What type of mattress should be chosen to avoid back pain and improve sleep quality?

Results of the systematic review done by Caggiari et al show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment.

Energy spent during daily activities is recuperated by humans through sleep, ensuring optimal performance on the following day. Sleep disturbances are common: a meta-analysis on sleep quality showed that 15–30% of adults report sleep disorders, such as sleep onset latency (SOL), insufficient duration of sleep and frequently waking up at night. Low back pain (LBP) has been identified as one of the main causes of poor sleep quality. Literature findings are discordant on the type of mattress that might prevent onset of back pain, resulting in an improved quality of sleep.

The authors conducted a systematic literature review of articles investigating the association of different mattresses with sleep quality and low back pain. The databases searched include the Cochrane Library, PubMed (Digital Biomedical Archives and Health Sciences of the US National Institutes of Health), Google Scholar, Web of Science and Scopus. Based on examined studies, mattresses were classified according to the European Committee for Standardization (2000) as: soft, medium-firm, extra-firm or mattresses customized for patients affected by supine decubitus.

A total of 39 qualified articles have been included in the current systematic review.

Level of evidence:

1 article was classified as evidence I (systematic review with and without meta-analysis);

7 as evidence II (randomized controlled clinical trial);

27 as evidence III (controlled clinical trial without randomization) and

4 as evidence level VI (evidence from a single descriptive or qualitative study).

The authors concluded that –

Based on data reported by literature, it can be claimed that medium-firm mattresses offer more advantages to subjects with non-specific low back pain. Studies have demonstrated, indeed, that these mattresses improve sleep quality and reduce risk of developing low back pain. Beds with active control improve column alignment and sleep quality. Temperature manipulation using a high-thermalcapacity mattresses (HHCM) caused a reduction in temperature increase of proximal skin on the back and of core body temperature, and an increase in slow sleep waves and sleep continuity; slightly manipulating the skin temperature, the wake-up can be delayed and deep sleep can be favoured.

Further reading:

What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature

Caggiari et al.

Journal of Orthopaedics and Traumatology (2021) 22:51

https://doi.org/10.1186/s10195-021-00616-5