How Hard Should A Mattress Be

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How to Pick Your Perfect Mattress

Ready for a new mattress? Here’s how to find the one that suits you best.

Getting a good night’s sleep depends on a lot of different factors — comfort, stress level, room temperature – but to get it right, you’ve got to start with the basics and your mattress is the first building block to a restful slumber.

If you’re in the market for a new mattress and have recently taken a stroll down the aisle of a bedding store, you know that there is a dizzying array from which to choose. How do you know which mattress is best for you?

To start, says Arya Nick Shamie, MD, associate professor of orthopedic surgery and neurosurgery at Santa Monica UCLA Medical Center, the mattress needs to support your body in a neutral position, one in which your spine has a nice curvature and your buttocks, heels, shoulders, and head are supported in proper alignment

"If the mattress is too firm, it will push on those main pressure points and take you out of alignment," Shamie tells WebMD. "If it’s too soft, those pressure points won’t be properly supported, so your whole body flops back." Both of these scenarios can lead to an achy morning.

Generally speaking, one type or brand of bed isn’t better than another, says Michael Breus, PhD, a WebMD sleep expert and author ofBeauty Sleep: Look Younger, Lose Weight, and Feel Great Through Better Sleep.But he does find that a firmer bed seems to be better for people with lower back pain.

In fact, researchers in Spain studied people with long-term back pain and found that on a 10-point hard-to-soft scale people who slept on a medium-to-firm mattress (5.6 on the scale) had less back pain than those who slept on a softer mattress.

Is It Time for a New Mattress?

How do you know if the bed you’re sleeping on is the right one?

"If you wake up in the morning and have some low back pain and can stretch and get rid of it in 15 or 30 minutes, that means you’re on an inappropriate mattress for you," Breus says.

The right mattress, on the other hand, is one on which you feel no pressure, almost like you’re floating in air, Breus says.

If you’re looking for a new mattress, experts suggest testing it in the store and laying down on each mattress in the position in which you normally sleep. Breus suggests spending at least 10 to 15 minutes on the bed. And, bring your own pillow! The more you can replicate the way you’ll be sleeping on the mattress once you get it home, the better your chances of picking the right one.


Innerspring Mattresses

Innerspring mattresses are still by far the most widely used. They support you with coil springs, and in most built today, each coil is individually enclosed. This helps the bed weather years of use and prevents the coils from popping out of the mattress. On top of the coils are a wide variety of materials added for comfort, from pillow to latex to memory foam. It’s all a matter of preference.

Salespeople may try to sell you on the idea that more coils mean more comfort, but that’s not necessarily true, Breus and Shamie say.

"You don’t really need a coil count above 390," Breus says. Beyond that, the difference in feel is so small it would be difficult to notice.

Pros:There are plenty of innerspring mattresses on the market from which to choose. They range in firmness, the fluffiness of the pillow top, and in price to fit nearly every preference and pocket book.

Cons:There’s no direct relationship in most cases between price and comfort, but Shamie suggests steering clear of the cheapest innerspring mattress. If there aren’t enough springs and cushion to offer you proper support, he says, you’ll likely wake up with an aching back.

Conditions:For someone who is very overweight, spring mattresses may offer a firmer support, making them easier to get in and out of, Breus says. Firmer versions are good for people with back pain. But spring-based mattresses can be comfortable for almost anyone.

Memory Foam Mattresses

Memory foam mattresses are growing in popularity. They are made of layers of different densities of foam that respond to weight and temperature, and are known for comfort because they contour to the specific shape of your body. Memory foam toppers are also available.

Pros:By molding to the shape of your body as your weight shifts through the night, memory foam reduces pressure points, and relieves pain. Memory foam also absorbs movement, so if you sleep with a partner, you’re not likely to be disturbed by his tossing and turning.

Cons:One of the biggest complaints with memory foam mattresses is that because these mattresses are temperature sensitive, softening and molding with your body heat, they can make you feel extremely hot during the night. Breus also says memory foam mattresses have been known to emit an unpleasant chemical smell.

Conditions:"If you have a hard time getting comfortable, if you have chronic fatigue, or some type of muscle pain, then a memory foam mattress would work well for you, assuming you don’t have temperature issues," Breus says.


Latex Mattresses

Latex mattresses are made from either natural or synthetic rubber, and are known for providing a very firm, bouncy support that is uniform throughout the bed.

Pros:"Quite frankly, I think one of the best materials is latex," Breus says. He likes it for being very firm and supportive, but also for providing comfort similar to memory foam. Unlike the memory foam mattresses, however, Breus says latex pushes back, ultimately providing more support.

Cons:If you don’t like the feel of a firm mattress, latex is probably not the right choice for you.

Conditions: Either a latex mattress or latex mattress topper is great for relieving back pain because they offer the best combination of comfort and support, Breus says.

Air Mattresses

We’re not talking about the blow-up mattresses you put your holiday guests on for a few days. Higher-end air beds look like a standard innerspring mattress, but use air-filled chambers instead of coils, and are covered by a foam layer on top.

Shamie notes that air beds have long been used for patients with spinal cord injuries who are lying in bed for a long time. They can be adjusted so they don’t continue to press on the same areas of the body, which helps to avoid skin breakdown in patients who can’t move.

Pros:"Couples who have dramatic differences in their individual preference for comfort and firmness levels might do very well with an air mattress," Breus says. The reason is that the firmness of each side of the bed can be altered. If you like it firmer than your partner, these beds can be adjusted for that.

Like latex and memory foam, you can also find air toppers for your mattress.

Cons:Shamie says people sometimes fail to make their air bed firm enough and wake up with back aches. Less sophisticated air mattresses also pop up on one side when you sit on the opposite end. For that reason Breus says, you want multiple chambers so that doesn’t occur.

Conditions:These beds are particularly useful when sleeping partners have different needs. If one of you has a bad back, one side can be made firmer than the other to provide greater support.


Adjustable Beds

These beds are able to bend and elevate at varying angles. As a result, the mattress has to be flexible. Different types of mattresses can be used on an adjustable bed – memory foam, latex, or air, for example. Spring mattresses are more difficult to use, however, because the springs don’t handle the bending well.

Pros:For people who have difficulty getting in and out of bed or who like to watch television in bed, Shamie says, adjustables can make life easier by moving you closer to where you need to be.

Conditions:If you suffer from sleep apnea, sleeping flat can make the condition worse by cutting off airways and causing the tongue to fall into the back of the throat, Shamie says. People who experience acid reflux can also benefit by sleeping in a bed that elevates their upper body.

Shamie also suggests adjustable beds for people with hip or back pain who have a hard time moving from a lying position to sitting up or standing.

Sofa Beds

When you have guests staying for a night or two, sofa beds come in handy. The mattresses in these beds tend to be very thin so they are flexible enough to fold and collapse into the couch. It’s a great convenience to have a sofa bed, but you’d be hard-pressed to find someone who raves about their comfort.

Pros:Sofa beds are convenient, especially if you have limited space. But from a health perspective, Shamie and Breus don’t see any advantages.

Cons:A night or two on a sofa bed is OK. But "this is probably the worst kind of bed you can sleep on long-term," Shamie says. The mattresses used in most sofa beds are very thin and the springs quite weak. "It really leads to an uncomfortable situation," Shamie says.

If you’re really tight for space and need a bed that folds up, Shamie says that futons, while not the most supportive, are better for your back than the typical sofa bed.

Conditions:There are no conditions for which a sofa bed will be helpful, according to the experts. But if you have a bad back or hips, these beds will be especially uncomfortable.


When to Part With Your Old Mattress

Today’s mattresses are made to last a lifetime. But you probably shouldn’t plan on keeping yours for that long. Our bodies change over time, Breus says, so the mattress that was once a joy to sleep on may no longer feel comfortable a few years down the road.

In addition, mattresses collect dust mites, fungus, and other germs that can exacerbate allergies and impact your sleep patterns. After 10 to 15 years, it’s time to think about buying a new bed.

Ultimately, the experts say that the best bed for you is the one that feels most comfortable. And remember, Shamie says, "There’s no mattress that’s going to save your body when you get only five hours of sleep." In order to feel your best, you need to get enough rest… no matter what type of mattress you’re sleeping on.


Arya Nick Shamie, MD, associate professor of orthopedic surgery and neurosurgery, Santa Monica UCLA Medical Center.

Breus, Michael, PhD, WebMD sleep expert and author ofBeauty Sleep: Look Younger, Lose Weight, and Feel Great Through Better Sleep

Kovacs, FM.The Lancet, November 2003; vol 362: pp 1599-1604.

Sarasota & Venice Mattress Stores

Mattresses are a major part of our lives, but how hard or soft they are can make a big difference for the quality of sleep you’ll get. Let’s look at the pros and cons of each type.

Pros of a Hard Mattress

1. They facilitate a neutral spine position, keeping your body straighter
2. They reduce the pressure on your circulation system, allowing blood to flow better
3. They prevent your lower back from collapsing, which allows you to inhale more oxygen while you’re sleeping
4. They support the use of props like body pillows and pillows between the knees
5. The human body can adapt to sleeping on a hard mattress and begin finding it comfortable

Cons of a Hard Mattress

1. Changing to a hard mattress (from a soft one) can be uncomfortable for several days
2. Studies have suggested that hard mattresses are not a good option for people with certain lower back problems (arthritis, rheumatism, scoliosis, etc.)
3. It can be harder to notice the differences in firmness between harder mattresses, and some may not be quite firm enough
4. Very few locations ever advertise their mattresses as "hard and solid" instead of "soft and plush", perpetuating the problem of people who are harming their bodies by sleeping on the wrong type of mattress
5. Body weight can eventually create indentations

Pros of a Soft Mattress

1. Soft mattresses can reduce back pain and help aging individuals deal with joint pain and problems
2. Slimmer, lighter people can sleep on a medium-firm mattress and enjoy the plushness without sacrificing spinal support
3. Soft mattresses can be a better option for people who sleep on their side, especially in a fetal position
4. Softness can be added through the use of pillow-top systems, allowing for a firm primary mattress with just a bit of softness on top
5. Research is continuing to work on ways to support the body even when softer mattresses are being used

Cons of a Soft Mattress

1. The softness can push a spine out of alignment and reduce the quality of sleep
2. Soft mattresses can be more expensive than their firmer counterparts
3. Two people may disagree on the amount of softness they want in a bed, making it harder to share
4. Soft mattresses tend to grow softer over time and may cease being appropriate after a few years of use
5. Tend to result in below-average buyer satisfaction

In short? You may want to consider a firmer mattress unless your doctor says otherwise.

Is Your Baby’s Crib Mattress Too Hard? (What to Do)

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Babies, and especially newborns, need a lot of support while they’re sleeping.

Not only that, a firm crib mattress is an absolute must when it comes to safe sleeping and SIDS (sudden infant death syndrome) prevention.

But many parents, after a few nights, week, or even months at home with baby, start to wonder: Is my baby’s crib mattress too hard or too firm?

Most likely, your baby’s crib mattress is exactly as firm as it’s supposed to be. What might seem rigid and uncomfortable to us adults is actually perfect for baby’s safety and development. You can switch to a softer mattress as baby gets a little bit older, and in the meantime, there are a few tips and tricks you can use to keep them comfortable while they sleep.

Let’s dive in a little deeper and explore the importance of a firm mattress for babies, when to switch to a softer mattress, and tips to keep baby comfortable if he’s having trouble sleeping in the crib.

How firm or hard should a crib mattress be?

I see this question over and over and over again on big parenting forums and mom discussion boards.

A baby is having trouble sleeping, and after trying every trick in the book to no avail, mom or dad tests out the crib mattress and finds that it’s hard as a rock.

Then they’re left wondering: Is the mattress too hard? Is that why my baby won’t sleep?

Chances are if you bought your crib mattress from a reputable company with all of the right safety certifications and inspections, the mattress is exactly as firm as it should be.

You would be surprised how firm a baby’s bed should really be! They need the support for a couple of important reasons:

  • Their bones are soft and just beginning to develop. Their spines, in particular, need far more support than adults do.
  • A firm mattress gives them a better base to push off of when they begin to wiggle and move around.
  • A mattress with too much give is a huge SIDS or suffocation risk for a baby that’s not able to move on its own very well yet.

So the bedding is SUPPOSED to be firm, or even hard.

Still, here are a couple of general rules of thumb you can use to gauge whether your child’s mattress is firm enough:

  • Press your hand into the sides and center of the mattress. It should have very little give.
  • When you release, it should quickly “snap” back into shape.
  • It definitely should NOT contour to the shape of your hand or body when laying down.

And ultimately, the overall rule is that if you think your baby’s mattress is cozy and comfortable, it’s probably too soft.

BUT… all of that doesn’t really help you if your baby doesn’t like the mattress or is having trouble sleeping. Believe me, I hear you!

Let’s talk about where to go from here.

When can my baby use a softer mattress?

There are a lot of first-hand accounts out there of parents using mattress toppers or pads, quilts, and other soft items to offset the firmness of their baby’s crib.

And from reading discussions online, a lot of the time it works! It seems some babies really do want a softer surface to sleep on.

But be warned: Putting anything in the crib other than a firm mattress and a tightly fitted sheet is a SIDS risk, and most doctors and pediatricians strongly caution against doing this.

The risk of SIDS peaks when baby is around 2-3 months old. So when it comes to newborns and smaller infants, it’s really best to stick with only the mattress, a tight sheet, and a really good swaddle.

According to Baby Center, 90% of SIDS cases occur in babies younger than 6 months — the likelihood of something going wrong during sleep decrease substantially after that.

However, SIDS risk still exists until a baby is 12 months old!

I wouldn’t consider switching to a softer mattress or adding a mattress topper/pad until baby is at least 6 months old and can move around or crawl on his own — and even then, you should definitely talk to your pediatrician first.

(I can’t stress that enough — I’m not a doctor and I don’t claim to be! Talk to yours before you make any major decisions about your baby’s safety.)

If you ARE looking for a good solution for a baby that likes softer bedding, I would definitely check out this Milliard Dual-Sided Crib Mattress on Amazon.

One side is super firm and safe for baby, while the other side is a little bit softer for an older baby or a toddler. Once you get the OK from your pediatrician to try a softer sleeping surface, you won’t have to buy something new — just flip it over!

Other ways to make baby more comfortable

Alright, so all of that still doesn’t really help if your baby isn’t ready for a soft mattress, but doesn’t like his firm one.

Fortunately, while you shouldn’t ADD anything into your crib for safety reasons, there are a few different things you can try to keep baby more comfortable and help him sleep better.

Let him sleep in a bassinet, cradle, or swing

It’s possible your baby just needs a different sleep environment. If so, you can plop him in a bassinet and keep him by your bedside — that’s a safe way to keep an eye on him and let him be close to you without bringing him to bed (which is a major no-no).

Or, try acradle! The gentle rocking motion may help soothe him and put him into a deep snooze.

Swings are a fantastic option for naps or short bursts of sleep, but usually aren’t safe for all-night sleep. (You guessed it, too much time spent upright can be a SIDS risk for baby.)

Try different pajamas and swaddles

A good swaddle can make a world of difference for young babies.

When it comes to newborns, it’s best to keep them tightly swaddled for overnight sleep, but you can experiment with different techniques and products.

One thing you might try is comparing sleep sacks with a little or a lot of room for their legs and seeing which one baby likes better.

These SwaddleMe swaddles on Amazon keep baby balled up tight, with very little wiggle room for legs. They’re as snug and cozy as it gets.

These Halo Sleepsack swaddles, on the other hand, give your baby a little more breathing room in the legs.

Both are great! Try both varieties and see if they help at bedtime.

Alter the sleep environment

When it comes to crib sleeping for newborns or younger babies, there’s really not much you can do to the crib itself safely.

But you can try lots of different things in and around the room to create a better sleeping environment.

Try a little white noiseor other sound machine sounds to soothe baby, or even play lullaby music.

Get the temperature right!Somewhere between 65-72 degrees in baby’s room is the ideal range, but you can try the lower or higher end if you think baby is getting too cool or hot at night.

Make it darker.You might think a room that’s too dark will scare your baby, but really the fear of the dark doesn’t start until later in life. Too much light can trigger alertness, so try making the room extremely dark or only using a very small, dim nightlight.

Related: Should I buy a breathable crib mattress?

There’s really no harm in a breathable mattress as long as it’s firm enough and up to the most recent safety standards, but “breathable” can be very misleading.

It implies that it’s OK to put baby to sleep on their side or stomach, or that you’ll be OK if you don’t follow the general guidelines for safe sleep.

That’s really not true. The only safe way to put a baby to sleep is on his back on a firm crib mattress with a tightly fitted sheet — that’s it!

You should only let baby sleep on his stomach or side if you’re specifically instructed by a doctor for a specific medical reason.

Related: Should I use sleep positioners to keep baby from rolling over?

In most cases, no, you shouldn’t!

Very young babies and newborns are extremely unlikely to roll themselves over on their own, so a positioner is unlikely to help very much. (Babies usually start learning to roll over around 4-months-old).

Plus, it’s just another obstacle in the crib that could become a major suffocation hazard. Most pediatricians and children’s groups strongly advocate against using any extra sleep props in the crib with your baby.

Wrapping Up

Your baby’s mattress might feel too hard to overly firm, but the reality is — it’s supposed to be that way!

There are extremely important safety and development reasons behind those stiff mattresses. And even though they may not be what YOU would want to sleep on, they are perfectly suited for newborns and young babies.

When your child gets a little older and has better motor control (and his SIDS risk starts to go down because of age), you can consider a softer mattress with input from your pediatrician.

And in the meantime, there are tons of things you can try in your baby’s room (or out) to make sleeping a little more comfortable.

Just remember not to put anything extra in the crib with a young baby, even if people online tell you it works! It’s just not worth the risk.

Hard Mattress Vs Soft Mattress – Which Is Better

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Poor body alignment and an improper mattress may prevent you from enjoying deep, restorative sleep. Sleep ergonomics can help you improve your sleep quantity and sleep quality. Read on to know more about this.

How well your body is aligned during sleep is, in essence, a strange, yet a very important, question. It is a strange question because common sense dictates that any posture in which you are able to sleep comfortably is a good one for you.

Yet, it is an important question on two counts: the position you are comfortable sleeping in may prevent your body from realigning itself, and misalignment can cause various health issues in the long run.

Besides other things, misalignment can cause or worsen back pain and affect both the quality and quantity of your sleep. Sleep deprivation or poor sleep quality, in turn, can impact your physical and psychological health.

Why do we get comfortable with an improper sleeping posture?

A comfortable sleeping position may not be always an ideal one, but why do we get comfortable with an improper sleeping posture in the first place? The answer lies in the inherent nature of the human body.

The human body, you see, is very adaptive. It automatically adjusts itself to counter any misalignment. If your body is not aligned properly, it will position itself in such a way as to counter any prevailing misalignment.

Comfort, simply put, can be an adaptive response, and may not be necessarily good for your health.

Importance of alignment when we sleep

Here’s one test question for you:do you often experience daytime sleepiness, headache, fatigue, and/or lack of focus after a night’s sleep?

If yes, chances are your body is poorly aligned during sleep.

To be more specific, you may be breathing shallowly during sleep. There is a clear and strong relationship between body alignment and breathing and sleep quality.

Structural imbalance in the body affects breathing, which, in turn, affects sleep quality. When our spine is in its natural position – a position in which the neck (cervical), middle back (thoracic), and lower back (lumbar) are in good alignment – our lungs are able to hold more oxygen. Adequate intake of oxygen during sleep facilitates smooth functioning of the parasympathetic nervous system (PSNS), which induces and promotes relaxation.

On the other hand, reduced oxygen intake causes an excess production of cortisol (the stress hormone) and adrenaline, which prevents the body from relaxing. Correct body alignment during sleep also promotes proper blood circulation throughout the body and relieves joint pain, both of which help you get a good night’s sleep.

In whichever position you sleep, it is important that you maintain a ‘spine-neutral’ position (neutral spine position is the same as the spine’s natural position).

The mattress you sleep on has a huge influence on your structural balance. If the mattress is not appropriate, it can create, mask, and/or worsen structural imbalances, which can be detrimental to good sleep. It can also lead to health conditions such as sleep apnea and back pain.

Hard Mattress vs. Soft Mattress

Some say a hard mattress is better than a soft mattress, some say a soft mattress is better, and some say whichever type of mattress you are comfortable with is the right one for you.

Nevertheless, it is now believed that a it’s not only the firmness of the mattress but it’s ability to support the right parts of your body correctly. Proper alignment is critical to prevention of tossing and turning which leads to sleep disruption. We put together aspecial web classthat goes deeper into this…

Advantage of Hard Mattress

The new ergonomics of sleep dictates that when it comes to mattresses, less is usually better. The less cushioning the mattress provides, the more it is likely to support or facilitate a neutral-spine position during sleep.

According to the ergonomics of sleep, it is necessary that bones have some resistance for good sleep. When you lay down on a hard bed with a thin, hard mattress, your bones bears the most, if not all, of the pressure.

This, in turn, frees your muscles and allows your arteries and veins to relax. As a result, the blood circulation in the body improves, helping you sleep better. The other benefit of a hard mattress is that it prevents your lower back from collapsing when you lay on it. This ensures that your airways are not constricted, permitting you to inhale more oxygen. Ample oxygen intake, as we’ve seen already, is crucial for good sleep. Switching to a hard mattress after sleeping for many years on a soft mattress may not be easy.

You may feel a bit uncomfortable during the first few nights. The feeling of discomfort usually dissipates on its own within a few days. That said, people who have health issues like back pain, rheumatism, arthritis, weak capillaries, or scoliosis should not go for a hard mattress.

Technology is slowly evolving and beginning to understand that just the right firmness is required to support the body.

Advantage of a soft mattress

A new study has pointed out that a soft mattress may be beneficial to people with back problems, refuting the age-old belief that people with back issues should sleep only on hard surfaces. Here are the details of the scientific study: In the study, Spanish researchers analyzed the effect of mattresses on 313 participants who had back pain. The participants were randomly divided into two groups.

One group was asked to sleep on a firm mattress that had a softness rating of 2.3 out of 10. The other group was asked to sleep on a medium-firm mattress that had a softness rating of 5.6. The duration of the study was 90 days. The researchers assessed the patients at the start of the study and upon the completion of the trial.

Patients were also asked to assess their condition on a daily basis and to rate on a scale of 1 to 10 the intensity of pain they felt on rising from the bed, the intensity of pain while sleeping, and the degree of discomfort, disability, or pain they experienced during the day on a scale of 1 to 10.

At the end of the study, all participants experienced improvement in their condition. However, the participants who slept on a medium-firm mattress for 90 days experienced better results. The condition of participants who experienced back pain while lying down improved by as much as 80% on a medium-firm mattress, and 70% on a firm mattress.

The degree of discomfort experienced during the day decreased by an impressive 50% for participants who used a medium-firm mattress, and 30% for those who slept on a firm mattress. Overall, the participants who slept on a medium-firm mattress for the duration of the trial were less likely to require any pain-relieving drug treatment.

Again, it’s important to have the “right firmness”.

So what is the right firmness?

Great question! We cover that in our web class…

Disadvantage of a soft mattress

A soft mattress may be disadvantageous for healthy people as it may cause the back to collapse when you lie on it. When the back is collapsed, the lungs are not able to take in as much oxygen, which can prevent you from getting good sleep.

Bottom Line

Proper body alignment during sleep is necessary as it allows you to enjoy a good night’s sleep. Your mattress affects your body alignment which influences the quality of sleep.

The answer is lies not only in the firmness but also material which distributes weight correctly.

Plus there are certain things you can do to sleep more deeply so you can feel energized, refreshed and ready to take on the world!

We dive deep into this and much more…

…in a special web class that will give you powerful tips to sleep better and also help you understand further the 1 Secret To A Better Night’s Sleep.Hint: it’s what you sleep on!😉

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.

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