By Tim Smithies and Dr Ian Dunican

Wherever possible, treating sleep disorders/ disturbances with effective non-pharmacological treatments is best. For example, Continuous Positive Airway Pressure (CPAP) machines are commonly prescribed for obstructive sleep apnea (OSA), and Cognitive Behavioural Therapy (CBT)-I is a standard treatment for insomnia. However, where specialised devices/ treatments are unavailable or for sleep problems outside of OSA and insomnia, we turn to alternative aids, often in the form of devices and products. Autonomous sensory meridian response (ASMR), yoga/ relaxation, aromatherapy, mouth taping (1) and sleep robots are all examples of alternative aids used for various sleep issues and with varying effectiveness.

Weighted blankets are the most talked about non-pharmacological alternative sleep aid (2). The concept of weighted blankets is simple; they provide gentle and evenly distributed pressure (known as deep touch pressure), which relaxes the nervous system. Like receiving a hug, weighted blankets’ deep touch pressure supposedly increases serotonin and melatonin levels while decreasing cortisol. Through this mechanism, studies have shown benefits for the use of weighted blankets for (but not limited to): anxiety/ distress levels of inpatients at psychiatric facilities (3, 4), residents (5) in nursing homes, and adult patients recovering from chemotherapy, (6) as well as a reduction of symptoms for infants with Neonatal Abstinence Syndrome (7).

Regarding sleep outcomes, weighted blankets have received much attention as a potential aid in mitigating sleep problems in children with autism spectrum disorder (ASD). The consistent sensory stimulation from the weighted blanket has been posited to promote sleep for children with ASD, though while children and parents have reported favourable things about the blankets, studies have shown minimal (8) or no (9) change in objectively measured sleep outcomes. Another study reported that parents of children with ADHD noticed the benefits of weighted blankets for sleep (sleep onset latency and sleep continuity) and general life (anxiety, life balance, participation in school) outcomes (10). However, no objective sleep measures were taken in this study.

For adults, there is also a lack of data on whether they can mitigate insomnia/ other sleep disorders or improve overall sleep quality for the everyday person. For example, a study by members of SleepScore Labs found weighted blankets to improve wake after sleep onset, sleep efficiency, and sleep maintenance of adults with sleep onset/ maintenance issues, who also reported feeling more rested and less stressed through the day, and more relaxed come bedtime (11). However, given that these findings were only reported as a conference abstract and not as an entire article, as well as the support of the study by a weighted blanket manufacturer (Gravity Blanket), these findings should be taken with a large pinch of salt. In addition, another study found nighttime weighted blanket use to reduce chronic pain in suffering adults; however, it produced no objective benefit in sleep outcomes (12). Besides these two studies, there is nothing else in the peer-reviewed literature on whether weighted blanket use benefits adults’ sleep.

Based on the available research, it is tough to recommend weighted blankets as a tool to mitigate sleep issues or improve sleep quality – there is not much evidence out there, and what is available tends to suggest little to no benefit. However, unlike alternative sleep aids (like mouth taping), they have no real downside or safety risk. Weighted blankets are safe and feasible for populations like the elderly with dementia (13), children post-operation (14), and even infants with neonatal abstinence syndrome (7). Provided correct blanket weight (typically 10% of bodyweight), the only real issue with weighted blankets is that they can get too hot for some people. Hence, if you are intrigued and want to see if a weighted blanket is comfortable and suitable for you, do; don’t expect any sleep miracles.

Before you go, did you know that at Melius Consulting, all our Consultants and Associates hold PhD qualifications in addition to their business experience. They also have academic appointments at various Universities globally, collaborate with international educational institutions and hold scientific advisory positions. We provide specialist support in developing literature reviews and white papers for organisations. A literature review (meta-analysis, systematic, general, narrative, brief or scoping review) using the hierarchy of evidence has many benefits to a business or an organisation, including;

• An assessment of the current state of research
• Identification of the experts and institutions
• Areas of further research.
• Determination of methodologies used in past studies
• Provides a direction for future research or projects

Similar, a white paper may be developed to provide information in the form of a report to the organisation on a particular problem statement or a complex issue and provide an overview including current condition, target condition, benefits and recommended direction. A white paper can be used to support leaders in understanding a topic, solving a problem, and or making a decision. Literature reviews and white papers are strongly recommended before embarking on a project or a business decision to ensure the best possible business outcome based upon the evidence at the lowest cost possible. Melius Consulting can assist your organisation.

References

1. Smithies TD, Dunican IC. Melius Consulting: Melius Consulting. 2022. Available from: https://meliusconsulting.com.au/mouth-taping-and-sleep-apnea-shut-your-mouth-about-shutting-your-mouth/.
2. Williamson AA, Mindell J, Cicalese O, Varker A, Carson M. A social media analysis about the use and efficacy of alternative child sleep aids. Pediatrics. 2021;147(3):1-2. DOI: 10.1542/peds.147.3-MeetingAbstract.1-a.
3. Becklund AL, Rapp-McCall L, Nudo J. Using weighted blankets in an inpatient mental health hospital to decrease anxiety. J Integr Med. 2021;19(2):129-34. DOI: 10.1016/j.joim.2020.11.004.
4. Novak T, Scanlan J, McCaul D, MacDonald N, Clarke T. Pilot study of a sensory room in an acute inpatient psychiatric unit. Australas Psychiatry. 2012;20(5):401-6. DOI: 10.1177/1039856212459585.
5. Hjort Telhede E, Arvidsson S, Karlsson S. Nursing staff’s experiences of how weighted blankets influence resident’s in nursing homes expressions of health. Int J Qual Stud Health Well-being. 2022;17(1):2009203. DOI: 10.1080/17482631.2021.2009203.
6. Vinson J, Powers J, Mosesso K. Weighted Blankets: Anxiety Reduction in Adult Patients Receiving Chemotherapy. Clin J Oncol Nurs. 2020;24(4):360-8. DOI: 10.1188/20.Cjon.360-368.
7. Summe V, Baker RB, Eichel MM. Safety, Feasibility, and Effectiveness of Weighted Blankets in the Care of Infants With Neonatal Abstinence Syndrome: A Crossover Randomized Controlled Trial. Adv Neonatal Care. 2020;20(5):384-91. DOI: 10.1097/anc.0000000000000724.
8. Gee BM, Lloyd K, Sutton J, McOmber T. Weighted Blankets and Sleep Quality in Children with Autism Spectrum Disorders: A Single-Subject Design. Children (Basel). 2020;8(1). DOI: 10.3390/children8010010.
9. Gringras P, Green D, Wright B, Rush C, Sparrowhawk M, Pratt K, et al. Weighted blankets and sleep in autistic children – A randomised controlled trial. Pediatrics. 2014;134(2):298-306. DOI: 10.1542/peds.2013-4285.
10. Larsson I, Aili K, Nygren JM, Jarbin H, Svedberg P. Parents’ Experiences of Weighted Blankets’ Impact on Children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Sleep Problems-A Qualitative Study. Int J Environ Res Public Health. 2021;18(24). DOI: 10.3390/ijerph182412959.
11. Danoff-Burg S, Rus HM, Cruz Martir L, Raymann RJ. Worth the weight: Weighted blanket improves sleep and increases relaxation. Sleep. 2020;43(SUPPL 1):A460. DOI: 10.1093/sleep/zsaa056.1197.
12. Baumgartner JN, Quintana D, Leija L, Schuster NM, Bruno KA, Castellanos JP, et al. Widespread Pressure Delivered by a Weighted Blanket Reduces Chronic Pain: A Randomized Controlled Trial. J Pain. 2022;23(1):156-74. DOI: 10.1016/j.jpain.2021.07.009.
13. Harris ML, Titler MG. Feasibility and Acceptability of a Remotely Delivered Weighted Blanket Intervention for People Living With Dementia and Their Family Caregivers. J Appl Gerontol. 2022:7334648221111123. DOI: 10.1177/07334648221111123.
14. Eull D, Zachrison B, Nickel A. Feasibility trial of weighted blankets as an intervention for emergence delirium in postoperative pediatric patients. J Pediatr Nurs. 2022;62:30-5. DOI: 10.1016/j.pedn.2021.11.022.