How the Sleep Surface Can Impact Health and Wellness Benefits

By Dr. Robert Oexman, Director of the Sleep To Live Institute

The sleep surface has gotten surprisingly little attention over the years in research. We spend a third of our lives on a mattress and it can be a major contributor to how well we sleep during the night and how we feel physically in the morning. Aches and pains will generally prompt a visit to the nearest mattress store where consumers tend to have great anxiety over spending what they perceive may be too much for something that they will use more than anything in their lives. While one 2008 study out of Oklahoma State suggested that sleep quality may be dependent on timely replacement of bedding systems, most people still put off mattress shopping to the last possible moment and at their own expense.

When looking at the sleep surface, there are multiple aspects to consider. The overall “firmness” or spinal support of a mattress set is the characteristic that most people think about when discussing a bed. There has been some research on the pressure effects of a standard mattress over the years. One study found associations between the average pressure of a particular surface and its perceived comfort. Pressure is also dependent upon the sleeper’s position, with another study showing that the lateral position has a higher maximum pressure than either supine or prone positions.

Most of the research that has been done on mattress support characteristics has centered on back pain, specifically the low back or lumbar region. An older view on mattress firmness maintained that firmer is better for people with back pain. However, that older mentality has been refuted in more recent work as it was discovered that the natural curvature of the spine is compressed with an excessively firm mattress. Today, some studies have concluded that a medium-firm mattress is preferable for back pain. The converse is true of a mattress that is too soft for someone; it will not provide adequate support and therefore cause excessive curvature of the spine. The important take-away from the studies done in this area is that the sleep surface is a significant factor in pain relief and the right change in support can result in a reduction of morning stiffness—with some of them going on to report that sleep quality also improves in these participants.

But it’s not only consumers with back pain that can benefit from finding the proper level of mattress support. One 2000 study found that a change in firmness can result in improved sleep quality for people who do not suffer chronic pain. With studies showing that these improvements varied from both soft and hard mattresses for different participants, there is further evidence that a mattress’ firmness is likely to be specific to a particular body style.

The research shows that the sleep surface can have an affect on both pain and sleep quality, but it is also important to note the relationship between the two. It is clear that pain can have a significant impact on sleep but what the research is suggesting is that this is a reciprocal relationship. This is leading investigators to recommend sleep management as part of a pain treatment in addition to addressing pain for improvement of disrupted sleep.

Shopping for a mattress is not something that consumers generally enjoy. The Better Sleep Council found that a third of consumers admitted to actually having anxiety about it. The complexities of construction and lack of universal comparisons across brands make it difficult for consumers to know where and why they need to invest their money. Much of the focus on showroom floors is about the construction and how it supports and comforts, but without a basis of comparison with the rest of the industry or an adequate explanation as to how certain features are going to improve their life, those details fall too often short of gaining consumer confidence. The more important message should be on how the sleep surface impacts sleep and what health and wellness benefits can be realized with the right surface.