How Firm Mattress Should Be

Home   /   How Firm Mattress Should Be

Firm and Soft Mattresses for Bad Backs

Grant Hughes, MD, is board-certified in rheumatology and is the head of rheumatology at Seattle’s Harborview Medical Center.

Soren Hald Collection / Stone

If you’re one of the over 70 million Americans who deals with daily back pain, a lot may be stacked against you at bed time. You likely know first-hand how pain can limit things—like the number of hours of you get per night, how restful the sleep you do get is, how well you function during your waking hours, and how satisfying, overall, sleep is to you.

Your Mattress and You

Sleeping on a mattress that is not right for you, given your individual condition, may be one of your biggest obstacles to rest and repose.

And this may mean you need to go shopping. If that’s the case, what type of mattress should you buy?

To a great extent, mattress choice is a highly personalized one. Likely the most important thing you can do is to match the firmness of your prospective mattress to your spine’s unique needs for support and comfort.

Dr. Michael Perry, M. D., Medical Director of the Laser Spine Institute in Tampa, FL, recommends staying away from either extreme of firmness when selecting a mattress, stating that studies generally find a medium-firm mattress does the trick for most types of back problems.  

A 2003 study published in Lancet confirms this, saying, "a mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain."  

There’s nothing like a good dose of facts, so here’s a quick run down on mattress firmness research as it relates to back pain.

A Survey of Temporary Back Pain From Foam Mattresses

One hundred Indian medical residents who slept on foam mattresses were surveyed about the effects of this on their spines in a 2000 study published in theJournal of the Association of Physicians of India. The mattresses in question were 10 centimeters in thickness—the kind one might find in a youth hostel. The residents experienced temporary backaches from the mattresses, but not the generally more serious type that is also accompanied by nerve symptoms such as sciatica, radiculopathy, or paresthesia (pins and needles.)

The sleep-induced pain was relieved for most of the residents (61%) once they returned to their own beds, and it came back when they again slept on the foam.  

Firm vs Soft

In an effort to confirm that hard mattresses exert a positive effect on the sleep of people with chronic low back pain, as is commonly believed, participants in a study tested bedding with varying degrees of firmness.

The study, a randomized controlled trial, was published in the April 2008 issue of Spine.  

A “soft” mattress group slept on a water bed.

A second group slept on a Tempur-pedic mattress, which is known for its ability to conform to your body shape without sacrificing support.

And the “hard” mattress group slept on a futon.

Overall participants favored the water bed and foam (Tempur-pedic) mattresses the most in terms of pain relief, ability to function and number of hours slept per night. That said, the difference in scores between these two types of mattresses and the hard mattress was small.

"A Tempur-pedic with a dial-in firmness feature would be my top choice," Perry comments. "When you need more support, you can simply press a button and presto! The beauty of Tempur-pedic is that you can get support where you need it. You can also get on-demand softness."

He adds that a dial-in water bed also has advantages, clarifying that more water equals more firmness.

“Just remember not to dial in so much water that your mattress bursts,” he quips.

On the flip side, Perry says that if you don’t dial in enough water, your water bed mattress may surround and enclose your body, which can decrease the quality of your sleep.

In fact, he adds, “some of my patients report they feel smothered when their water bed isn’t firm enough. This is because the lungs have less room to expand when you’re sunken down. Of course, the cure is to firm it up by in dialing more water."

Even in light of this potential drawback, self-inflatable water beds may be the way to go. A 2015 review of studies published inSleep Healthconfirmed all of Dr. Perry’s opinions, concluding that a medium firm mattress with custom inflation capabilities proved the most optimal choice for spinal alignment and sleep comfort.  

Keep in mind that few studies have been conducted on this topic overall. But those that can be found in the medical literature point to achieving the right firmness in your mattress as a key to sound sleep—despite the back pain.

How firm should a mattress be for lower back pain?

Research is limited, but in one study, researchers assigned new mattresses to more than 300 people with low back pain. They used either medium-firm or firm mattresses for 90 days. Those in the medium group reported the least amount of discomfort.

You might consider getting a memory foam mattress (instead of a traditional innerspring one). The foam molds to your body. The downside: Some memory foam mattresses keep in heat; and the material might have more chemicals.

Reviewed by Nayana Ambardekar on February 6, 2019

Cleveland Clinic: "Is Your Sleep Position Causing You Back Pain?"

Consumer Reports: "Mattress Buying Guide."

Harvard Healthbeat: "What Type of Mattress is Best for People With Low Back Pain?"

Jacobson, BH. "Grouped Comparisons of Sleep Quality for New and Personal Bedding Systems." , 2008.Applied Ergonomics

Kovacs, FM. “Effect of firmness of mattress on chronic non-specific low-back pain." , November 2003.Lancet

Mayo Clinic: "Slide show: Sleeping positions that reduce back pain."

University of Utah Health Care: “Good Sleeping Posture Helps Your Back."

Cleveland Clinic: "Is Your Sleep Position Causing You Back Pain?"

Consumer Reports: "Mattress Buying Guide."

Harvard Healthbeat: "What Type of Mattress is Best for People With Low Back Pain?"

Jacobson, BH. "Grouped Comparisons of Sleep Quality for New and Personal Bedding Systems." , 2008.Applied Ergonomics

Kovacs, FM. “Effect of firmness of mattress on chronic non-specific low-back pain." , November 2003.Lancet

Mayo Clinic: "Slide show: Sleeping positions that reduce back pain."

University of Utah Health Care: “Good Sleeping Posture Helps Your Back."

How Firm Should A Baby Crib Mattress Be?

October 13, 2017

One of the most important considerations parents should have about their baby’s mattress is the firmness level. While it’s tempting to want baby to have a cushion-soft surface that seems cozy to us as adults, it can be dangerous if a crib mattress is soft, floppy, or saggy.

Why You Don’t Want a Soft Mattress

For starters, babies’ bones are still developing and their bodies need much more support than ours do as adults. Adults may find comfort and support from a wide range of materials and firmness levels, but for babies it’s important to remember that firmer is always better. If it feels cozy to you, it’s probably too soft for your baby.

Babies, especially newborns and young infants, lack mobility and can’t get around very well. So they have a harder time lifting themselves up and repositioning like an adult would. If they stay on their back during sleep that’s one thing, but once they start rolling onto their tummies this can present a pretty serious risk. A softer mattress that is flexible at the edges can also increase the chance that arms or legs can get stuck between the mattress and the crib.

To reduce the risk of these potential hazards, it’s best to choose a firm crib mattress with firm edges. Safety recommendations also caution parents to place babies to sleep on their backs and to keep all soft materials (bedding, toys, etc.) out of the crib environment.

How Firm Should A Crib Mattress Be?

Consumer Reports recommends that you “Press on the mattress in the center and at the edges. It should snap back readily and should not conform to the shape of your hand.” So when you’re testing crib mattress firmness, feel free to put pressure on the mattress to make sure it resists the impression of your hand. It should feel a bit firmer than you’d think is comfortable. But trust us – babies need the firmer surface and sleep just fine!

The Ideal Firmness for a Crib Mattress

At Lullaby Earth, your baby’s safety is our priority. Our crib mattresses are made with firm, flat support, as recommended by the Consumer Product Safety Commission (CPSC) and also feature reinforced edges for a snug fit in the crib.

Our 2-stage or “dual firmness” crib mattresses have a firm side and a cushion firm side. When baby is around one year old you can switch to the cushion firm side for a little more cushion during the toddler years!

We do recommend you confirm with your pediatrician before flipping the mattress, since some babies may need a bit more time on the firmer infant side.

How firm should a crib mattress be? We’ve got the answers. Choose a mattress that will help your baby to sleep safe and sound.

Crib Mattress Firmness: What Is Safe for Newborns and Babies?

When it comes to your little one, you want to be sure that they are getting the best night’s sleep possible in a safe sleeping environment. When purchasing a mattress for your baby’s crib, pay attention to how firm the bedding is. Manufacturers of the best crib mattresses know that for safety and developmental reasons, firm is best. But how firm should a crib mattress be? Here is everything you need to know about purchasing the best crib mattress for your child.

Crib Mattresses Should Be Firm and Flat

As tempting as it may be to purchase a soft and cloud-like mattress for your baby’s crib, you should absolutely avoid doing so. There are multiple reasons for this, including your baby’s developmental health.

Babies do a lot of growing, and a firm mattress is able to provide their spines and bones with support. Unfortunately, as comfortable as a soft mattress may seem, it is unable to provide the growth support that babies need.

Additionally, soft bedding increases the likelihood of infant death. SIDS, sudden infant death syndrome, is more likely to occur in a crib with a soft mattress, as is suffocation. Alternatively, firm mattresses have proven to be safer sleeping environments for babies.

How to Determine If a Mattress Is Firm Enough

When shopping for crib mattresses, firmer is better. In fact, one good rule of thumb is to purchase the firmest mattress you can find. Even if this type of mattress isn’t comfortable for you, that’s not a problem. In fact, most mattresses that are comfortable for adults are too soft and pose a safety hazard to babies.

To test a mattress before you purchase it, press down on the mattress’s center and edges. A firm mattress won’t indent to your pressure and will instead snap back into its original position quite quickly. As an extra safety precaution, you want to be sure that your crib mattress is firm around its edges so as to prevent a gap forming between the mattress and the side of the crib when in use.

Other Mattress Precautions to Be Aware of When Shopping

Along with your mattress’s firmness, you also want to check to make sure the mattress you are going to buy isn’t being recalled. Furthermore, conducting a two-finger test between the mattress and your crib can help prevent your child from getting stuck in the gap between the mattress and crib frame. To perform the two-finger test, simply place your fingers between the mattress and the crib’s side. Only two fingers should be able to fit in that space. If there’s excess room, it’s a sign that you need a different sized crib mattress.

Also be sure that there are no springs sticking up through the cushioning, as this could be harmful to a sleeping baby. Generally, you want to avoid using secondhand mattresses if possible.

Quickly Clean Up Spills on Your Baby’s Crib Mattress

Just because a crib mattress appears clean, it might not be telling the whole story. Bacteria and other harmful elements can collect in a crib mattress if it’s not carefully cleaned and monitored. Always make sure that if your child’s diaper leaks or if anything is spilled on your baby’s crib mattress that you’re cleaning it immediately.

To clean a crib mattress, start by wiping off excess fluids with a damp sponge. From there, pat the area dry with a washcloth. You should always replace your baby’s sheets when a spill has occurred, immediately tossing the dirty sheets into the washing machine for a thorough clean.

If the spill has gone beneath the sheets, make a mixture of some soapy water and dab the spill with a sponge that has absorbed some of that mixture. You always want to avoid rubbing a spill, as it can lead to the spill going even deeper into the mattress and leaving a stain. Finally, dry the mattress by gently dabbing it with a clean washcloth.

If you think that the spill may have seeped into the mattress itself, keep an eye on it in the coming days. If discoloration begins to appear, it may be time for a new crib mattress. You may even want to consider purchasing a mattress pad to help protect your crib mattress from future spills and leaks.

Hi, I am Chelsey! I’m a writer and editor currently living in Boston, Massachusetts. Before this, I’ve called both Los Angeles, CA and Brooklyn, NY home. Prior to joining the ReviewThis team, I worked as a lifestyle writer for Bustle and City Guide NY. You can add me on Twitter (@chelseygrasso) to keep up with my latest publications and interests!

Firm or soft mattress? Choosing a firm or soft mattress can be hard. Our guide helps you choose the perfect mattress to improve your sleep.

Should Mattresses Be Firm Or Soft?

Getting a good night’s sleep depends on many things, ranging from the temperature of your bedroom, to how dark it is, and even whether you’ve had a stressful day. But one also has to start with the basics to get it right. One major key to a restful slumber is to choose the right mattress.

How can you determine whether a firm or soft mattress is best for you?

As shown by medical experts, if your mattress is too firm, it will push on the primary pressure points and cause your spine to be misaligned. A mattress that’s too soft is not a good thing either. A squishy mattress won’t adequately support your body . The last thing you need is an achy morning.

If you find yourself having to stretch for at least 15 to 30 minutes every morning to get your back pain under control, it will make you realize that the mattress you are sleeping on is not right for you.

Tips and Tricks to Help You Choose the Right Mattress

When you’re shopping for a mattress, experts suggest that you lie down on each mattress you’re considering, in the position in which you would usually sleep. You’ll get the best sense of whether the mattress would be a good fit if you spend at least 15 minutes on the bed, and if you even bring your pillow along to best replicate your sleeping situation.

You will know your mattress is right for you when you experience no pressure.

Innerspring Mattresses

The most traditional types of mattresses, there are many brands and varieties of innerspring mattresses on the market from which to choose. You can narrow down your choices based on the firmness of the bed and features like a fluffy pillow top.

Usually, spring mattresses are ideal for larger-sized individuals as they offer firmer support and are easier to get in and out of.

In most instances, these types of mattresses are the most affordable, but steer away from the cheapest innerspring mattresses as you will most likely wake up with back pain.

Memory Foam Mattresses

What is great about this type of mattresses is that they mold to the shape of your body as you move around to different positions at night. Memory foam relieves pain as it reduces pressure points.

Furthermore, it absorbs any movement, which is great when you share your bed: you will not get disturbed while your partner tosses and turns.

However, it has been shown that memory foam mattresses are temperature sensitive as they soften and mold with your body heat, making it extremely hot and uncomfortable during summer.

Air Mattresses

The firmness of air mattresses on each side of the bed can be altered, which is suitable for couples who have their individual preferences when it comes to firmness and comfort levels. These bed can easily be adjusted to accommodate dramatic differences.

Like memory foam and latex, one can find air toppers for these mattresses.

The only problem is that you can end up with a backache should you fail to make your air mattress firm enough.

Keep an eye out for inferior quality air beds: they tend to pop up on the one side when you sit on the other end.

Latex Mattresses

These are made from either synthetic or natural rubber and are known for offering a bouncy, yet firm support.

Experts reckon that latex materials provide comfort that is similar to memory foam in terms of being supportive and firm. Some would go one step further and say that it is even better.

But, if you do not like firm mattresses, then latex is not the right choice.

Sofa Beds

These are great when you have guests over for a night or two, and are convenient in cases when you have limited space. But while a couple of nights on a sofa bed is okay, it is not a good option for everyday use.

The mattress on a sofa bed tends to be very soft and thin, the springs are weak, and often the folding frame of the bed can create uncomfortable ridges against your back.

In Closing

If you are looking for the best mattress firmness for your needs, a firm mattress will likely be the most comfortable choice. The next time you’re mattress shopping, seek out memory foam or latex for a comfortable sleeping experience.


Hello, I’m Jaques and I am part of the ReviewThis writing team. I have 8 years of writing experience and have been involved in product reviews and descriptions since 2015. I specialize in home improvement accessories and equipment, and I enjoy being able to teach my readers new things about the products that they buy and bring into their homes!

Add a Comment: