What to look for when buying a mattress?
Buying a mattress is a significant and consequential expense, so it is best to try out a mattress before committing to it. Does this mean that a mattress from a box is out of the question? Not at all, if the manufacturer offers the standard 100-day money-back guarantee. A hundred days is a much more thorough inspection period than whatever customers can find out during the time they spend trying out mattresses at a store.
There are four key factors to consider when buying a mattress:
Spinal alignment
Maintaining the natural curve of the back helps promote restful sleep. This means that the back ought not to be excessively arched, but not flat either. Some of this can be accomplished with an appropriate sleeping position.
For back sleepers, placing a small pillow under the knees and a flatter pillow under the lower back will reduce pressure on the spine.
Sleeping on the stomach is not recommended for back pain sufferers because it does not preserve the curvature of the spine. But for those who cannot help but sleep that way, using a flat pillow or no pillow at all for the head is recommended. Some doctors also advise placing a small flat pillow under the stomach, hips, pelvis.
For side sleepers, placing a pillow between the knees in a way that promotes the alignment of the hip bones can bring relief. The American Academy of Family Physicians points to this position as the healthiest for low back pain. It advises sleeping with knees bent and a pillow under the head and neck and a pillow between the knees.
Mayo Clinic offers a helpful slide show showing positions that promote pain-free backs.
In addition to smartly situating our bodies during sleep, mattresses can play a role in promoting the proper alignment, too.
In 2015, Consumer Reports found that medium-firm to firm mattresses tend to promote the natural curvature of the spine. For back sleepers, mattresses that best accomplished this goal ranged from an innerspring mattress (not the best choice for those back sleepers who tend to roll over to their sides), memory foam beds dubbed by the manufacturers as “ultra firm,” which CR found to be medium firm, to adjustable air mattresses (which are also good for those who occasionally roll over to their sides).
The American Academy of Family Physicians recommends using a firm mattress to promote the proper alignment. This recommendation is, however, is challenged by some data, including the already mentioned Lancet study.
Medium-firm to firm mattress can work well for those who end up sleeping on their stomachs or for larger people (those weighing 230 pounds and above) who need more resistance to hold up their weight. But some softness—provided by a pillow top, for example—is often needed to cushion the shoulder and hip bones of side sleepers. A mattress that is too firm can “push on [the] main pressure points and take you out of alignment,” according to Arya Nick Shamie, associate professor of orthopedic surgery and neurosurgery at Santa Monica UCLA Medical Center. “If it’s too soft, those pressure points won’t be properly supported, so your whole body flops back.”
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