Is there evidence that using a particular type of mattress improves sleep quality?

Evidence on Mattress Types and Sleep Quality

Medium-firm mattresses that are custom-adjusted to individual preferences provide optimal sleep quality, comfort, and spinal alignment for adults, particularly those with back pain.

Mattress Types and Sleep Quality

Evidence for Medium-Firm Mattresses

The most recent and highest quality evidence demonstrates that mattresses subjectively identified as medium-firm and those that are custom-inflated (self-adjusted) are optimal for promoting sleep comfort, quality, and spinal alignment 1. This finding is particularly important for individuals with back pain, as appropriate mattress selection can significantly reduce discomfort.

Research shows that replacing old bedding systems with new medium-firm mattresses can lead to significant improvements in:

• Sleep quality and comfort
• Reduced back pain and stiffness
• Decreased physical discomfort during sleep 2

These benefits appear to be independent of variables such as age, weight, height, and body mass index, suggesting that medium-firm mattresses may be beneficial across diverse populations.

Customized Mattress Selection

For individuals with specific pain conditions, mattresses specifically layered with foam and latex based on the person's dominant sleeping position can provide progressive improvement in:

• Back pain
• Back stiffness
• Overall sleep quality 3

In a 12-week study, participants with chronic back pain experienced significant reductions in pain and discomfort when their mattresses were replaced with ones designed for their specific sleeping positions 3.

Mattress Technology Considerations

When comparing different mattress technologies:

• Alternating air pressure mattresses with less extreme pressure changes and lower peak inflation pressures (such as the Nimbus II in one study) performed better for patient comfort and sleep quality compared to those with more dramatic pressure fluctuations 4
• The ability of a mattress to automatically adjust pressure based on the user's position and weight appears to enhance comfort 4

Environmental Factors Affecting Sleep Quality

Beyond mattress selection, several environmental factors influence sleep quality:

• Sleep Environment: Creating a dark, quiet, and comfortable sleep environment with appropriate use of earplugs and eye masks can increase total sleep time 5
• Room Temperature: While evidence regarding the optimal temperature of mattresses is not yet sufficient, warm temperature has been recommended by researchers 1
• Regular Exercise: Regular physical activity, including yoga, has been shown to improve sleep quality, global sleep quality, daytime functioning, and sleep efficiency 5

Non-Pharmacological Approaches to Improve Sleep

The American College of Physicians recommends cognitive behavioral therapy for insomnia (CBT-I) as the most effective first-line treatment for improving sleep quality, which should be implemented before considering pharmacological interventions 5. Additional non-pharmacological approaches include:

• Sleep Hygiene Practices:

  • Maintaining a regular sleep-wake schedule
  • Getting regular morning or afternoon exercise
  • Ensuring daytime exposure to bright light
  • Avoiding heavy meals, alcohol, and nicotine near bedtime
  • Avoiding caffeine after noon and limiting daytime naps 5

• Behavioral Techniques:

  • Stimulus control (going to bed only when sleepy, maintaining consistent sleep-wake times)
  • Sleep restriction (limiting time in bed and avoiding long or late afternoon naps)
  • Relaxation techniques (progressive muscle relaxation, guided imagery, breathing control)
  • Mindfulness meditation 5

Special Considerations

For Infants and Children

For infants, safety considerations are paramount:

• Firm mattresses that maintain their shape are essential to reduce the risk of SIDS and suffocation 6
• Soft mattresses, including those made from memory foam, could create indentations and increase the risk of rebreathing or suffocation if the infant is placed in or rolls over to the prone position 6
• Mattress toppers designed to make the sleep surface softer should not be used for infants younger than 1 year 6

For Adults with Back Pain

For adults with back pain, medium-firm mattresses specifically designed for their sleeping position can provide progressive improvement in both back pain and stiffness over time 3. The benefits of appropriate mattress selection become more prominent with continued use (from week 1 to 4 of observation) 2.

Conclusion

When selecting a mattress to optimize sleep quality:

1. Choose a medium-firm mattress that allows for custom adjustment when possible
2. Consider your dominant sleeping position when selecting mattress materials and design
3. Ensure the mattress maintains proper spinal alignment
4. Implement good sleep hygiene practices alongside appropriate mattress selection
5. Replace older mattresses, as new bedding systems have been shown to improve sleep quality regardless of baseline sleep quality

Remember that sleep quality is defined as an individual's self-satisfaction with all aspects of the sleep experience 7, and appropriate mattress selection is an important component of creating an optimal sleep environment.