The use of weighted blankets is a sensory technique that provides deep pressure stimulation. Evidence suggests that deep pressure stimulation produces a calming effect to the autonomic nervous system in our bodies (Chen et al., 2016; Reynolds et al., 2015). Our autonomic nervous system controls involuntary actions like the beating of our hearts and is responsible for our fight or flight response and recovery from fight or flight. However, there is little research to support the use of weighted blankets despite anecdotal support by parents, caregivers, and therapeutic staff, and none of the research has included individuals with Down syndrome (Champagne & Stromberg, 2004; Mullen et al., 2008). Additionally, there are no clear guidelines or protocols for weighted blanket use at this time, although several researchers have suggested a blanket weight of 7-10% of someone's body weight (Chen et al., 2013, 2016; Gee et al., 2016).
At the Adult Down Syndrome Center, we frequently begin with weighted objects as our first line approach to help with anxiety (especially around medical equipment and procedures or changes in routine), transitions, and compulsive behaviors. This is because of the calming effect mentioned previously. In addition to weighted blankets, there are also weighted lap pads, shoulder/neck wraps, and pillows. It is important to talk with an occupational therapist to determine if a weighted blanket will be appropriate for you or your loved one. Not everyone will tolerate the use of a weighted blanket, even if it is the correct weight for them.
Weighted blankets come in a variety of sizes, textures, and designs. As mentioned above, it is recommended that a weighted product be 7-10% of a person's body weight. However, it can be less weight if that works best! Many commercial weighted blankets advertise weights that are more than the recommended 7-10%. Please keep that in mind if purchasing commercially available products and purchase the weight that is recommended (7-10% of body weight) and not the one suggested for your body weight on the packaging.
Sensory input should not be provided for long periods of time. This is because our bodies tend to tune out input once they realize it is not causing harm, making it no longer effective. Think about what happens when you put on jewelry: you may notice the necklace or ring initially, but at some point, you forget you are wearing it. It is the same with the use of weighted blankets! Therefore, it is not recommended to sleep with a blanket on all night long. Research suggests that there is inconclusive evidence to support the use of weighted blankets to improve overall sleep quality (Eron et al., 2020; Gee et al., 2016). It is also highly recommended not to sleep under a weighted blanket, especially if there are concerns with seizures, asthma, sleep apnea, or cardiac issues. However, a weighted blanket could be used as part of the bedtime routine to help an individual calm him/herself before falling asleep. It is best if weighted products are used with supervision to ensure safety.
Additional resources are available in the Sensory section of our online library.
References
Champagne, T., & Stromberg, N. (2004). Sensory approaches in inpatient psychiatric settings: Innovative alternatives to seclusion and restraint. Journal of Psychosocial Nursing and Mental Health Services, 42, 34-44.
Chen, H.-Y., Yang, H., Chi, H.-J., & Chen, H.-M. (2013). Physiological effects of deep touch pressure on anxiety alleviation: The weighted blanket approach. Journal of Medical and Biological Engineering, 33, 463-470.
Chen, H.-Y., Yang, H., Meng, L.-F., Chan P. S., Yang, C.-Y., and Chen, H. M. (2016). Effect of deep pressure input on parasympathetic system in patients with wisdom tooth surgery. Journal of the Formosan Medical Association, 115, 853-859.
Eron, K., Kohnert, L., Watters, A., Logan, C., Weisner-Rose, M., & Mehler, P. S. (2020). Weighted blanket use: A systematic review. American Journal of Occupational Therapy, 74(2), 1-14.
Gee, B. M., Peterson, T. G., Buck, A., & Lloyd, K. (2016). Improving sleep quality using weighted blankets among children with autism spectrum disorder. International Journal of Therapy and Rehabilitation, 23, 173-181.
Mullen, B., Champagne, T., Krishamurty, S., Dickson, D., & Gao, R. X. (2008). Exploring the safety and therapeutic effects of deep pressure stimulation using a weighted blanket. Occupational Therapy in Mental Health, 24, 65-89.
Reynolds, S., Lane, S. J., & Mullen, B. (2015). Effects of deep pressure stimulation on physiological arousal. American Journal of Occupational Therapy, 69(3), 1-5.