The efficacy of weighted blankets for sleep in children with attention‐deficit/hyperactivity disorder—A randomized controlled crossover trial

Abstract

SummaryWeighted blankets are a non‐pharmacological intervention for treating sleep and anxiety problems in children with attention‐deficit/hyperactivity disorder. However, research on the efficacy of weighted blankets is sparse. The aim of this randomized controlled trial with a crossover design (4 + 4 weeks) was to evaluate the efficacy of weighted blankets on sleep among children with attention‐deficit/hyperactivity disorder and sleeping problems. Children diagnosed with uncomplicated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attention‐deficit/hyperactivity disorder with verified sleep problems were randomized to start with either a weighted blanket or a lighter control blanket. Data collection was performed at weeks 0, 4 and 8 using actigraphy, questionnaires and a daily sleep diary. T‐tests were used to evaluate efficacy. The study included 94 children with attention‐deficit/hyperactivity disorder (mean age 9.0 [sd 2.2] years; 54 [57.4%] boys). Weighted blankets had a significant effect on total sleep time (mean diff. 7.72 min, p = 0.027, Cohen's d = 0.24), sleep efficiency (mean diff. 0.82%, p = 0.038, Cohen's d = 0.23) and wake after sleep onset (mean diff. −2.79 min, p = 0.015, Cohen's d = −0.27), but not on sleep‐onset latency (p = 0.432). According to our exploratory subgroup analyses, weighted blankets may be especially beneficial for improving total sleep time in children aged 11–14 years (Cohen's d = 0.53, p = 0.009) and in children with the inattentive attention‐deficit/hyperactivity disorder subtype (Cohen's d = 0.58, p = 0.016). Our results suggest that weighted blankets may improve children's sleep and could be used as an alternative to pharmacological sleep interventions.

The effect of weighted blankets on sleep and related disorders: a brief review

“…It is important to note that weighted blankets can be dangerous, especially for children and the elderly. The higher weight of weighted blankets may cause pain, anxiety, and panic to a few children ( 33 , 73 ). In general, children under 3 years of age or weighing less than 50 pounds should not use weighted blankets due to the risk of suffocation or entrapment.…”

Sex Differences in Children with Uncomplicated Attention Deficit/Hyperactivity Disorder and Sleep Problems

“…Interestingly, while one systematic review showed that children above nine years had longer TSTs than younger children [ 64 ]; in our cohort, those younger than nine years had longer sleep times than their older counterparts (see Supplementary Materials ). A randomised controlled trial (RCT) of the same group of children found that weighted blankets significantly improved ActiGraph-measured WASO, TST, and SE, but not SOL, compared to using a lighter control blanket [ 44 ].…”

“…Maybe the relatively young age of the children in our cohort explains their lack of self-experienced problems with insomnia. The RCT on the same group of children showed that weighted blankets decreased sleep problems, causing the total scores of CSHQ and ISI to range within normative values for children with ADHD [ 44 ].…”

“…This study is cross-sectional, with baseline data from a cohort of children participating in a randomised controlled study [ 44 ]. This study included 96 children—55 boys and 41 girls aged 6–14 years.…”