A very common question that often patients address to the orthopedic surgeon is: “What is the most suitable mattress?“. Especially people who have chronic discomfort in the middle, the back and the shoulders or suffer from morning stiffness and pain are particularly concerned and feel confused when they must choose from the many options offered in the market. Below some frequently asked questions are answered through studies that were independent from the mattress manufacturers.

Can the mattress affect the quality of sleep and reduce aches and pains?

The answer comes from a study carried out by researchers from the University of Oklahoma. 59 healthy people who had purchased their bed at least five years ago, they were given new beds with moderate to hard foam mattresses with incorporating springs. After 28 nights, all participants in the survey said they had less back pain, better movement in the shoulders, better quality sleep and greater comfort in the new beds.

What are the characteristics for someone to look for when choosing a new mattress?

Two features associated with how comfortable the mattress is

  1. The pressure exerted on the spine and
  2. The deformation brought about therein.

Researchers from South Korea, measured the deformation and the pressure on the spine and correlated with assessments of the mattress by the participants. The researchers concluded that the participants showed Preferably the layers to which the curvature of the spine in a horizontal position was similar to the curvature of the body in an upright position. The study also investigated the pressure distribution span that receives the body other than the maximum pressure. The researchers found that participants felt more comfortable when the amplitude of the pressure was narrower.

Utilizing these results, the same researchers held a new study. In this, participants were monitored for 6 days and nights in a sleep laboratory using the electroencephalogram, electromyogram sensors and brain waves, eye movements, the movements of the chin, heart rate and body temperature. When participants slept on mattresses that were considered “comfortable”, based on the deformation of the spine and the pressure distribution, the efficiency of their sleep and percentage of deep sleep were higher, while the percentages of those who woke up was lower.



What is the role in the hardness of the mattress in sleep quality?

According to literature, 95% of orthopedics believes that the mattress plays a role in the management of chronic low back pain, and 76% of them recommend a firm mattress. Researchers at the Institute of biomechanics of Valencia, examined the hardness of the mattress and concluded that the “objective hardness” – as calculated load ratio / deformation and the “average pressure” as measured by models correlate with subjective perception of cruelty. Also, found that the objective hardness and mean pressure are linked to the overall comfort feel and with less difficulty in movement on the mattress.

Finally, they found that people who have a higher body mass index tend to be more sensitive to changes in hardness. Thus, one might conclude that the harder the mattress, the better.

But a team of researchers at the Kovacs Foundation in Palma de Mallorca and another 6 Spanish centers, wanting to examine this belief, they put 313 adults with chronic back pain, on hard or medium-hard mattresses. After 90 days, volunteers who used moderate hardness mattress had better results in regards to pain during bedtime, in pain on awakening and restricting compared to patients who used hard layer.


Taking all this into account, we conclude that patients should choose mattresses that do not distort the spine, which evenly distribute the patient’s weight and are of moderate hardness.


Of course, few are those who can use special equipment to control the mattress to buy. Thus, it is not easy to know the deformation of the spinal column and the distribution of the weight, when lying on a mattress.

However, as mentioned above, these factors and the subjective feeling of comfort coincide. Thus, the logical approach is still the best advice for the mattress purchase option “Choose what makes you feel most comfortable.”