Weighted Blanket Precautions Contraindications | Death-Related Product Recall

Introduction

Occupational therapists often recommend weighted blankets for their patients. Research is not definitive about the effectiveness of this modality for certain uses such as sleep. Older research reports improvement in anxiety for 63% of study participants in an exit survey for a 30-pound weighted blanket. 76% reported this modality being more effective than no blanket. A systematic review published in AOTA by Eron and colleagues (2020) reported benefits of weighted blankets in limited settings and populations. They concluded that weighted blankets may be an appropriate therapeutic tool in reducing anxiety, however, not enough evidence exists to suggest its helpfulness with insomnia.

Takeaway: weighted blankets may help with anxiety, but not so much with sleep-related difficulties such as insomnia.

Death-related to Weighted Product

Recently, Target recalled a brand of their weighted blankets due to several reported deaths in children. This is truly tragic and personally, I would not recommend this modality for children.

If you do decide to recommend or use weighted blankets with clients for occupational therapy here are some general precautions and contraindications. It is recommended that 5-10% of the person’s body weight should be how much a weighted blanket weighs.

Weighted Blanket Precautions & Contraindications

  • When in doubt, obtain a doctor’s order first.
  • Do not use for those with cardiac or circulatory problems.
  • Do not use with respiratory problems.
  • Do not use with thermoregulatory problems.
  • Do not use with orthopedic issues, e.g., broken bones.
  • Do not use with open wounds or sutures following surgery, e.g., Ex-fix.
  • Do not use with people who are prone to overheating.
  • Do not use with unstable medical conditions such as those who obtunded, seizures, hypersomnia, obtunded.
  • Do not use with skin conditions such as pressure ulcers or eczema.
  • Re-consider if pros outweigh cons for those with hemi-paresis.
  • Avoid use for those with quadriplegia.
  • Avoid using during pregnancy.
  • Do not use as a restraint.
  • Avoid using if a person is already in a restraint.
  • Do not use over the head.
  • Avoid using with clients who are claustrophobic.
  • Avoid using with clients who lack cognitive abilities to problem solve for their safety, e.g., late-stage dementia.
  • Do not use with infants or small children (Target recall death!)

Alternatives to

If certain clients are not candidates for the use of weighted blankets for their anxiety, consider the many alternatives and modalities that are available in conjunction with psychosocial approaches.

  • Aromatherapy
  • IHA
  • Breathing techniques
  • Yoga
  • Music
  • Calming lights
  • Nature videos
  • Mindfulness
  • Guided meditation
  • Mental imagery
  • Progressive muscle relaxation
  • Art therapy
  • Journaling
  • Social support
  1. Mullen, B., Champagne, T., Krishnamurty, S., Dickson, D., & Gao, R. X. (2008). Exploring the safety and therapeutic effects of deep pressure stimulation using a weighted blanket. Occupational Therapy in Mental Health, 24(1), 65-89.[]
  2. Eron, K., Kohnert, L., Watters, A., Logan, C., Weisner-Rose, M., & Mehler, P. S. (2020). Weighted blanket use: A systematic review. The American Journal of Occupational Therapy, 74(2), 7402205010p1-7402205010p14.[]