Importance: Sensory integration modalities, such as weighted blankets, are used in occupational therapy practice to assist with emotional and physical regulation. However, the research related to the use and effectiveness of weighted blankets is sparse.

Objective: To identify, evaluate, and synthesize the current literature to help develop the impetus needed to launch a research study into the effectiveness of using weighted blankets to decrease anxiety and insomnia.

Data sources: A literature search was conducted between January 23, 2018, and March 1, 2018. Databases and sites included the Cochrane Library, PubMed, PsycINFO, CINAHL, OTseeker, Web of Science, and Nursing Reference Center Plus. Search terms included weighted blanket, deep pressure, and occupational therapy as well as combinations of these terms.

Study selection and data collection: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were included if the study used weighted blankets as the modality of deep pressure stimulation. Data from presentations, conference proceedings, non-peer-reviewed literature, dissertations, and theses were excluded.

Findings: Only 8 studies were included: 4 Level I, 2 Level III, and 2 Level IV studies. The outcomes of these studies suggest that weighted blankets have the potential to be beneficial in limited settings and populations.

Conclusion and relevance: Weighted blankets may be an appropriate therapeutic tool in reducing anxiety; however, there is not enough evidence to suggest they are helpful with insomnia.

What this article adds: Evidence-based research on the effectiveness of weighted blankets in reducing anxiety and insomnia is sparse. More research is needed to define guidelines for the use of weighted blankets in clinical practice and to investigate the underlying mechanism of action. This systematic review can be used to begin an investigation of the use of weighted blankets for larger and more diverse populations.