Weighted Chain Blankets Effective Intervention for Insomnia in Psychiatric Disorders

by | Oct 13, 2020 | 2020, Brain Health, Sleep

Written by Joyce Smith, BS. This study found that insomnia patients with psychiatric disorders experienced reduced insomnia severity, improved sleep and less daytime sleepiness when sleeping with a weighted chain blanket.

A common symptom in psychiatric conditions among our adult population is insomnia, characterized by difficulty falling asleep and often accompanied with daytime fatigue, anxiety and depression 1,2. Affecting 30 -40 % of our population, insomnia is a core feature of ADHD 3, bipolar disorder 4 and generalized anxiety disorder 5 with prevalence rates as high as 80%, 70%, and 70% respectively. A recent study 6, found that insomnia persisted in 75% of participants for up to 12 years after baseline.

This current randomized, controlled study 7 involved 120 adults previously diagnosed with clinical insomnia and one of the co-occurring psychiatric disorders: major depressive disorder, bipolar disorder, attention deficit hyperactivity disorder (ADHD), or generalized anxiety disorder. Participants included twice as many women as men which is consistent with earlier studies that show a higher prevalence of insomnia among women 8.Participants were blindly randomized in a 1:1 ratio to four weeks of sleeping at home with either a chain-weighted blanket or a control blanket. Participants in the weighted blanket group received 8-kilogram (about 17.6 pounds) chain blankets. Ten participants, finding them too heavy, received lighter 6-kilogram (about 13.2 pounds) blankets. Controls slept with 1.5 kilograms (about 3.3 pounds) light plastic chain blankets. The primary outcome was changes in insomnia severity, using the Insomnia Severity Index (ISI) scale. Wrist actigraphy was used to estimate sleep and daytime activity levels.

At the end of four weeks, participants using the weighted blanket reported significantly reduced insomnia severity, better sleep maintenance, a higher daytime activity level, and reduced symptoms of fatigue, depression and anxiety. Nearly 60% of weighted blanket users had a positive response with a significant decrease of 50% or more in their ISI score from baseline to the four-week endpoint compared with only 5.4% of the control group (P <.001) . The weighted blanket group also experienced significant remission (an ISI score of seven or less) of 42.2% in the weighted blanket group, compared with 3.6% in the control group. A 12-month open continuation phase (n=112) followed, in which participants continued using weighted blankets and control patients switching from a light to a weighted blanket were followed-up at 8 weeks with a visit, and again at 6 and 12 months with a telephone interview. Participants who continued to use weighted blankets through this 12-month phase maintained their four-week positive effect on sleep, while the controls who chose to switch over experienced a reduction in insomnia severity similar to that of participants using the weighted blankets initially. At the end of the 12-month phase, 92% of participants were all positive responders and 78% were in remission.

A possible explanation for the calming and sleep-promoting effect of chain blankets, with metal chains sewn in, apply pressure to the entire body as a form of deep tissue stimulation similar to acupressure and massage 9. Evidence suggests that deep pressure stimulation increases parasympathetic arousal of the autonomic nervous system and at the same time reduces sympathetic arousal, which is considered to be the cause of the calming effect 10,11.

The use of sleep journals or polysomnographic recordings would have enhanced the sleep investigation; however, the study is generalizable and validates that weighted blankets can safely and effectively treat insomnia in patients with co-occurring major depressive disorder, bipolar disorder, ADHD or generalized anxiety disorder.

Source: Ekholm, Bodil, Stefan Spulber, and Mats Adler. “A randomized controlled study of weighted chain blankets for insomnia in psychiatric disorders.” Journal of Clinical Sleep Medicine 16, no. 9 (2020): 1567-1577.

© 2020 American Academy of Sleep Medicine

Posted October 13, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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