Heavy blankets are a safe and effective intervention in the treatment of insomnia.
That’s according to Swedish researchers who found that insomnia patients experience better sleep and less daytime sleepiness when they sleep with a weighted chain blanket.
Results of the randomized controlled study show that participants who wore the weighted blanket for four weeks reported a significant reduction in the severity of insomnia, better maintenance of sleep, an increased level of activity during the day, and a reduction in symptoms. of fatigue, depression and anxiety.
Participants in the weighted blanket group were nearly 26 times more likely to experience a 50% or greater decrease in the severity of their insomnia compared to the control group, and were nearly 20 times more likely to achieve remission of their insomnia. Positive results were maintained during a 12-month open-label follow-up phase of the study.
“A suggested explanation for the calming and stimulating effect of sleep is the pressure applied by the chain blanket at different points on the body, stimulating the sensation of touch and the sensation of the muscles and joints, similar to acupressure and massage.” said lead researcher Dr. Mats Alder, consultant psychiatrist in the department of clinical neuroscience at the Karolinska Institutet, Stockholm.
“There is evidence to suggest that deep pressure stimulation increases parasympathetic excitation of the autonomic nervous system and at the same time reduces sympathetic arousal, which is considered the cause of the calming effect.”
The study, published in the Journal of Clinical Sleep Medicine, involved 120 adults (68% women, 32% men) previously diagnosed with clinical insomnia and a concurrent psychiatric disorder: major depressive disorder, bipolar disorder, attention deficit hyperactivity disorder, or generalized anxiety disorder. They had an average age of about 40 years.
Participants were randomly assigned to sleep for four weeks at home on either a chain blanket or a control blanket. Participants assigned to the weighted blanket group tested an 8 kilogram (approximately 17.6 pound) string blanket in the clinic.
Ten participants found it too heavy and instead received a 6 kilogram (approximately 13.2 pound) blanket. Control group participants slept with a lightweight 1.5-kilogram (about 3.3-pound) plastic chain blanket. Change in severity of insomnia, the main outcome, was assessed using the Insomnia Severity Index. Wrist actigraphy was used to estimate levels of sleep and daytime activity.
Almost 60% of weighted blanket users had a positive response with a 50% or more decrease in their ISI score from baseline to the four-week endpoint, compared to 5.4% of the control group. Remission, a score of seven or less on the ISI scale, was 42.2% in the weighted blanket group, compared with 3.6% in the control group.
After the initial four-week study, all participants had the option of wearing the weighted blanket during a 12-month follow-up phase. They tested four blankets with different weights: two chain blankets (6 kilograms and 8 kilograms) and two ball blankets (6.5 kilograms and 7 kilograms).
After the test, and they were allowed to freely choose their preferred blanket, and the majority chose a heavier blanket, only one participant discontinued the study due to feelings of anxiety when using the blanket. Participants who switched from the control blanket to a weighted blanket experienced an effect similar to that of patients who used the weighted blanket initially. After 12 months, 92% of weighted blanket users responded and 78% were in remission.
“I was surprised by the large size of the insomnia effect of the weighted blanket and was pleased with the reduction in levels of anxiety and depression,” Adler said.
In a related comment, also posted on JCSMDr. William McCall writes that the study results support the psychoanalytic theory of the “holding environment,” which states that touch is a basic need that provides calm and comfort.
McCall urges providers to consider the impact of sleeping surfaces and bedding on sleep quality, while calling for more research on the effect of heavy blankets.
Reprinted from American Academy of Sleep Medicine.
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