Weighted blanket and sleep medication use among adults with psychiatric diagnosis – a population-based register study

Abstract

Objective

To measure rate of subscription of common sleep medication and diagnoses of substance use disorder (SUD) before and after receiving a prescribed weighted blanket (WB) among patients with psychiatric diagnoses.

Materials and methods

Using register-based data of health-related factors in a Swedish region, a total of 1785 adult individuals with a psychiatric diagnosis, received a WB and resided in the region during the study period were identified. Using each individual as their own control, the rate of one-year prior prescription of WB or diagnosed SUD was compared to rate after a half year wash-out after prescription of WB for a full year.

Results

The number of patients without prescription of sleep medication increased by 3.3% (95% confidence interval (95%CI): 0.2–6.4, p=.04). Furthermore, the proportion without a prescription of benzodiazepine receptor agonist/antihistamines sleep medication increased by 5.5% (95%CI: 2.2–8.8, p=.001). Melatonin prescription increased after WB by 3.6% (95%CI: 1.1–6.2, p=.006). Younger age and unipolar-, anxiety-, attention-deficit/hyperactivity-, and post-traumatic stress disorder was associated with decreased use while psychotic-/bipolar- and personality disorder was not associated with a decrease in the use of sleep medication. The number of alcohol SUD diagnoses did not increase while sedative SUD rate increased statistically significantly by 0.7% (odds ratio = 1.63, p=.02). In a multivariate model, only younger age predicted discontinuation of sleep medication while psychotic-/bipolar- and personality disorder had statistically less decrease.

Conclusion

This observational register study found a statistically significant association between WB use and decreased use of common sleep medication except melatonin that increased slightly.

Keywords:

• Sleep
• epidemiology
• pharmacoepidemiology
• treatment
• psychiatry

Acknowledgements

The authors wish to thank Gothia Forum for the support and coordination of this project. Especially Emilie Pauli and Anneli Karlsmo, project coordinators. Furthermore, we express our gratitude to Bo Zetterlund and Jan Kilhamn for initiating the Regional process of evaluation weighted blankets as a medical intervention.

Disclosure statement

All authors declare no conflict of interest in the publication of this article.

Additional information

Funding

Steinn Steingrimsson’s research time is financed by grants from the Swedish State under the Agreement between the Swedish Government and the County Councils, the ALF Agreement [ALFGBG-786541]. The funder had no influence over the conduct or reporting or the review.

Notes on contributors

Steinn Steingrímsson

Steinn Steingrímsson, MD, PhD, docent and specialist in psychiatry at Sahlgrenska Academy, University of Gothenburg. Main research focus is on direct environmental effect on psychiatric outcomes with a specific emphasis on digital tools.

Ellen Odéus

Ellen Odéus, PhD student and holds a position as an occupational therapist at Queen Silvia’s Childrens hospital in Gothenburg. Research focus concerns sleeping habits and preconditions to health changes in sleep behaviors in children and adolescents with neuropsychiatric disorders.

Mats Cederlund

Mats Cederlund, MD, PhD, Specialist in Child Neurology and Child Psychiatry, Habilitation & Health, Region Västra Götaland, Sweden.

Stefan Franzén

Stefan Franzén, PhD, Senior statistician at the Centre for Registries, Region Västra Götaland, and adjunct lecturer at the Health Metrics Unit, School of public Heath Göteborg University.

Carina Helgesson

Carina Helgesson, OT, Head of Regional Primary Health Care Unit, Health Care Pharmacy and Medical Aid, Region Västra Götaland, Gothenburg, Sweden.

Kristina Nyström

Kristina Nyström, OT, Strategist Medical Aid, Habilitation & Health, Region Västra Götaland, Gothenburg, Sweden.

John Sondell

John Sondell, data analyst at the department of Data Management and Analysis, Head Office, Region Västra Götaland, Gothenburg, Sweden.

Arve Opheim

Arve Opheim, PT PhD, Head of research and development at Habilitation & Health, Region Västra Götaland, Sweden and leader of research group “Movement and function” at Sunnaas Rehabilitation Hospital, Norway. Main research interests in neurologic rehabilitation, disability and health care.