Review of Adjustable Beds

By: Ron Miller, PT
December 14, 2004

Choosing a comfortable bed and mattress

People with back pain should be especially choosy about the type of bed and mattress they sleep on. While there is very little research in general about what types of mattresses and beds are best for the back—and no real medical research about adjustable beds—we do get a lot of questions about whether or not an adjustable bed is a better option than a flat mattress for people with back pain. This article provides a brief review of how an adjustable bed works and some theoretical advantages that some patients might find beneficial.

How an adjustable bed works

As the name suggests, an adjustable bed (also called a Semi-Fowler bed, as it places the patient in a semi-Fowler position) can be adjusted to a number of different positions. For individuals with certain types of back problems, sleeping on an adjustable bed that is at a slight incline (e.g. 30 to 45 degrees) may be comfortable, with the upper body positioned higher up than the lower body (as when sitting in a recliner) and some support under the knees to bend the knees at a slight angle. The combination of upper body incline and the knee support can help take some of the stress off the lower back. Provided that the patient is comfortable sleeping in this manner through the night, this position can support the curves osf the spine and relieve pressure on the entire body.

Potential benefits of an adjustable bed

Basically, an adjustable bed has the potential to help anyone who feels more comfortable in an inclined position (such as sitting on a recliner with the feet up) rather than when lying on a regular flat mattress. The following provides a few examples of certain back conditions and how an inclined position in an adjustable bed can sometimes help the patient feel more comfortable.

• Degenerative spondylolisthesis. For some people with degenerative spondylolisthesis, sleeping in a reclining position with support under the knees can reduce some of the pain discomfort in the lower back, making it easier to sleep through the night.

• Osteoarthritis. Individuals with osteoarthritis in the spine, or facet joint arthritis, often wake up feeling quite stiff and sore in the morning. Sleeping on an adjustable bed may possibly provide better support and therefore decrease the irritation by minimizing joint compression.

• Spinal stenosis. People with spinal stenosis most often feel more comfortable when bending forward instead of standing up straight. Likewise, sleeping on a flat mattress can sometimes be less comfortable for people with this condition than sleeping in the reclining position, such as that afforded by an adjustable bed.

In addition, after having low back surgery, some patients feel that an adjustable bed is more comfortable than a flat mattress. Like most choices when it comes to mattresses, this is largely a matter of personal preference.

In general, it is reasonable for a patient to consider the option of an adjustable bed if he or she feels better sitting in a reclining chair with the knees supported or slightly elevated and if he or she is having trouble getting a good night’s rest on a conventional flat mattress. If a patient is not sure if they would benefit from an adjustable bed, or is not sure about buying a new bed, then it is also possible to use pillows to prop up the upper body (being careful to provide support for the lower back) and placing a pillow beneath the knees.

Patient’s preference should determine the choice of bed and mattress

It is important to remember that the patient’s personal preference for sleep comfort and back support should ultimately determine which type of bed or mattress is best. There is no single type of bed or mattress that works for all patients, and there is no real medical evidence that supports that an adjustable bed is a preferable option. The bottom line is that whichever bed or mattress allows a patient to sleep comfortably and without additional pain or stiffness is the best choice for that individual.