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

Figures & data

Table 1. Demographics of patients receiving a prescription of weighted blanket in the Region Västa Götaland from April 2015 to January 2018.

Diagnosis	Total n = 1785	Males n = 500	Females n = 1285	Age group
				18–24 n = 404	25–64 n = 1223	≥65 n = 158
Major mental disorders
Psychotic and related	111 (6.2)	43 (8.6)	68 (5.3)	9 (2.2)	86 (7.0)	16 (10.1)
Bipolar disorder	214 (12.0)	37 (7.4)	177 (13.8)	23 (5.7)	180 (14.7)	11 (7.0)
Unipolar depression	664 (37.2)	173 (34.6)	491 (38.2)	149 (36.9)	480 (39.2)	35 (22.2)
Neurodevelopmental disorders
ADHD	691 (38.7)	240 (48.0)	451 (35.1)	220 (54.5)	469 (38.3)	2 (1.3)
ASD	261 (14.6)	113 (22.6)	148 (11.5)	95 (23.5)	166 (13.6)	0 (0)
Mental retardation	153 (8.6)	70 (14.0)	83 (6.5)	32 (7.9)	117 (9.6)	4 (2.5)
Other developmental	55 (3.1)	27 (5.4)	28 (2.2)	24 (5.9)	31 (2.5)	0 (0)
Other
Dementia	144 (8.1)	38 (7.6)	106 (8.2)	1 (0.2)	37 (3.0)	106 (67.1)
Anxiety	827 (46.3)	193 (38.6)	634 (49.3)	201 (49.8)	572 (46.8)	54 (34.2)
OCD	98 (5.5)	23 (4.6)	75 (5.8)	25 (6.2)	73 (6.0)	0 (0)
PTSD/stress reactions	359 (20.1)	60 (12.0)	299 (23.3)	54 (13.4)	304 (24.9)	1 (0.6)
Eating disorders	84 (4.7)	3 (0.6)	81 (6.3)	32 (7.9)	52 (4.3)	0 (0)
Personality disorder	268 (15.0)	27 (5.4)	241 (18.8)	55 (13.6)	211 (17.3)	2 (1.3)

ADHD: attention deficit/hyperactivity disorder; ASD: autism spectrum disorder; OCD: obsessive-compulsive disorder; PTSD: post-traumatic stress disorder.

Diagnoses refer to diagnostic code given in the year preceding prescription. Numbers given as n (%).

Table 2. Main outcomes of sleep medication use and substance use disorder prior and following prescription of weighted blanket (n = 1785).

Prescription	Pre index n (%)	Post index n (%)	%-difference [95%CI; p]	Odds ratio [95%CI; p]
Sleep medication
Melatonin	309 (17.3)	374 (21.0)	3.6 [1.1, 6.2; 0.006]	1.27 [1.11, 1.44; 0.0003]
Mirtazapine	272 (15.2)	243 (13.6)	–1.6 [–3.9, 0.7; 0.18]	0.88 [0.78, 0.99; 0.03]
BZRA	719 (40.3)	650 (36.4)	–3.9 [–7.1, −0.7; 0.02]	0.85 [0.79, 0.92; <0.0001]
Antihistamines	661 (37.0)	594 (33.3)	–3.8 [–6.9, −0.6, 0.02]	0.85 [0.77, 0.93; 0.0005]
No prescription	599 (33.6)	658 (36.9)	3.3 [0.2, 6.4; 0.04]	1.16 [1.05, 1.27; 0.002]
No BZRA/antihistamines	774 (43.4)	872 (48.9)	5.5 [2.2, 8.8; 0.001]	1.25 [1.15, 1.35; <0.0001]
Substance use disorder
Alcohol	69 (3.9)	64 (3.6)	–0.28 [–1.52, 0.96, 0.72]	0.92 [0.73, 1.17; 0.51]
Sedatives	21 (1.2)	34 (1.9)	0.73 [–0.08, 1.54, 0.10]	1.63 [1.06, 2.50; 0.02]
Other	117 (6.6)	120 (6.7)	0.17 [–1.47, 1.80, 0.89]	1.03 [0.85, 1.24; 0.77]

BZRA: benzodiazepine receptor agonist; CI: confidence interval; p: p value. P-value of <0.05 is indicated in bold.

Figure 1. Forest plot of risk for continued prescription of sleep medication before and after weighted blanket by sex and age. (a) Prescribed medication after. (b) No prescription after.

Figure 2. Forest plot of risk for continued prescription of sleep medication before and after weighted blanket by diagnosis group. (a) Prescribed medication after. (b) No prescription after.

Table 3. Multivariate risk factor analysis for continuing of prescription of sedatives/hypnotics the year after weighted blanket.

Variable	Odds ratio; 95%CI	p Value
Female	1.06; 0.88–1.28	.52
Age 18–24 years	0.55; 0.38–0.78	.001
Age 25–64 years	Reference
Age >64 years	1.23; 0.71–2.13	.46
Major mental disorder
Psychotic and related	2.56; 1.27–5.26	.009
Bipolar disorder	2.17; 1.27–3.70	.005
Unipolar depression	0.89; 0.64–1.25	.52
Neurodevelopmental disorders
ADHD	0.88; 0.62–1.25	.46
ASD	1.12; 0.68–1.85	.66
Intellectual disabilities	0.92; 0.48–1.75	.80
Other developmental disorder	0.92; 0.35–2.44	.86
Other
Dementia	0.72; 0.32–1.67	.44
Anxiety	1.37; 0.99–1.89	.06
Obsessive-compulsive disorder	1.47; 0.65–3.23	.35
PTSD and other stress reactions	0.88; 0.60–1.30	.53
Eating disorders	1.54; 0.70–3.33	.28
Personality disorder	2.04; 1.28–3.23	.003

ADHD: attention deficit/hyperactivity disorder; ASD: autism spectrum disorder; OCD: obsessive-compulsive disorder; PTSD: post-traumatic stress disorder. P-value of <0.05 is indicated in bold.

Table 4. Change in amount of sleep medication prior and after prescribed weighted blanket among patients receiving a medical prescription in both periods.

Prescription	n	Pre index mg [95%CI]	Post index mg [95%CI]	mg-difference [95%CI]	p Value
Benzodiazepine receptor agonists
Flunitrazepam	14	0.5 [0.2, 0.9]	0.7 [0.4, 1.1]	0.2 [–0.3, 0.7]	.34
Zolpidem	192	8.4 [7.4, 9.5]	9.4 [8.3, 10.6]	1.0 [–0.6, 2.6]	.21
Zopiclone	496	5.5 [5.1, 6.0]	6.4 [5.9, 6.9]	0.9 [0.2, 1.5]	.008
Antihistamines
Alimemazine	248	26.6 [23.2, 30.1]	29.8 [26.1, 33.5]	3.2 [–1.9, 8.2]	.22
Levomepromazine	62	29.3 [19.3, 39.2]	38.8 [27.7, 49.9]	9.5 [–5.4, 24.4]	.20
Propiomazine	326	26.2 [24.1, 28.3]	30.6 [28.3, 32.8]	4.4 [1.3, 7.4]	.005
Promethazine	175	34.5 [27.9, 41.1]	39.8 [33.1, 46.6]	5.3 [–4.1, 14.7]	.39
Melatonin	?	2.3 [2.0, 2.7]	3.4 [3.2, 3.7]	1.1 [0.7, 1.6]	<.0001
Mirtazapine	243	22.9 [20.7, 25.2]	26.1 [23.7, 28.5]	3.1 [–0.2, 6.4]	.06

CI: confidence interval. P-value of <0.05 is indicated in bold.