title: Weighted blankets and sleep in autistic children--a randomized controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of a weighted-blanket intervention in treating severe sleep problems in children with autism spectrum disorder (ASD).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Children's Sleep Medicine, Evelina London Children's Hospital, St Thomas' Hospital, London, United Kingdom; paul.gringras@gstt.nhs.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Gringras
authors.affiliation: Centre for Rehabilitation and.
authors.forename: Dido
authors.initials: D
authors.lastname: Green
authors.affiliation: Lime Trees Child and Family Unit, York, England; and.
authors.forename: Barry
authors.initials: B
authors.lastname: Wright
authors.affiliation: Children's Sleep Medicine, Evelina London Children's Hospital, St Thomas' Hospital, London, United Kingdom;
authors.forename: Carla
authors.initials: C
authors.lastname: Rush
authors.affiliation: Department of Psychology, Oxford Brookes University, Oxford, United Kingdom;
authors.forename: Masako
authors.initials: M
authors.lastname: Sparrowhawk
authors.affiliation: Children's Sleep Medicine, Evelina London Children's Hospital, St Thomas' Hospital, London, United Kingdom;
authors.forename: Karen
authors.initials: K
authors.lastname: Pratt
authors.affiliation: Department of Psychology, Oxford Brookes University, Oxford, United Kingdom;
authors.forename: Victoria
authors.initials: V
authors.lastname: Allgar
authors.affiliation: Lime Trees Child and Family Unit, York, England; and.
authors.forename: Naomi
authors.initials: N
authors.lastname: Hooke
authors.affiliation: Lime Trees Child and Family Unit, York, England; and.
authors.forename: Danielle
authors.initials: D
authors.lastname: Moore
authors.affiliation: Department of Clinical Neurophysiology, John Radcliffe Hospital, Oxford, United Kingdom.
authors.forename: Zenobia
authors.initials: Z
authors.lastname: Zaiwalla
authors.affiliation: Department of Psychology, Oxford Brookes University, Oxford, United Kingdom;
authors.forename: Luci
authors.initials: L
authors.lastname: Wiggs
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D001512:Bedding and Linens; D002648:Child; D002652:Child Behavior; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology*; D002675:Child, Preschool; D015897:Comorbidity; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000628:therapy*
keywords: autism spectrum disorder; children; severe sleep problems; total sleep time; weighted blankets