Weighted Blanket Weight Recommendations
For adults, use a standard 15-lb weighted blanket regardless of body weight, as this weight has been validated in clinical trials for therapeutic benefit without requiring individualized weight-based calculations. For children with ADHD and sleep problems, weighted blankets showed modest efficacy, though specific weight recommendations are not established in the available evidence 1, 2, 3.
Adult Weight Recommendations
A 15-lb weighted blanket is the evidence-based standard weight for adults, as demonstrated in a randomized controlled trial of 94 adults with chronic pain where this weight produced significant reductions in pain perception (Cohen's f = 0.19) compared to a 5-lb control blanket 3.
The 15-lb weight was effective across varying adult body weights in the chemotherapy anxiety study, indicating that individualized weight-based calculations are not necessary for therapeutic effect 2.
Adults with high trait anxiety showed stronger responses to the 15-lb weighted blanket, suggesting this weight is particularly beneficial for anxious individuals 3.
Pediatric Considerations
For children with ADHD (mean age 9.0 years, SD 2.2), weighted blankets produced small but statistically significant improvements in total sleep time (7.72 minutes, Cohen's d = 0.24) and sleep efficiency (0.82%, Cohen's d = 0.23) 1.
Weighted blankets showed greatest benefit in older children aged 11-14 years (Cohen's d = 0.53) and those with inattentive ADHD subtype (Cohen's d = 0.58), suggesting age and symptom profile matter more than precise weight calculations 1.
The specific weights used in the pediatric ADHD trial were not detailed in the available evidence, representing a gap in weight-specific guidance for children 1.
Critical Contraindications
Weighted blankets are absolutely contraindicated in infants under 12 months due to suffocation risk. The following populations must avoid weighted blankets:
Infants younger than 4 months of age - any loose bedding including weighted blankets increases SIDS risk (OR: 2.8-4.1) and suffocation risk through airway obstruction 4.
All infants and young children who cannot independently remove the blanket - soft bedding can obstruct airways and cause overheating, with pillows, quilts, and heavy blankets identified as hazardous 4.
Individuals sleeping on couches or armchairs - these surfaces create extraordinarily high risk of death through entrapment or overlay, which would be exacerbated by weighted blankets 4.
Bed-sharing situations with infants - when soft bedding accessories are used during bed-sharing, SIDS risk increases substantially (OR: 2.8-4.1) 4.
Additional Safety Considerations
Preterm or low birth weight infants have increased baseline SIDS risk and should not have any loose bedding including weighted blankets in their sleep environment 4.
Individuals with respiratory compromise who cannot independently reposition or remove the blanket should avoid weighted blankets due to potential airway obstruction risk (extrapolated from infant safety data) 4.
Parents of infants who smoke or consumed alcohol have dramatically increased bed-sharing risks (OR: 1.66-89.7 for alcohol, OR: 4.7-10.4 for smoking), and any additional bedding including weighted blankets would compound these risks 4.
Implementation Guidance
No titration period is required for adults - the 15-lb weight can be introduced immediately for overnight use based on the trial protocols 2, 3.
For children with ADHD, a 4-week trial period is reasonable to assess efficacy, as this was the crossover interval in the pediatric study showing benefit 1.
Return rates are high (specific percentage not provided), indicating many individuals do not find long-term benefit, though those with dementia, anxiety, autism, or intellectual disability retained weighted blankets longer than others 5.
The prescription process for weighted blankets is longer and more costly than sleep medication, suggesting they should be reserved for individuals likely to benefit (high anxiety, specific diagnoses) rather than used as first-line therapy 5.