Mattress Guidelines for Sleep Comfort

The right mattress can help provide a good night’s sleep, leading to feelings of rest and refreshment upon waking up.

Sleeping is the only time the muscles, ligaments, and other structures in the spine can completely relax. With a back injury or disorder, optimal sleep is especially important to the healing process.

This article outlines a number of useful guidelines for selecting a mattress or bed—as well as recommendations for sleep positions and use of pillows—for a number of specific back conditions.


The Best Mattress Is a Personal Choice

Research points to both a significant reduction in chronic lower back pain and improvement in sleep quality from using a medium-firm mattress.1 Yet, research regarding mattress firmness is not extensive, leaving mattress firmness largely a matter of personal preference.

If a mattress is more than 5-7 years old, or if a different mattress is found to yield a better sleep experience, it is likely time to consider a replacement. Medical research studies show that participants switching from an old mattress to a new one reported a reduction in back pain and improvement in sleep quality.2

No single type of mattress or bed works well for everyone, and there is no best kind of mattress for back problems. Likewise, there is no consensus on an ideal sleep position. All of this is due to several factors:

  • There are numerous underlying causes of back problems, and different underlying causes may respond better to specific types of beds, mattresses, and sleep positions.

    See Causes of Lower Back Pain

  • Back pain can have numerous contributing factors, and so a specific sleeping position may alleviate one contributing factor but exacerbate another.
  • Sleeping preferences may be unrelated to the quality and support of a mattress. For example, some people prefer a mattress that keeps cool in order to prevent becoming uncomfortably warm at night.

    See How to Evaluate a Mattress


The variety of mattress options available means people have more choices than in the past in regards to finding a mattress to fit their individual health conditions and preferences.

See Considerations When Buying a New Mattress


  • 1.Ahmed Radwan A, Fess P, James D, et al. Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of pain controlled trials. Sleep Health. Volume 1, Issue 4, December 2015, Pages 257–267.
  • 2.Jacobson BH, Boolani A, Smith DB. Changes in back pain, sleep quality, and perceived stress after introduction of new bedding systems. J Chiropr Med. 2009;8(1):1-8. And Jacobson BH, Boolani A, Dunklee G, Shepardson A, Acharya H. Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Appl Ergon. 2010;42(1):91-7.