Less insomnia with a weighted blanket: Swedish study involving 120 adults with a mental health condition

You go to bed at a reasonable time and fall asleep after a while. At three o'clock, you are awake again and your thoughts start running wild. You look at your phone and calculate how many hours you have left. The next day, you struggle through it, and in the evening it starts all over again.

Do you have depression or an anxiety disorder and sleep like this? Then you are not alone. In a Dutch population study in the Tijdschrift voor Psychiatrie, almost half of the people with an anxiety or mood disorder experienced sleep problems, compared with about one in five people without such a condition. A weighted blanket is something people try in that situation. In Stockholm, adults receiving psychiatric care were even prescribed one, according to the researchers below about 2,700 times a year.

In a 2020 study, researchers at the Karolinska hospital in Stockholm investigated whether such a blanket really makes a difference. The study included 120 adults with insomnia and depression, bipolar disorder, an anxiety disorder or ADHD. A random draw determined who slept under an 8 kg (or 6 kg) weighted blanket for four weeks and who slept under a light 1.5 kg blanket. On an insomnia questionnaire (0 to 28 points), the score fell on average from 21.7 to 9.2 with the heavy blanket, and from 21.2 to 18.8 with the light one. For 59% of the people with the heavy blanket, the score was at least halved; with the light blanket, this was 5%.

That difference is substantial. Still, participants could probably tell whether their blanket was heavy or light, and a movement sensor worn on the wrist did not show less time spent awake at night. Below, you can read how the study was conducted and what conclusions you can and cannot draw from it.

Why this was investigated

Insomnia is common among people with a mental health condition and often persists for a long time. According to the researchers, about 40% of all people with insomnia do not benefit sufficiently from the usual treatments, cognitive behavioral therapy and sleep medication. As far as was known, no randomized study with a comparison group had yet been conducted in this population.

How the study worked

Psychiatric outpatient clinics in the Stockholm region referred patients between 2015 and 2017 who had experienced insomnia for at least two months. The participants were 18 to 77 years old, two thirds were women and most used medication, which they were not allowed to change.

The researchers call the blanket a chain blanket. This is a weighted blanket in which metal chains are sewn in instead of small glass beads. The comparison blanket had plastic chains of the same shape and weighed 1.5 kg. Participants were only told that there were two types of chain blanket, not that they differed in weight. Ten people found 8 kg too heavy and received 6 kg.

The main measurement was the Insomnia Severity Index (ISI), seven questions about falling asleep, staying asleep, daytime complaints and worries about sleep. Anyone whose score was at least halved counted as a responder. Anyone who scored 7 or lower was in remission: in other words, they no longer had clinically significant insomnia. Someone who did not know who had which blanket administered the questionnaire. Fatigue, low mood and anxiety were also measured, and participants wore an actigraph: a small wrist device that measures movement.

After four weeks, everyone was allowed to use a heavy blanket, for up to one year after the start; 112 of the 119 participants did so.

What the researchers found

• The difference in ISI score was already present after one week. On average, participants with the heavy blanket went from almost "severe" to below the threshold for clinical insomnia.
• For 38 of the 64 people with the heavy blanket (59%), the score was at least halved, compared with 3 of the 56 with the light blanket (5%). 27 of the 64 people with the heavy blanket (42%) achieved remission, compared with 2 of the 56 with the light blanket (4%).
• The effect did not differ by diagnosis or between men and women.
• During the day, participants with the heavy blanket were less tired, less low in mood and less anxious, and they moved more.
• At night, the actigraph showed no difference in sleep duration or in the time people spent awake, even though participants themselves said they slept through better.
• One participant stopped because the blanket caused an anxious feeling; no other side effects were reported.
• After twelve months, 92% counted as responders and 78% were in remission. Those who switched from the light to the heavy blanket improved by about the same amount.

What this study does not say

• You can feel the difference between 1.5 kg and 6 or 8 kg. Participants therefore probably knew which blanket they had, and the ISI is a questionnaire about your own experience. Expectations may then play a role. The assessor did not know, although this went wrong once: a participant said that the blanket had set off the metal detector at the airport.
• Across the group as a whole, the movement sensor did not show that people spent less time awake. The study did not include a measurement in a sleep center.
• In the following year, everyone had a heavy blanket and knew it. It cannot be determined from that phase whether the improvement was caused by the blanket or by the passage of time.
• All participants had insomnia and a mental health diagnosis. The study says nothing about people who are otherwise healthy and sleep poorly.
• This study involved chain blankets; blankets with glass beads were not tested.

How this fits with other research

Sleep researcher W. Vaughn McCall called the effect impressive in an accompanying commentary, but felt that the study should first be repeated before the blanket can be included in a treatment guideline. He regarded explanations such as deep pressure stimulation as ideas that still need to be investigated.

Later studies found smaller improvements, or improvements only in how people assessed their own sleep. In a 2024 Chinese study of 102 otherwise reasonably healthy adults with insomnia, people with a weighted blanket felt that their sleep had improved more, but the frequency of waking did not differ. In a Danish study of 45 people with depression, participants slept about thirteen minutes longer (read the summary of the Danish study on depression). A 2024 meta-analysis of eight studies in people with a mental health condition found a small effect on anxiety. The combined effect on insomnia, based on three studies, was just not significant. Without one outlying study, there was a small reduction, and the authors describe the blanket as a potentially useful addition to treatment.

In a small Turkish study without a comparison group, 26 people with insomnia fell asleep faster under a weighted blanket, but they also had more breathing pauses. The researchers recommend first checking whether you have sleep apnea; more about this can be found on the safety page. You can see the bigger picture in the overview of all the research.

Study in brief

• Researchers: Bodil Ekholm, Stefan Spulber and Mats Adler, Karolinska
• Year and journal: 2020, Journal of Clinical Sleep Medicine
• Country: Sweden
• Study type: randomized (a random draw determined who received which blanket), followed by one year without a comparison group
• Participants: 120 adults with insomnia and depression, bipolar disorder, an anxiety disorder or ADHD
• Duration: 4 weeks, follow-up to 12 months
• Blanket: 8 or 6 kg chain blanket, compared with 1.5 kg
• Source: Ekholm, Spulber & Adler, 2020

What you can take from this as a reader

Have you been sleeping poorly for a long time and do you have a mental health condition? Then your healthcare provider or GP is the first person to talk to. A weighted blanket is not a replacement for treatment; participants in this study continued taking their medication as usual. If you snore heavily or have breathing pauses at night, it is better to first check whether you have sleep apnea.

For the weight, the rule of thumb is approximately 10% of your body weight, a practical guideline and not an outcome of this study. You can read more about this in the article about choosing the right weight.

Source

Ekholm, B., Spulber, S., & Adler, M. (2020). A randomized controlled study of weighted chain blankets for insomnia in psychiatric disorders. Journal of Clinical Sleep Medicine, 16(9), 1567-1577. DOI Checked on 2026-10-12.

Written by Koen Dolron, owner of Novaline. Koen is not a doctor and Novaline does not provide medical advice: this page is intended as information. The summary is based on the original publication, which you can read yourself via the link above. Are you unsure whether a weighted blanket is suitable for you or your child, for example because of a medical condition or medication? Consult your GP or healthcare provider first.

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