Weighted blankets, benefits, precautions plus when and why to use them

How do weighted blankets work?

The core idea behind all weighted products is that they provide additional deep touch pressure.  We explore deep touch pressure in our post – Everything You Need to Know About the Touch Sense.  You may want to read the post first before you continue.  For those who really want to understand the neurology behind deep touch pressure, we would recommend our online Sensory Processing Disorder training.

When something touches the skin, the skin receives sensory messages about the touch.  This includes how hard or soft the touch was. A feather for example is soft or light touch.  Deep touch pressure refers to firmer touch or a squeeze. A good example of this is when you receive a firm hug from someone. That ‘harder’ touch gives the brain different sensory information to a feather.

What are the benefits of weighted blankets?

It is thought that touch pressure, alongside proprioceptive sensory input, is more calming than light touch.  Consider for a moment receiving a massage.  Usually, the therapist uses a firmer pressure. This is what helps you to relax.  If the therapist started to tickle you, you would probably become very alert and the massage would be less enjoyable.

The hypothesised benefit of weighted blankets, pads, animals and vests is that they provide deep touch pressure.  The pressure from the weight activates the touch sensors in the same way a massage therapist can.  This is why weight can be calming and beneficial for some individuals, including those with autism.  The calming effect is thought to help to reduce stress and anxiety.

Do weighted blankets and similar products work?

Honestly, weighted products won’t work for everyone.  Like all sensory strategies, they help some people and not others.  This is because everyone is different.  Sometimes, they are described as the magic bullet for calming and anxiety reduction – the essential solution you have been looking for.  But, it’s common for them to make no difference at all.

There is limited evidence that they make changes to sleep duration, time taken to get to sleep or sleep quality.  However, when given the option to keep the blankets after studies participants often choose to keep them.  There is emerging evidence that they may be helpful to support anxiety.  If you’re really interested in learning about the evidence you can listen to this BBC sliced bread podcast which Kim contributed to.

Listen to Kim discuss the pros and cons of weighted blankets with the BBC

Words of caution when for using weighted blankets and products

Before continuing, there are a few points that need to be highlighted.  This includes consideration around evidence for and safety when using weighted blankets.

What evidence is there to support their use?

Despite the claims, there is little to no high quality research on the use of weighted blankets and other products. Much of the research that is available is poor quality.  It also typically concludes that the products have little to no benefit for sleep and the effects are highly individual.  Despite this, you will find countless testimonials of success, including benefits like decreased anxiety, decreased stress, and improved sleep.  Please read these testimonials with a degree of caution.  Whilst it is great if you or your child experience benefits from using a weighted blanket, please don’t be disheartened if you do not.

More recently there are claims that weight blankets can be used to help with epilepsy as they support ‘better sleep.’  These claims have no grounding in research.  Also, in my opinion, a blanket could be more dangerous than helpful if a child had a seizure whilst lying under it.  It is important to check with health professions first before considering using a these products if you have any concerns or questions.

As noted above in the podcast, there is emerging evidence that weighted blankets may help to support anxiety.

Weighted blankets should never be used as a restraint

Weighted blankets and other weighted products should never be used as a restraint.  Firstly, they are not designed for this purpose.  Secondly, it is a violation of the individual’s rights.  If you ever see this occurring please raise it with management and ensure that there is a policy in place for correct use.

Weighted blankets can be dangerous

Before going any further, the reader must be aware that there is a danger when using these products.  There was a very sad case, in 2008 in Canada, where a child died because they were suffocated whilst wrapped in a weighted blanket.  Weighted products are NOT TOYS.  They need to be used with proper supervision and careful monitoring.

Not everyone will like them

Please make sure you respect the individual’s preferences. Everyone is different and some individuals just really don’t like the feeling of extra weight. Never force it onto them because you have read that it can help. Be mindful of what will meet their needs.

Which individuals can weighted products help?

As mentioned above, the idea behind weighted products is to help with calming.  Therefore, it would follow that they will be best suited for children who experience sensitivity with their senses.  This could include individuals who experience sensory overload or those who experience common sensory differences like touch sensitivity or sound sensitivity.  It might include those with autism or ADHD.

Examples of when you might use weighted products

In addition, the products can help children with poor proprioceptive awareness.  This is because they provide extra sensory feedback which lets the individual know where they are.  Sitting under a weighted lap pad or weighted blanket provides a physical boundary for the child to let them know where they are.  For children that lean on their peers or move about on the mat, this can sometimes help them to stay in their own space.

Finally, weighted vests in particular, can sometimes help sensory seekers.  This is again because they give that extra bit on continual sensory feedback to the brain.  For some individuals this can be enough to reduce their sensory seeking behaviours and help to focus their attention.

Things to consider when purchasing or making weighted blankets and products

It’s worth considering the following things before you purchase (or make) a weighted product

What is it filled with?

Commercial products are typically filled with plastic pellets.  These are available for purchase if you are going to make your own blanket.  They are recommended as they last well and also dry out if they get wet.  Unlike rice or sand or other things products are sometimes filled with.

Also, make sure the product has individual sections for the weight so that it is evenly distribute.  This is pretty normal for modern products.  But, make sure you double check as without sections all of the weight ends up on one side.

Are the weights sewn in?

There are typically two options when purchasing weighted products.  The weights are either sewn into the product.  Or, the product contains pockets you can put the weights into.  The benefit of pockets is that the amount of weight can be changed.  This is fantastic if the product is being used with multiple children as you can easily change the weight.  It can also be helpful for families as they can add weight as the child grows.  However, it also means the children can remove the weights and weights can sometimes go missing if they aren’t stored well.  You will need to decide on the best option for your needs.

How are you going to wash it?

These products can be heavy, especially if you have a blanket for an adult or adolescent!  Being able to remove the weight is helpful for washing as not all machines can manage the load of larger items.  Many of the products come with water resistant surfaces which is helpful as this means they need washing less.  However, the toys are often soft and may not work well if they are being shared between children as washing is harder to manage.  A removable cover can also be a helpful as this can be washed more easily.

Are weighted blankets always really expensive?

Yes.  Unfortunately you are looking at upwards of £70 for a blanket and this will increase depending on the weight.  To keep costs down, if you are able to, you can make your own.  Also, often you can find them second hand at a lower cost on eBay or in the sensory or autism Facebook groups.

Guidance for getting started with weighted products

The first question is always, how much weight should be in the weighted blanket or product?  There is a general rule that weighted products should weigh no more than 10% of the individual’s body weight for blankets. And, yes, it is possible for a weighted blanket to be too heavy.  This is why blankets should not be shared unless children are similar weights themselves.  For toys or lap pads 5% is sometimes recommended.

There is also some literature saying that after 20-30 minutes the effects of the product have worn off; however there is no solid research to support this claim.  It is important to monitor the individuals’ response.  If it is still helping and your lesson is 40 minutes long, then the extra ten minutes might just help them to attend.  Equally some individuals may only tolerate the weight for 10 minutes.

How to use weighted blankets

Weighted blankets are typically available in single and double bed sizes.  As mentioned above they can be used to provide touch pressure sensory input at times when the individual needs to calm down.  Usually the individual will lie or sit under the blanket.  Some individuals like to have the blanket wrapped around their shoulders.  Weighted blankets can be a great addition to sensory play as you can put things under them to go and collect, or you can have the child crawl from one side to the other.

It is important these are supervised closely.  Ensure that the individuals’ head is visible and the adult is monitoring breathing.  If the individual does go completely under the blanket, ensure that they can independently get themselves back out and that they can verbally respond so adults can double check they are safe.  Children should not be left unsupervised and unless they are able to independently get out they should never be rolled or completely wrapped up.  In school it is helpful to have a clear policy for use and ensure that all staff are aware of the risks.

What about bed time?

There are anecdotal reports that weighted blankets can be helpful for sleep.  However, the reports of success vary hugely.  There are also a number of different Lycra sleep socks on the market.  These products wrap around the mattress and in theory provide extra deep touch pressure whilst the individual sleeps.  You will find advocates for all products.

Typically it is not recommended that children sleep under weighted blankets.  This is due to the risk of suffocation.  Risks would be higher for children who have asthma, allergies or any condition that affects their breathing.  They are definitely not recommended for individuals who cannot move out from under them independently.

Use them before bedtime

Weighted blankets could be used before bed time to help with lowering arousal.  They are great for story time before bed.  It may be that you leave them on the lower half of the child’s body (i.e. their hips and legs) for an extra 10-15 minutes as they start to drift off to sleep.  However, it is best to not leave all night for young children.  Sometimes you can achieve a similar effect with a heavier duvet, an extra blanket or tucking the sheets quite firmly.

It’s tricky to give a specific age for when blankets can be used at night as all children are different sizes and have different levels of mobility.  When considering using a blanket through the night you must ensure the individual can independently pull it on and off.  It is important they do not put their head under the blanket whilst sleeping.  And, they are not recommended for any individuals with breathing conditions (e.g. asthma).

My experience is that very few individuals like the blankets for sleep.  Many complain that they are too hot under them.  Others don’t like the feeling of having them on.  Some move about so much that they never really stay under them for very long.  If using there is a general recommendation of maximum blanket weight of ten percent of the individual’s body weight.  The blanket should lay on top of the bed, rather than drape over the sides (again to avoid trapping and restriction).

How to use weighted lap pads, shoulder pads and animals

Weighted lap pads and animals are designed to sit on top of a child’s lap.  These can be great for children who have poor proprioceptive awareness, as it gives them extra feedback about where they are.  This can decrease their fidgeting and also help them to stay in their space, especially on the floor.  They can also be used with small children instead of a blanket when lying down.  Some children like the feel of animal ones as well, and this helps them to regulate.  They are a good addition to most classrooms.

Weighted shoulder pads are designed to sit on the child’s shoulders.  If I am honest I have personally never had much luck with these.  It’s hard to get them to fit well on the shoulders.  Some children don’t like the feel of the pad on their neck.  The snake shaped animals can work better as they conform around the neck and shoulders.  A larger lap pad can also be folded in half long ways and drape them over the shoulders for mostly the same effect.

What about weighted vests?

Weighted vests are designed to be worn over the top of clothing.  These can work better than shoulder pads, as they don’t fall off.  Again, they can be helpful for some children but not others.  You must ensure the vest is the right size and weight for the child.  Some children also prefer the squeeze vests / bear hugs rather than weighted vests.  If there is a likelihood the vest will be thrown, then the weight free ones are also a better option.

It is also important to consider the child’s overall mobility and joint stability when using these.  If a child has very low tone, i.e. they are quite floppy; a weighted vest may not be the best solution for them.  The squeeze vests are likely a better option.  You should seek guidance from your occupational therapist.

In conclusion

Weighted products can be a useful sensory strategy, for some individuals.  It’s important to make sure they are used safely and monitored well.  If you are every unsure you should check with your occupational therapist for further guidance.  If you want to learn more about using sensory strategies, these are discussed in Level 2&3 of the GriffinOT online sensory training.

Finally, you must always remember that they won’t be a magic bullet for everyone.  At the end of the day the best thing to do is to test before you buy and to see what works for our own child or the individual you’re supporting.

Further guidance:

This guidance document, which Kim contributed to, published by the Royal College of Occupational therapists gives a quick summary of the current evidence and recommendations.