63% reported lower anxiety after use, and 78% preferred the weighted blanket as a calming modality. The results of this study will be used to form the basis for subsequent research on the therapeutic influence of the weighted blanket with adults during an acute inpatient mental health admission.
  • Article
    • Amy Collins
    • Rosalind J Dworkin
    In this pilot study, we determined the effectiveness of a weighted vest on attention to task for second-grade general education students with difficulty attending. We used an intervention and a control group and an ABA design to compare participants' percentage of time on task with and without a vest. Ten participants from nine elementary schools in a suburban Texas school district were randomly assigned to an intervention or a control group. Control group participants wore a nonweighted vest. Participants, classroom teachers, and research assistants who coded the data were blind as to the group to which the participants were assigned. A repeated measures analysis of variance indicated no significant differences between groups or between baseline, intervention, and withdrawal conditions. Our results indicated that the weighted vests were not effective in increasing time on task. These results should be generalized cautiously owing to the small sample size and participant selection process.
  • Article
    • Maurice Moyses Ohayon
      Maurice Moyses Ohayon
    • Gaby Bader
      Gaby Bader
    To assess the prevalence of insomnia symptoms, their associated factors and daytime symptoms in the general population of Sweden. This is a cross-sectional postal survey performed in the general population of Sweden aged between 19 and 75 years (6 million inhabitants). A total of 1209 out of 1705 randomly selected participants from the National Register of the Total Population completed the questionnaire. The participation rate was 71.3%. Participants filled out a paper-pencil questionnaire composed of 157 items covering sociodemographic characteristics, sleeping habits and environment, sleep quality and sleep symptoms, and health status. We found 32.1% (95% confidence interval: 29.5-34.8%) of the sample reported having difficulty initiating (DIS) or maintaining sleep (DMS) or non-restorative sleep accompanied with sufficient sleep (NRS) at least 4 nights per week: 6.3% of the sample had DIS, 14.5% had DMS and 18.0% had NRS. Results from logistic regressions showed that restless legs symptoms, breathing pauses during sleep and depressive or anxious mood were associated with DIS and DMS but not NRS. Living in an urban area (OR:2.0) and drinking alcohol daily (OR:4.6) were associated only with NRS. Daytime symptoms were reported by over 75% of subjects with insomnia symptoms. DIS, DMS and NRS were associated with daytime fatigue but not excessive sleepiness as measured by the Epworth scale. DIS was associated with the use of sleeping pills or natural sleeping aid compounds in multivariate models. Insomnia symptoms occurring at least 4 nights per week are frequent in Sweden, affecting about a third of the population. Subjects with NRS have a distinctly different profile than those with DIS or DMS, which suggests different etiological causes for this symptom.
  • Article
    • Charles M Morin
      Charles M Morin
    Bibliogr. s. 213-231