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Pediatrics. 2014 Aug;134(2):298-306. doi: 10.1542/peds.2013-4285. Epub 2014 Jul 14.

Weighted blankets and sleep in autistic children--a randomized controlled trial.

Author information

  • 1Children's Sleep Medicine, Evelina London Children's Hospital, St Thomas' Hospital, London, United Kingdom;
  • 2Centre for Rehabilitation and.
  • 3Lime Trees Child and Family Unit, York, England; and.
  • 4Children's Sleep Medicine, Evelina London Children's Hospital, St Thomas' Hospital, London, United Kingdom;
  • 5Department of Psychology, Oxford Brookes University, Oxford, United Kingdom;
  • 6Department of Clinical Neurophysiology, John Radcliffe Hospital, Oxford, United Kingdom.



To assess the effectiveness of a weighted-blanket intervention in treating severe sleep problems in children with autism spectrum disorder (ASD).


This phase III trial was a randomized, placebo-controlled crossover design. Participants were aged between 5 years and 16 years 10 months, with a confirmed ASD diagnosis and severe sleep problems, refractory to community-based interventions. The interventions were either a commercially available weighted blanket or otherwise identical usual weight blanket (control), introduced at bedtime; each was used for a 2-week period before crossover to the other blanket. Primary outcome was total sleep time (TST) recorded by actigraphy over each 2-week period. Secondary outcomes included actigraphically recorded sleep-onset latency, sleep efficiency, assessments of child behavior, family functioning, and adverse events. Sleep was also measured by using parent-report diaries.


Seventy-three children were randomized and analysis conducted on 67 children who completed the study. Using objective measures, the weighted blanket, compared with the control blanket, did not increase TST as measured by actigraphy and adjusted for baseline TST. There were no group differences in any other objective or subjective measure of sleep, including behavioral outcomes. On subjective preference measures, parents and children favored the weighted blanket.


The use of a weighted blanket did not help children with ASD sleep for a longer period of time, fall asleep significantly faster, or wake less often. However, the weighted blanket was favored by children and parents, and blankets were well tolerated over this period.

Copyright © 2014 by the American Academy of Pediatrics.


autism spectrum disorder; children; severe sleep problems; total sleep time; weighted blankets

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