Let’s make one thing clear, we do not intend to be biased. Our main mission at Truhugs is to spread the truth, even if it harms us. There are too many biases and fallacies in the market, and we do not intend to be one of those brands. In fact, today’s article discusses how a weighted blanket didn’t work.
Yep, you read that right; we are posting an article on a study on autism and sleep issues that found no success with weighted blankets. “Why,” you ask? To be transparent. To be honest. To gain your trust. Above all, to show you that things don’t always work, and we are well aware of that. We do not have blinders on that shield us from the possibility of weighted blankets being ineffective, that would be crazy!
Because weighted blankets are a “newer” trend, we fully recognize that they are not a cure-all. Part of our due diligence has involved reading every study that involves weighted blankets or similar mechanisms. By understanding situations in which weighted blankets do or do not help, we can begin to develop a protocol for dosing and weight requirements.
So although – spoiler – the study discussed in this article found no significant benefits for comorbid autism and sleep disorders, it does get us one step closer to understanding the overall efficacy of weighted blankets for autism and sleep issues.
So, without further ado, let’s dive into this!
Weighted Blankets for People with Autism and Sleep Issues
We have posted an article on autism and how weighted blankets can serve as a tool for behavioral modification, and we have posted about insomnia and how weighted blankets can alleviate symptoms of sleep disturbance. Still, we have not explored the intersection between these two conditions. So, here it is.
Gringras, Green, Wright, Rush, Sparrowhawk, Pratt, Allgar, Hooke, Moore, Zaiwalla, and Wiggs (2014) all worked together to determine if weighted blankets would increase the total sleep time and decrease the time it takes to fall asleep in 64 children with ASD between the ages of 3 and 16.8.
I would like to pause and give all of these authors credit because their experimental design was comprehensive and accounted for factors that most researchers don’t consider (or at least report in the manuscript).
The children were recruited from three separate locations in the United Kingdom. They all held an autism diagnosis that was confirmed through assessments (diagnostic tools), school reports, and observations of their parents and a qualified treatment team. They also all had sleep disturbances, which were defined as difficulty falling asleep at least three out of five nights, and getting less than seven hours of sleep at least three out of five nights.
Why did they choose children with autism spectrum disorder instead of typical children who suffer from sleep concerns? Modern technology has caused a lot of sleep disturbances amongst school-aged children, so this study could have easily encompassed a general sample size of children. Well, fun fact, 40%-80% of children with autism have sleep issues, that’s a high prevalence rate.
Also, if someone who has autism benefits from a weighted blanket, then maybe this could be applied to those who aren’t hypersensitive to stimuli?
This is the line of logic I would follow if I were conducting a study like this. Try something with a more severely affected population, and then work your way down. Also, those who have autism have enough symptoms, so if there’s something that can alleviate sleep problems, then I’m sure anyone with autism would be thankful.
How Were Data Collected for Autism and Sleep?
After the children were recruited, the study began. They wore an actigraphy watch (which is like a Fitbit) to measure their restlessness throughout the night, and they kept a journal to document their sleep habits.
For the first 7 – 21 days, they slept as they would with the actigraphy and sleep journal. This acted as a baseline so that sleep with the blanket could be compared to something. Also, during this baseline phase, parents were asked to complete three questionnaires:
- The children’s Sleep Habits Questionnaire was used to determine how problematic sleep disturbances were.
- The Social Communication Questionnaire was used to determine the severity of the autism diagnosis.
- The Short Sensory Profile Caregiver Questionnaire was used to determine sensory processing and behavioral and emotional responses.
There were two blankets used (so two different “treatment phases”). One blanket had steel pellets (the weighted blanket), and the other was the same size, material, and had light plastic pellets (which were the same size) to act as a non-weighted blanket. Two different sizes of blankets were used so that the child could be matched with their appropriate weight/ size blanket.
The children were randomized into groups using block randomization, where one group received the non-weighted blanket first, and the other received the weighted blanket first. This was done to ensure that results were actual and not caused by a certain order.
For each treatment phase, the children had the blanket for 12 – 16 days. The used the blanket during a school period so that there wouldn’t be disturbances in the sleep schedule for holidays or breaks.
Do Weighted Blankets Help with Autism and Sleep Issues?
I already spoiled this for you at the beginning, but they found no significance. Meaning, they found no change in sleep duration between the baseline and non-weighted blanket to the baseline and weighted blanket. But before we dive into this, it’s important to note that not all of the participants made it to the end of the study. Six of the participants were dropped from the study due to not being able to withstand the texture of the blanket(s) or flat out refusing to use the blanket(s).
Something that the researchers found surprising was that 11 participants were subthreshold of an autism diagnosis per the Social Communication Questionnaire results. However, there were other tests that helped confirm the diagnosis.
Total Sleep Time (In Minutes)
(Notice how there were differences between the actigraphy watch and self-report with total sleep time.)
Time (in minutes) It Took To Fall Asleep
The only significant finding within the study was that there was better sleep while the control blanket was used. This, of course, was not the hoped-for outcome. The children did self-report that they liked the weighted blanket better than the control blanket, and that’s important because those who have autism can be oversensitive to sensations.
Also, parents reported that they thought their child’s sleep was better with the weighted blanket compared to without, and they thought their child’s behavior was calmer on days where the weighted blanket was used the night prior, but the data does not validate this. Why did the parents perceive these benefits when they weren’t picked up by the sleep diaries or actigraphy watch? The researchers did not note the cause; however, in my opinion, it could be that parents were eager to have something help with sleep disturbances and were seeing changes that weren’t occurring.
Looking back to the insomnia article, there were significant changes when a weighted blanket was used, so why were there no changes with this population? There are many factors that could explain why there is a variance, one being the population difference; this article fixated on children with an autism diagnosis, whereas the other focused on adults with insomnia. Both articles used actigraphy watches. However, the adult insomnia article also used polysomnography recording, so it’s possible that this extra measurement provided information that was not accounted for in the children with autism study.
Further, the two studies were conducted in different years, so maybe there was a difference in weighted blanket construction between the two studies (this is a reach, but could be considered). This goes to show that research is not generalizable, as much as we wish it could be. Research only gives a glimpse into the effectiveness of something, but it can never give us a full scope.
Autism and Sleep Issues Advice
Despite our competitors’ remarks, weighted blankets are NOT a cure-all. The fact is, they don’t work with every population and every situation. This is why we replicate findings. There are so many variables that go into a study, and what may have worked once may not work again. This is why trusting exploratory studies is risky because they don’t have the same validity as a study that has been replicated and found the same results as the original.
It’s even possible that because there are so many claims on the market of weighted blankets causing improvements in XYZ symptom, that when a person receives the weighted blanket, they believe in the product, so it works, even if it doesn’t work. This is called a placebo. Most cold medicines are placebos and don’t help you get over a cold faster, but because you believe it works, it does. Confusing, I know.
As always, take these findings with a grain of salt. Although the weighted blanket did not work in this study, it’s possible that it could work with others who have been diagnosed with autism and struggle with insomnia. Autism is a spectrum, so it is possible that the severity of autism that these kiddos experienced influenced the results, or it may have been the type of deep pressure touch mechanism implemented.
I encourage all parents (and people in general) to do thorough research and choose to implement what feels right for them. Parents may read this article and still choose to implement a weighted device during bedtime routines because weighted blankets for sleep and anxiety are effective for their child. Choose what’s right for you!
We don’t aim to steer you away from weighted blankets, we obviously love them enough to start a business based around them! We simply want to spread the truth and work toward creating that weighted blanket protocol!
Gringas, P., Green, D., Wright, B., Rush, C., Sparrowhawk, M., Pratt, K., Allgar, V., Hooke, N., Moore, D., Zaiwalla, Z., & Wiggs, L. (2014). Weighted blankets and sleep in autistic children – A randomized controlled trial. Pediatrics, 134(2), 298 – 306. doi:10.1542/peds.2013-4285