https://www.selleckchem.com/products/DMXAA(ASA404).html Study objectives This study aimed to evaluate the effect of weighted chain blankets on insomnia and sleep-related daytime symptoms for patients with major depressive disorder, bipolar disorder, generalized anxiety disorder (GAD) and attention deficit hyperactivity disorder (ADHD). Methods One hundred twenty patients were randomized (11) to either a weighted metal chain blanket or a light plastic chain blanket for four weeks. The outcome was evaluated using the Insomnia Severity Index (ISI) as primary outcome measure and the Day and Night Diaries (DND), Fatigue Symptom Inventory (FSI), and Hospital Anxiety and Depression Scale (HADS) as secondary outcome measures. Sleep and daytime activity levels were evaluated by wrist actigraphy. Results At four weeks, there was a significant advantage in ISI-ratings of the weighted blanket intervention over the light blanket (p less then 0.001) with a large effect size (Cohen´s d 1.90). The intervention by the weighted blanket resulted in a significantly better sleep-maintenance, a higher daytime activity level and reduced daytime symptoms of fatigue, depression and anxiety. No serious adverse events occurred. During a 12 months open follow up phase of the study, participants continuing using weighted blankets maintained the effect on sleep, while patients switching from a light to a weighted blanket got a similar effect on ISI-ratings as participants using the weighted blanket from the beginning. Conclusions We conclude that weighted chain blankets are an effective and safe intervention for insomnia in patients with Major depressive disorder, Bipolar disorder, Generalized Anxiety Disorder, or ADHD, also improving daytime symptoms and levels of activity.Study objectives To systematically survey the scientific literature concerning the effect of playing a wind instrument or singing on sleep, snoring, and/or OSA. Methods The PubMed, EMBASE, and Cochrane databases were searched