Better Sleep – what your mattress firmness has got to do with it

By Dr. Tania Aloisio

A great night’s sleep can leave you feeling rested, recharged, and ready to conquer the world.   Unfortunately, for many of us, especially those of us suffering from backache, a great night’s sleep can be elusive.  Instead of resting, we find ourselves flipping and fluffing our pillows, twisting and turning to find a comfortable position, or even getting out of bed just to find some relief.  We might then wonder why, when we’re so tired, it is so hard to get a good night’s sleep?  Is it us or could it be that our mattresses have seen better days (or nights)?  People will wake up in the night for a variety of reasons, but if it is because of stiffness and achiness, it is a problem that can be solved.

The first step to setting things right is seeing your chiropractor.  Those stiff and tight muscles, achy joints and/or underlying alignment/postural issues will often prevent us from finding a comfortable position and ultimately getting a good night’s sleep.  We need to remember that a good night’s sleep is critical to restoring our physical, mental and emotion well-being as our optimal physical, mental and emotional state is also essential to a good night’s sleep.

Next, you may consider whether it is time to say ‘good-bye’ to that old mattress and ‘hello’ to a new piece of nightly heaven. Mattresses that are more than 10 years old or show visible signs of wear and tear (ie. sagging) are not likely to be up to the job of assuring you a good night’s sleep.  However, if you are waking up with aches and pains; just not sleeping as well as you used to; or the last good night’s sleep you had was not in your own bed: this is your body’s way of telling you that you definitely need to consider a new mattress. But, where do you start and what do you need to really need to know about buying a new mattress?

Mattresses are health care products and as such should be fitted to the person so that the natural position of the spine is maintained throughout the night, thereby reducing unnecessary stresses on the body.  Sleeping on the right kind of mattress has been shown to reduce back pain by 57%; decrease back stiffness by 59%; and improve the quality of ones’ sleep by 61%.

What aspect of the mattress makes the difference between a good or bad night’s sleep? We could look at the intricacies of the coil systems, steel gauge rating, foam density and padding, but what it will ultimately come down to is how you feel when you sleep on it.

We know that people who have chronic low-back pain will be more sensitive to mattress firmness than healthier people. Firmness is the bedding industry’s term for stiffness. Firmer beds don’t necessarily have higher coil counts or stronger gauges of steel, but often have stiffer padding and foam.  A firmer bed provides support by preventing the back from sinking more deeply into the bed and irritating the spinal joints as soft or worn out mattresses generally do over time. A softer mattress, however, has the advantage of conforming to and cushioning the natural curvatures of the body. However, if it is too soft, it will allow the spinal joints to sink into non-neutral positions often resulting in pain or discomfort.  So, what is the best firmness? In one study of 313 adults with chronic low back pain who complained of backache while lying in bed and on rising (sound familiar?), medium firm mattresses*, compared to firm mattresses had better outcomes for pain while lying in bed and on rising, and better overall disability scores at 90 days. They also reported less daytime low-back pain.

Sounds great to me!

With research in hand that suggests we are best off with a medium firm mattress, we can start the in-store test drive. Most of us will normally lie down on the bed, but you want to make sure that you lay there for as long as possible. You also want to make sure that you move around and put yourself in positions you would normally sleep in to see how you feel. Grab a pillow to simulate the experience if necessary.  Yes, this may seem awkward, but remember you will be spending 6-8 hours a night lying on that bed, so it is important that you are comfortable. A plush pillow top may be an option if you need a little extra cushioning for added comfort.  It is also important to remember that getting a new mattress is like getting a new pair of shoes, you have to break it in.   So while you may initially experience some discomfort until your body has adjusted to the new mattress, you can rest assured a great night’s sleep awaits you.

Please contact our office for additional information and/or questions and we will gladly address any additional questions you may have. Stay-tuned for future blogs on Better Sleeping and a variety of other health related topics.

 *Note: Medium firm mattress rating (Hs scale rating 2∙3) – Mattress firmness is rated on a scale developed by the European Committee for Standardization. The scale starts at 1∙0 (firmest) and stops at 10∙0 (softest).

  1. Bergholdt K, et al. Better backs by better beds? Spine, 2008; 33(7): 703-708.
  2. Jacobson BH, et al. Effectiveness of a selected bedding system on quality of sleep, low back pain, shoulder pain, and spine stiffness. Journal of Manipulative and Physiotherapeutic Therapies, 2002 Feb;25(2):88-92.
  3. Kovacs FM, Abraira V, Pena A, et al. Effect of firmness of mattress on chronic non-specific low-back pain: randomized, double-blind, controlled, multicenter trial. Lancet, 2003; 36(2): 1599-604.

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