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Weighted blankets to lighten the burden of insomnia

Background

Insomnia (issues falling or staying asleep) can result in fatigue, anxiety, and depression. About 40% of insomniacs do not respond to the two standard treatments — pharmaceuticals and cognitive behavioral therapy. Weight blankets apply deep pressure stimulation (DPS) to the whole body; there is mixed evidence that they improve sleep and anxiety, maybe through an increase in parasympathetic tone and a decrease in sympathetic tone in the autonomic nervous system. DPS also increases the production of oxytocin, a hormone critical to relaxation and sleep. Can weighted blankets alleviate insomnia in people with psychiatric conditions?

The study

In this 4-week randomized controlled trial, 120 people with bipolar disorder, major depressive disorder, generalized anxiety disorder, or attention deficit hyperactivity disorder slept with either a metal-chain blanket (8 or 6 kg) or a plastic-chain blanket (1,535 grams).

The primary outcomes were difficulty falling and staying asleep and daytime symptoms related to sleeplessness, as measured by the Insomnia Severity Index (ISI).

The secondary outcomes were measured using notably the Fatigue Symptom Inventory (FSI), which measures daily patterns of fatigue, and the Hospital Anxiety and Depression Scale (HADS), which measures levels of anxiety and depression. Total sleep time, number of awakenings, and total time awake after sleep onset (WASO: wake after sleep onset) were also analyzed. Sleeptime and daytime activity levels were measured by wrist actigraphy.

The results

Metal-chain blankets improved ISI scores (after one week), alleviated symptoms of anxiety and depression, decreased daytime fatigue, and increased daytime activity. They didn’t have a significant effect on objective measures of total sleeping time or incidents of waking after sleep onset, but the participants using them reported an improved ability to maintain sleep.

After completing the 4-week controlled phase of the study, the 119 participants (one of the original 120 had dropped out) were invited to continue in a 12-month open phase, and 112 agreed. The participants who had been assigned metal-chain blankets kept using them, and the participants who had been assigned plastic-chain blankets were given weighted ones instead. Improvements increased during the 12-month follow-up period.

Note

After the 12-month continuation phase, 92% of the 119 participants who had completed the controlled phase saw their ISI score reduced by 50% or more, and 78% were in remission.

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