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

Summary & key facts

This study tested whether weighted blankets help children with attention-deficit/hyperactivity disorder who have sleep problems. Ninety-four children, average age about 9 years, each tried a weighted blanket for four weeks and a lighter control blanket for four weeks while researchers measured sleep with a wrist tracker, sleep diaries and questionnaires. The weighted blanket led to small but consistent improvements: roughly 8 more minutes of sleep, a tiny rise in sleep efficiency, and about 3 fewer minutes awake after falling asleep. The blanket did not shorten the time it took children to fall asleep. The benefit was bigger for 11 to 14 year olds and for children with the inattentive form of ADHD. These results suggest weighted blankets might be a modest non-drug option to improve sleep for some children with ADHD.

Key facts:

• The study used a randomized crossover design so each child used both a weighted blanket and a lighter control blanket for four weeks each.
• Ninety-four children with uncomplicated ADHD took part. Their average age was about 9 years and most were boys.
• Sleep was measured with a wrist activity tracker, daily sleep diaries and questionnaires at the start, after the first four weeks, and after the second four weeks.
• Compared with the lighter blanket, the weighted blanket increased total sleep time by about 8 minutes on average.
• The weighted blanket improved sleep efficiency by less than 1% and reduced minutes awake after sleep started by about 3 minutes.
• The weighted blanket did not make children fall asleep faster.
• Researchers found larger improvements in total sleep time for children aged 11 to 14 and for children with the inattentive subtype of ADHD, but those subgroup results were exploratory.
• Overall the changes were small, so weighted blankets may offer a modest non-drug option for improving sleep in some children with ADHD rather than a large or guaranteed fix.

Abstract

Weighted 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.

Topics

Attention Deficit Hyperactivity Disorder Sleep and related disorders Sleep and Wakefulness Research

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Actigraphy Anxiety Attention deficit hyperactivity disorder Computer science Insomnia Internal medicine Medicine Operating system Pediatrics Physical therapy Psychiatry Psychology Randomized controlled trial Sleep (system call) Sleep disorder Sleep onset Sleep onset latency

Conditions & symptoms

ADHD Anxiety Sleep disorder Difficulty focusing Poor sleep