Dear Doctors: My niece got me a weighted blanket for my birthday, which she says helps you sleep. I admit I was skeptical, but I used it for a month, and she may be right. Instead of waking up a few times at night, I sleep right through. Is it the power of suggestion, or is there a reason this is working?

Dear Reader: Weighted blankets have become increasingly popular in recent years. They were originally developed as a therapeutic tool to help people with conditions such as autism, in which anxiety can be a persistent symptom.

Unlike an ordinary comforter, which is made entirely of fabric, the interior of a weighted blanket is lined with a heavy material of some kind. Depending on the manufacturer, this may be tiny spheres made of glass, plastic or metal, or natural fillers such as rice, grain, beans or sand. These fillers are sewn into pockets or channels and arranged so that their weight is distributed evenly throughout the blanket.

Someone lying under a weighted blanket feels a sensation of gentle pressure evenly distributed across their entire body. Occupational therapists refer to this as deep touch pressure. Research has found that this type of compression activates the centers of the brain that oversee involuntary processes such as heart rate, blood pressure, respiration and digestion. It has long been used, often to beneficial effect, on individuals with a wide range of sensory disorders.

Studies looking into weighted blankets over the years have observed a range of potential benefits. These include easing insomnia in adults living with depression, anxiety and attention deficit disorders; lowering anxiety in some children with mental health disorders; and improving sleep in older adults living in a nursing home. The researchers noted that while using a weighted blanket, the participants in their studies were able to fall asleep more easily, woke less frequently during the night and felt an increased sense of calm during the day.

A new study in Sweden has potentially linked the use of weighted blankets to increased melatonin production. Melatonin is a hormone that plays an important role in the sleep-wake cycle. Researchers found that when a group of 26 young adults with no previous sleep problems used a weighted blanket at night, their bodies produced more melatonin than when sleeping with a conventional blanket. It’s a small and short study -- just two days -- but the results take the weighted blanket conversation in an intriguing direction.

The accepted guidance regarding weighted blankets is to select a product that is 10% or less of the person’s total body weight. The specific material used in the filling is a matter of personal preference. However, weighted blankets are not for everyone. They should never be used by or on someone who would not be able to remove the covering themselves. This includes infants, young children and older or frail adults. They also may be unsuitable for people living with certain medical conditions, such as Type 2 diabetes, asthma, sleep apnea, low blood pressure and circulatory problems.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: I am dealing with prostate cancer. I have a Gleason score of 8, which I understand makes me high-risk. I am undergoing hormone therapy, and brachytherapy is pending. Any wisdom you can share about this or advances in prostate cancer treatment would be greatly appreciated.

Dear Reader: We’re sorry to hear about your diagnosis. The prostate is a walnut-sized gland in men that sits in front of the rectum and just below the bladder. As men grow older, their risk of developing prostate cancer increases.

Once a cancer diagnosis has been made, additional tests are used to assess how the cancer cells are behaving in the body. This is known as staging. One of these is a numerical measure known as the Gleason grading system. It is determined by examining the cancer cells under a microscope, and it reflects how likely a cancer is to spread beyond its initial site. A lower Gleason score indicates the cancer is growing slowly and has not yet become aggressive. A Gleason score of 8 indicates the presence of what is known as a high-grade cancer. That reflects an increased risk that an existing cancer may begin to spread.

Your medical team is addressing this with brachytherapy. That’s a treatment in which a radioactive material is implanted within the prostate gland. This allows the energy from the radiation to remain localized, killing the cancer cells and minimizing damage to surrounding healthy tissues. In high-dose brachytherapy, which is often done in multiple sessions, a high-energy radiation source is put in place for just a few minutes and then removed. Low-dose brachytherapy involves the permanent placement of low-energy radioactive seeds, which are about the size and shape of grains of rice. Both forms of brachytherapy have been shown to be helpful in slowing or preventing the spread of a localized cancer.

A new treatment for patients with a certain type of metastatic prostate cancer has recently received Food and Drug Administration approval. Known as Pluvicto, it’s a radiopharmaceutical. That’s a drug that uses radiation to fight disease at the cellular level. In this case, the drug is administered by injection or infusion. As it travels throughout the body, the drug seeks out cells with a specific biomarker, which identifies them as being cancer cells. The drug then emits a microscopic amount of radiation. It’s enough to kill or damage the cancer cell but does minimal harm to the surrounding healthy tissues. The treatment consists of six doses, set six weeks apart.

There has also been encouraging news about another type of radiotherapy, known as metastasis-directed therapy, or MDT. This treatment uses recent advances in imaging technology to precisely train intense beams of radiation on tumors from multiple directions. This makes it possible to intensify the therapeutic dose of radiation, and at the same time spare healthy tissue. A study into the therapy, which included more than four years of follow-up, found the therapy improved outcomes in many of the participants.

If your cancer has begun to spread, you might ask your medical team to explore if any of these therapies might be appropriate for you.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: I broke my ankle about 18 months ago. Now, in the area just above the break, the skin on my leg has turned a dark color, like a bruise. It doesn’t seem to be going away. Is there anything I can do to lighten this up? Do you think that laser therapy could help?

Dear Reader: You have described a condition known as “hemosiderin staining.” The term refers to areas of discolored skin that usually affect the lower leg, typically on the ankle and the top of the foot.

Hemosiderin staining occurs when the smallest blood vessels, known as capillaries, begin to leak. This can be due to a wound, a broken bone, a surgical incision or other types of trauma. It is also associated with certain illnesses that affect circulation. The most common of these is chronic venous insufficiency. This is a condition in which structural changes to the one-way valves in the veins prevent blood from circulating efficiently.

Both trauma and venous insufficiency result in the localized pooling of blood, which the body quickly begins to break down into its components. As the red blood cells are dismantled, the iron that they contain is released. This leads to the formation of a type of protein known as hemosiderin, which stores iron in the body. It’s the presence of iron that gives hemosiderin a rusty, brownish-yellow color. Over time, areas of hemosiderin staining can change color and intensify, becoming dark brown or even black.

In most cases, hemosiderin staining that has been caused by physical injury will gradually disappear as the damaged tissues heal. Depending on the individual, their general health and the nature and severity of their wound, it can take weeks, months or more than a year for the collected hemosiderin to disperse. In some cases, the pigmentation will become permanent.

Some people have success lightening the discolored skin with the use of prescription creams that contain hydroquinone. This is a compound that lightens the skin by interfering with the production of melanocytes, which are cells that produce pigment. While topical creams can prevent existing discoloration from becoming more pronounced, they may not completely remove it.

Laser therapy has also proven to be helpful at fading the discolored areas. For hemosiderin staining, a device known as a Q-switched laser is often used. This is the kind of laser used in tattoo removal. The Q-switched laser delivers short pulses of energy that are precisely calibrated to penetrate into the lower layers of skin. There, they destroy the pigment-containing cells. Because the sensation can range from uncomfortable to painful, a topical anesthetic is used. This type of treatment requires a series of visits to a dermatologist. It’s important to work with someone who specializes in this type of treatment.

In and of itself, the accumulation of hemosiderin is not a threat to health. However, because this can be a sign of a more serious underlying condition, it would be a good idea for you to be evaluated by your health care provider.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)