Stress, Anxiety, Agitation, Traumatic Brain Injury (TBI), PTSD, Sleep Disorders, Alzheimer’s

The OTvest™ denim weighted vest is useful in reducing stress, anxiety, and agitation due to the calming effects of the deep pressure applied to the body. The OTvest is a simple, non-invasive intervention that can make a difference in relaxation!

Think of someone pressing gently but firmly down upon your upper back, shoulders, and the front of your shoulders. It feels good and has a wonderfully calming effect. We naturally do that to others when we see that they are anxious or overstimulated, and might even say, “Calm down” as we do it. That is similar to what the OTvest provides through the administration of calming, deep pressure applied by the patented weight insert hidden inside. By wearing the OTvest, calming deep pressure can be administered throughout the day, discreetly, and inexpensively, without the need of another individual providing the deep pressure. Persons putting the OTvest on for the first time almost always spontaneously say, "It feels good!"


Just as we hear runners say that running gives them a “natural high” because of the increase in dopamine, deep pressure changes the chemistry in our brains and can create a calming, focusing effect. The OTvest is a noninvasive, holistic treatment approach to promote a sense of well-being.

When using the OTvest™, denim weighted vest to address problems with inattention, stress reduction, anxiety, restlessness or agitation (TBI, PTSD and Alzheimer's), and sleep disorders or insomnia, medication may still be necessary when recommended by a physician, but often at a lesser dose than would otherwise be needed. When medication is prescribed and doesn't seem to be totally addressing the distractibility or lack of attention to task, trying a OTvest, weighted vest as a non-invasive addition to treatment is often a good start before increasing medication levels. Wearers have reported decreased sleeplessness when wearing the OTvest prior to bedtime, and often less need for medication to promote sleep or even the discontinuation of medication.  Many physicians are recommending the OTvest to patients. (Please view video for live interview with Robin who has cerebellar ataxia, and talks about her increased ability to sleep after wearing the OTvest, and discontinuing use of sleep medication.

Sleep deprivation in children can be mistaken for ADHD, as children often get more "wound up" when they lack sleep. The OTvest can be used prior to bedtime for those who have trouble falling asleep, as the calming effect promotes relaxation. Some wearers find that they no longer need medication previously prescribed for insomnia or narcolepsy when they wear the OTvest for about an hour prior to going to bed.

Stress, anxiety, agitation and sleep deprivation are often seen in post traumatic stress disorder, traumatic brain injury, Alzheimer's, and in movement disorders.  "Behavior deficits have been shown to occur in up to 70% of clients hospitalized with TBI (McNett, Sarver, & Wilczeski, 2012)¹. This study also reported that the most common behaviors associated with agitation include impulsiveness, restlessness, and a decreased attention span. These behaviors have shown to be a substantial obstacle to participation in the inpatient rehabilitation process, attaining goals, and achieving functional independence (Lequerica et al, 2007)²." Patient goals for rehabilitation can include initiatives designed "to gradually increase his attention span and reduce restless behaviors". ³

The OTvest, weighted vest can provide deep, sustained pressure using less weight than is necessary in other weighted vests on the market because of the density of the weights (dense steel rather than bulky sand or pellets) and the PLACEMENT of the weight directly UPON the body--not hanging in pockets supported by the garment rather than the body itself. This sustained deep pressure can create a sense of well-being, increasing focus and function, promoting better sleep, and decreasing anxiety, stress and agitation. Improvement in balance and awareness of where one is in space--where one's body is positioned--often shows improvement with the applied weight in the OTvest (proprioceptive input), and this also helps to decrease the accompanying anxiety that the lack of feeling "grounded" produces.  (also see information on MOVEMENT DISORDERS)

Psychiatric facilities, schools, specialized treatment programs, adults and parents across the country and internationally have been ordering the OTvest since 2002.

Why does the OTvest, weighted vest have this calming effect? Deep pressure is registered in the limbic system, hippocampus, and reticular activating system and may stimulate production of neurotransmitters to modulate arousal levels, similar to the effects of medications. The use of the OTvest applies this deep pressure in a holistic, non-invasive and easily applied, discreet manner.


As Ms. VandenBerg, MS, OTR, occupational therapist, who created the OTvest after being excited by the outcomes of her research, explains in her published and often referred to manuscript,"The Use of a Weighted Vest to Increase On-Task Behavior in Children with Attention Difficulties:" 4

"Farber (1982) supported a beneficial response to the application of deep pressure, suggesting that maintained pressure is calming as it facilitates an increase in parasympathetic or relaxed tone. In describing her own autism, Temple Grandin related her experience of severe anxiety and how deep pressure ultimately helped her reduce the anxiety’s debilitating effects by reducing overall arousal and facilitating attention and awareness (Grandin & Scariano, 1986). In studies done with children with autism, deep pressure has been found to have a calming effect (Edelson, Edelson, Kerr, & Grandin, 1999; Krauss, 1987; McClure & Holtz-Yotz, 1991; Miller et al., 1999; Zissermann, 1992)."

"Proprioception and deep touch-pressure are types of sensory information that can produce a calming effect (Ayres, 1972; Farber, 1982; Knickerbocker, 1980). Both are carried by the dorsal column system to higher levels in the thalamus and the reticular formation and then up to sensory areas in the parietal lobe of the cerebral cortex. According to Royeen and Lane (1991), “Since the reticular formation mediates arousal, the reticular projections of the dorsal column pathway may be related to the efficacy of these inputs in decreasing arousal and producing calming” (p. 115). The dorsal column system also has some connections with the limbic system via the hypothalamus and the anterolateral system. This functional redundancy in the nervous system may play a role in the efficacy of sensory integration intervention (Fisher et al., 1991).

An example of the nervous system’s functional redundancy is seen in the registration of deep pressure. Deep pressure is registered in the limbic system, hippocampus, and reticular activating system and may stimulate production of neurotransmitters to modulate arousal levels, similar to the effects of medications. The action of the neurotransmitters norepinephrine, epinephrine, and serotonin is associated with the limbic structures and components of the reticular system, hypothalamus, and cortex (Ashton, 1987). Medications allow more of these neurotransmitters to be available to the brain, influencing the level of arousal in the nervous system of [an individual] and thereby controlling hyperactivity and helping to increase the [individual's] ability to attend (Cohen, 1998; Hallowell & Ratey, 1994). The reticular system is aroused to varying degrees of alertness by sensory stimuli (Ayres, 1972), and touch-pressure appears to be particularly effective in dampening overly activating stimuli.

Deep pressure also sends sensory information into the Purkinje cells in the cerebellum, which then work to dampen stimulation entering the reticular formation through brain chemistry or neurotransmitters (Hanschu, 1998; Reeves, 1998). Purkinje cells are rich in serotonin and are responsible for inhibition of motor activity (Edelson, 1995). Children with ADHD have been found to have high levels of hyperactivity related to lower levels of serotonin in their blood (Gainetdinov et al., 1999; Taylor, 1994). Deep pressure may stimulate the increase in serotonin, as well as other neurotransmitters, to create a natural calming on the central nervous system in  those] with ADHD [and autism], anxiety, stress, traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD).

Ms. VandenBerg realized that the weight had to be in a more effective position, lying upon the body, after her research was published--and was driven to create that better weight placement than that used in her research. Here is the entire research manuscript published in The American Journal of Occupational Therapy by Nancy VandenBerg, MS, OTR, occupational therapist whose work in the public schools with children and young adults with attention difficulties, such as ADHD, traumatic brain injury,  children with autism and sensory processing disorders lead her to create the OTvest, weighted vest:

¹ McNett, M., Sarver, W., & Wilczewski, P. (2012). The prevalence, treatment and outcomes of agitation among patients with brain injury admitted to acute care units. Brain Injury, 26, 1155-1162.

² Lequerica, A., Rapport, L., Loeher, M., Axelrod, B., Vangel, S., & Hanks, R. (2007). Agitation in acquired brain injury: Impact on acute rehabilitation therapies. Journal of Head Trauma Rehabilitation, 22, 177-183.

³ Morro, K., Farley, J. (2016). Brain Injury in an Inpatient Rehabilitation Facility: Occupational Therapist's Role in Interdisciplinary Approach to Behavior Management. OT Practice, June 6, 2106, 15-18.

4 Quoted with permission by Nancy VandenBerg, MS, OTR, American Journal of Occupational Therapy, November/December 2001, Vol. 55, 621-628. doi:10.5014/ajot.55.6.621

References in the above AJOT quote can be found on the Links page to the entire AJOT manuscript.


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