Ready for a new mattress? Here's how to find the one that suits you best.
By Lisa Zamosky
Reviewed by Louise Chang, MD
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 of Beauty 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 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 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.
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.
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.
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.
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Arya Nick Shamie, MD, associate professor of orthopedic surgery and neurosurgery, Santa Monica UCLA Medical Center.
Breus, Michael, PhD, WebMD sleep expert and author of Beauty Sleep: Look Younger, Lose Weight, and Feel Great Through Better Sleep
Kovacs, FM. The Lancet, November 2003; vol 362: pp 1599-1604.
Reviewed on January 22, 2010
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