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  • Writer's pictureDr. Frank Wen, DC

What Should You Sleep On?

Updated: Jan 2, 2020

"What kind of bed should I be sleeping on?"

That's one of the most frequent questions my patients ask me. Common knowledge assumes that a firm bed is better, but that may not always be so. So many factors come into play when you are looking for the right bed and mattress set. With such a contentious topic of 'what truly makes a great night sleep,' lots of disinformation is thrown around that can quickly muddy the waters. So let us take some tips from the experts who conducted a study on this specific discussion.

A 2015 systematic review by physical therapists at Utica College reviewed 24 high-quality studies done between 2000-2014 to answer this question. They explored a wide variety of mattresses of different makes, at different temperatures, and different firmnesses. By the end of the study, they arrived at a few concrete conclusions while still leaving many popular opinions up for debate.

Picture of mattresses

Study Findings

  • Generally, medium-firm mattresses are associated with decreased pains, especially for those with chronic low back pain. One study found that a medium-firm bedding system reduced back pain by almost 50%. Improvements in shoulder pain, back stiffness, and sleep quality were also found in several studies. Another study further established how medium-firm mattresses facilitate correct spinal alignment during sleep. These studies show that medium-firm mattresses, overall, spread the sleeper's weight the most evenly throughout the mattress. This weight distribution alleviates stress on individual points throughout the body, all of which add up to better night sleep.

  • Customized bedding is also beneficial in reducing back pain, as well. Adjustable air topper and air mattresses offer the sleeper improved blood circulation, alternative pressure points, and added convenience they could find nowhere else. The added blood flow throughout the body during sleep helps invigorate the body during such a pivotal period of revitalization. Missing out on such an opportunity could hinder your comfort and add to chronic pain over time.

  • Soft beds can help decrease compression on joints. Still, firmer beds help maintain a spinal alignment similar to an individual's standing posture (which was favored by more subjects). Softer beds may seem appealing while window shopping for new mattresses at the store, but be mindful. The added compression of sleeping on a soft mattress every night at home can lead to chronic back pain.

What's my take on the study? When you have no choice for customization, a medium-firm bed is recommended. Of course, medium-firm may be subjective between individuals, making it worthwhile to try out different mattresses. It is essential always to do your research and find what works best for you.  

While the study suggests that customized beds and bedding systems can help subjects obtain tailored comfort, these can be a lot more expensive. In fact, the study even alluded to potential positive research done by Sleep Number on their own beds, but were not included because they did not meet quality standards. We get bombarded with so much information on what makes our night sleep the best that we can lose sight of what we need as individuals. It is such a personal choice. 

In the end, we spend a significant time of our lives sleeping, and we should be mindful of the investment we are making in a quality mattress. With many stores now offering free trial periods for their beds, it may not be a bad idea to sleep on it...

Since I've been a chiropractor in Kirkland for quite some time now, I'm more than happy to recommend where to find the right mattress right here in our community.  


Radwan A, Fess P, Torii A, 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 controlled trials. Sleep Health [serial online]. December 1, 2015;1:257-267. Available from: ScienceDirect, Ipswich, MA. Accessed November 7, 2017.

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