Weighted blanket by prescription: what Swedish users with ADHD and autism experience

Your child has been lying awake for a long time every evening for months. A consistent bedtime has done little to help. Now you're considering a weighted blanket. More than anything, you want to know what people who have been sleeping under one for years think of it, and whether they still use it.

Sweden has a lot of experience with this because you could obtain such a blanket through healthcare there. An occupational therapist prescribed it as an aid. In Stockholm, according to researchers at Karolinska Hospital, this amounted to about 2,700 blankets per year, for adults in psychiatric care alone.

Two Swedish studies examine this practice. For the first, from 2021, researchers called 85 children and adults with ADHD or autism who had received such a blanket through healthcare. Of them, 78% used it every night, and 81% said it helped them sleep through the night better. The second study used registry data from 4,092 people in western Sweden. People with dementia, anxiety, autism or an intellectual disability kept the blanket longer than others. Prescribing it cost the region almost three times as much as sleep medication.

Neither study had a comparison group. The first concerns what people reported themselves, while the second concerns how long they kept the blanket, not how they slept. In 2020, the Swedish regions were also advised to stop providing the blanket at healthcare expense. Below, you'll read how this worked and what conclusions you can and cannot draw from it.

Why combine these studies

Both studies concern the same Swedish practice: the weighted blanket as a healthcare aid. "By prescription" did not mean that you went to the pharmacy with a note. An occupational therapist assessed whether the blanket was suitable for you and requested it from the region's assistive-device center. The center supplied the blanket, and when you no longer needed it, you returned it there.

How this worked varied by region. In western Sweden, you had to have a long-term mental health condition and keep a sleep diary for two weeks. Did it take you more than an hour and a half to fall asleep, or did you wake up more than three times during the night? Then you were eligible. The patient paid nothing.

Bolic Baric 2021: what users with ADHD or autism say themselves

How the study worked

Researchers from Linköping searched the records of an assistive-device center for everyone who had received a weighted blanket through one of three habilitation centers in central Sweden between 2012 and 2015. Such a center supports people with disabilities. People who had received the blanket for sleep problems and had ADHD or autism were eligible: 227 people.

Of those, 85 took part (37%). The rest did not answer, did not want to participate, did not use the blanket or were excluded because of another diagnosis. They included 48 children aged 7 to 17, for whom a parent answered, and 37 adults aged 18 to 59. In a 5- to 15-minute telephone interview, they mainly answered yes-or-no questions about sleep, daily routines, school and work.

Most had a weighted blanket with chains inside (86%); the rest had one with plastic balls.

What the researchers found

Most participants started using it because they had trouble falling asleep (81%) or staying asleep (66%). Of the entire group, 78% used it every night. About a quarter also used it during the day, more often adults than children.

• 81% said they slept through the night better with the blanket.
• 59% said that going to bed and falling asleep became easier: 69% of the children compared with 46% of the adults.
• 26% noticed that getting up became easier, and 17% that things improved at school or work.

The researchers now want follow-up research with measurements, such as a wrist monitor, and preferably with randomization.

Study in brief

• Researchers: Vedrana Bolic Baric, Sofie Skuthälla, Malin Pettersson, Per A. Gustafsson and Anette Kjellberg
• Year and journal: online in 2021 (print 2023), Scandinavian Journal of Occupational Therapy
• Country: Sweden
• Study type: retrospective study with telephone interviews, without a comparison group
• Participants: 85 people with ADHD and/or autism: 48 children and 37 adults
• Duration: one interview, after 1 to 6 years of use
• Blanket: usually with chains (5 to 8 kilograms), otherwise with plastic balls (7 kilograms)
• Source: Bolic Baric and colleagues, 2021

Odéus 2023: who continued using the blanket

How the study worked

This study used the healthcare registers of Västra Götaland, Sweden's second-largest region. Everyone who received a weighted blanket through healthcare between May 2015 and the end of 2017 was included: 4,092 people aged 1 to 103. ADHD (48%), anxiety (41%), autism (32%) and depression (27%) were the most common. Insomnia was listed as a diagnosis in the records for only 27%.

The researchers looked at how long people kept the blanket before returning it, and followed everyone for an average of 2.1 years.

What the researchers found

During that period, 2,291 blankets were returned. Blankets with chains stayed out the longest: half had been returned after 2.3 years, compared with about a year and a half for those with plastic balls.

• People with anxiety (11% lower likelihood) or an intellectual disability (19% lower likelihood) returned the blanket less quickly, and the same was true for dementia and autism.
• It was returned sooner by people with ADHD (18% higher likelihood) and depression (13%).
• Among children up to age 6, the likelihood of returning it was 37% higher than among teenagers aged 13 to 17; among people over 65, it was 3.5 times higher.
• For each additional kilogram of weight, the likelihood of returning it was 3% lower.

Why someone returned the blanket was not recorded. It may have been because it did not help, but also because their sleep had improved again.

A blanket required 6 to 7 visits, compared with about 2 for sleep medication. Over more than two years, a blanket cost healthcare approximately € 352, while sleep medication cost € 124. The costs mainly covered healthcare providers' time, not the blanket itself.

Study in brief

• Researchers: Ellen Odéus, Emelie Pauli, Steinn Steingrímsson, and colleagues
• Year and journal: online 2022 (print 2023), Scandinavian Journal of Occupational Therapy
• Country: Sweden
• Study type: registry research with a cost comparison, without a comparison group
• Participants: 4,092 people aged 1 to 103 who received a blanket through healthcare
• Duration: May 2015 to the end of 2017, followed for an average of 2.1 years
• Blanket: with chains (64%), beads (20%), or fibers (16%)
• Source: Odéus and colleagues, 2023

What these studies do not say

• There was no comparison group and no randomization. So we do not know whether people without a blanket would also have slept better.
• In the interview study, people described their experiences retrospectively, sometimes after several years, and parents spoke on behalf of their children. The researchers themselves point out that parents want to see improvement.
• Nearly two-thirds of those who could have taken part did not participate, and these were more often adults. Perhaps they were less satisfied or no longer used the blanket.
• The registry study did not measure sleep, and the researchers do not know whether people actually used the blanket they kept.
• Both studies concerned people with a diagnosis who received the blanket through an occupational therapist, not people who bought one themselves.

How this fits with other research

Researchers from the same region also looked at sleep medication. Among 1,785 adults with a mental health condition, the proportion not using sleep medication increased by 3.3% after receiving the blanket (Steingrímsson and colleagues, 2022). Prescription melatonin use increased slightly. This was also registry research without a comparison group.

In October 2020, the MTP Council, an advisory body for the Swedish regions, recommended that weighted blankets should only be provided at the expense of healthcare within research, because the evidence was too weak. That recommendation concerned payment, not the blanket itself: according to the MTP Council, anyone who benefits from one can buy it themselves. The 2020 document has been replaced by a newer version with the same recommendation, which was reaffirmed in 2024. You can read what other bodies think in the overview of official positions.

There are randomized studies, such as the Swedish insomnia study, the large Swedish ADHD study and the study on children with autism. The bigger picture can be found in the overview of all research.

What you can take away as a reader

In the interview study, most participants were still using their blanket every night years later. These studies do not show whether the blanket itself improved their sleep. Have you or your child been sleeping poorly for a long time? Start with your GP or healthcare professional, because a blanket is not a substitute for treatment. Evening tips can be found in this article about calming a busy mind with ADHD.

As a rule of thumb, the weight should be approximately 10% of your body weight; this is a practical guideline, not a finding from this study (how to choose the right weight).

Is it for your child? A weighted blanket is not suitable for babies or children under 3. For older children, the same rule of thumb applies, and the child must be able to push the blanket off independently. Read more on the safety page.

Sources

Bolic Baric, V., Skuthälla, S., Pettersson, M., et al. (2021). The effectiveness of weighted blankets on sleep and everyday activities: A retrospective follow-up study of children and adults with attention deficit hyperactivity disorder and/or autism spectrum disorder. Scandinavian Journal of Occupational Therapy, 30(8), 1357-1367 (2023). DOI

Odéus, E., Pauli, E., Steingrímsson, S., et al. (2023). Weighted blankets for sleep problems: Prescription, use and cost analysis. Scandinavian Journal of Occupational Therapy, 30(2), 211-221. 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 for informational purposes. The summary is based on the original publications, which you can read yourself via the links 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 professional first.

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