We all have our comfort zones. Sleep therapists strongly recommend that your bed be one of them.
“Patients always ask about mattresses,” said Dr. Phyllis C. Zee, director of the Sleep Disorders Center at Northwestern University. “We prescribe a comfortable sleep environment, which includes a good box spring and mattress.”
Yet Zee and other sleep experts aren’t convinced that a new mattress is always the solution to a nighttime problem, despite the claims of bedding manufacturers and the popular opinion of many patients.
“The marketing message is this or that company’s mattress will improve your sleep,” Zee said. “I’m not aware of any studies to prove the claims. We need scientific evidence about whether a firm mattress is providing better quality of sleep.”
There are patients who insist a new mattress and box spring has smoothed the way to a good night’s rest, and Zee doesn’t dispute or discourage such conclusions, acknowledging that “a placebo effect” can occur. Improvement also can result from a switch in bed types; a firm mattress is dreamy for some people and a nightmare for others, and the same goes for softer sleep surfaces, including water beds.
In any case, the decision about whether your mattress is troublesome should be based more on common sense than research findings. When it comes to compromised quality of sleep, “people need to realize they are frequently the source of their own cure,” said Joyce Walsleben, director of the New York University Sleep Disorders Center. “You need to be your own detective, rule out what might be causing a problem.”
One common complaint is morning stiffness. Arthritis and back patients are all too familiar with the notion that the wrong type of mattress can disrupt sleep and lead to daytime pain.
“If you wake up sore or uncomfortable, then your mattress might be a root cause,” Walsleben said.
The NYU therapist said one convenient test is noticing how well you sleep in hotels or at friends’ homes. Sometimes the better sleep one gets on vacation is not due just to taking a break from daily stresses; a firmer mattress might provide more support to the spine or a softer bed could distribute body weight more evenly.
Zee pointed out that a firm mattress can relieve a cranky back but might not be entirely comfortable for other parts of your body. You might be trading off one symptom (spinal pain) for another (daytime drowsiness).
“You really don’t know about a mattress until you have slept on it for a while,” Zee said. “Most people find they prefer a medium-range firmness.”
A patient with arthritis or back problems can benefit from a firmer mattress that allows less movement while tossing and turning and offers more support to trouble spots. If you have achy knees and hips, you want a mattress that contours to your lower body. People who sleep on their backs should be thinking firmer rather than softer.
If you have neck problems, the right pillow might be more important than the right mattress. Some studies show that neutralizing the neck position can be beneficial; you want to look for a pillow that doesn’t allow your neck or head to sink into the mattress and bedding, and your neck shouldn’t be bent too far forward or backward. Using multiple pillows is not recommended for neck pain.
Overweight individuals tend to be most susceptible to mattress-related sleep disturbances, Zee said. And though no study shows it, mattress type probably affects younger people the least. Children can sleep on just about any bedding.
“I have one new patient who says her best sleep was on a cheap, soft mattress she had in college,” noted Zee. “She has spent a good deal of money on mattresses in recent years trying to re-create the feeling. It is likely other factors in her sleep environment are causing the problems.”
Zee said temperature is one element of the sleep environment that is sometimes overlooked (cooler is better). She also advises people on noise levels, light conditions and even bedding fabric (to rule out possible allergies).
A mattress can wear out, and the bedding industry uses eight to 10 years as a benchmark. Zee doesn’t disagree, but she suggests lumps, bumps, mattress tears, sagging and “funny squeaking noises” are more reliable indicators than age. If you sleep with a partner and one person rolls involuntarily when the other shifts positions, the box spring (also called the foundation) is failing.
Sometimes an overly firm mattress can be addressed with a supplementary foam product that fits over the mattress. The foam softens the surface a bit and can provide the right contour and support for the body.
When shopping for a new mattress, there are some accepted industry tips: Buy your mattress and box spring together for the best overall system. Make sure your queen- or king-size bed frame has a center support to prevent bowing. And don’t just sit on the edge of a bed or press down on the mattress; get into the bed, arrange yourself into a typical sleeping position and close your eyes.
Don’t get caught up in coil counts, either. Price is not necessarily an indicator of quality, though Zee said products at the extreme low end tend to be inadequate.
