Weighted blankets: Clinical benefits, but also potential risks?

By Carol Nathan | Fact-checked by Anastasia Climan, RDN, CD-N
Published April 17, 2023

Key Takeaways

  • Studies are looking at the physiologic effects that weighted blankets have on the body and whether there is a clinical rationale for HCPs to recommend them.

  • Two populations in particular that are being studied are older people and children. 

  • Some clinical benefits are being documented, but also some risks, mainly in children.

Researchers are studying weighted blankets in clinical settings to determine if there is a measurable effect for these popular consumer products, and whether HCPs can confidently recommend them to their patients for certain purposes and conditions.

Because sleep is such an important component of overall health, the nonpharmacologic approach to enhancing sleep offered by weighted blankets would be a welcome alternative to pharmacologic solutions. 

Scientific basis of weighted blankets

The clinical effect of weighted blankets is based on the theory of deep pressure therapy, according to Swedish researchers writing in Geriatrics.[] Deep pressure therapy is related to the theory of sensory integration, both of which involve how sensory stimuli are processed in the brain.

Deep pressure, it is theorized, can be calming, reduce anxiety, and improve sleep. This deep pressure can potentially stimulate production of serotonin (which increases relaxation), melatonin (which promotes sleep), and oxytocin. 

To investigate these theories about the effects of weighted blankets, a study done in Sweden and published in the Journal of Sleep Research looked at whether weighted blankets produced higher salivary concentrations of melatonin and oxytocin than with a light blanket.[] The analysis also compared potential differences in salivary concentrations of cortisol, subjective sleepiness, and sleep duration. 

The results showed that with use of a weighted blanket, the 1-hour increase of salivary melatonin from baseline was 32% higher than without the weighted blanket. The other parameters assessed did not produce any significant differences. 

This was the first study to show that weighted blankets lead to an increase of melatonin.

The authors caution that it is not yet clear whether the increase in melatonin is therapeutically relevant, but these results are encouraging.

Use in nursing homes 

The Swedish researchers publishing in Geriatrics reported on their study, which investigated the effect of weighted blankets on older people in nursing homes. Variables they assessed included overall QoL, sleep, nutrition, cognition, activities of daily living, and medication needs. 

The weighted blankets used for the study were durable and fireproof; hygiene covers were not used due to the risk of suffocation (see “Pediatric cautions” below). The intervention period was 28 days. 

In general, the study found that overall QoL improved, and sleep improved significantly, especially with regard to waking up during the night. All of the other factors improved as well, including cognition and nutrition. 

The improved sleep was an especially important finding, because sleep in nursing home residents is known to be poor, leading to consequences like depression and falls. 

The authors stated that these learnings could potentially reduce the need for medications in nursing home residents, which is an advantage, because the combination of multi-morbidities and polypharmacy in older people can lead to adverse effects.

Alternative to protective stabilization in pediatric dentistry

A retrospective cross-sectional study done in the US and published in Pediatric Dentistry evaluated pediatric dental sedation records after 6-pound, lead-free weighted blankets were introduced into the dental clinic.[] Investigators compared clinical outcomes before and after the blankets were used. 

The results showed that the need for protective stabilization decreased, from 78.7% before the blankets to 32.8% after the blankets were used. The results were not predicated on BMI, sex, or treatment amount. The authors suggest that other pediatric dental clinics should consider using weighted blankets as an alternative to protective stabilization. 

Pediatric cautions

While all of these clinical benefits are encouraging, there is a reason for parents to be cautious using weighted blankets at home for children. The US Consumer Products Safety Commission issued a recall for a particular brand of weighted blanket that was marketed to parents of young children.[] Two children, a 4-year-old and a 6-year-old, reportedly became trapped in the cover of a weighted blanket and died due to asphyxia. 

If a weighted blanket has a zipped cover, young children can become entrapped by unzipping and entering the blanket, posing a risk of asphyxiation. 

Most weighted blankets, however, do not have zipped covers. 

What this means for you 

HCPs can confidently recommend weighted blankets for adult patients who have problems sleeping, or for patients who experience frequent sleep waking at night. Weighted blankets can also be used by adults for overall anxiety. Older patients in nursing homes will especially benefit from these blankets. In general, weighted blankets probably should not be recommended at this time for children during sleep. They have been useful in the supervised pediatric dental setting, where they can reduce the need for protective stabilization.

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