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. 2015 Dec;1(4):257-267. doi: 10.1016/j.sleh.2015.08.001. Epub 2015 Oct 19.


A significant number of US citizens lack appropriate sleep for several reasons. Back pain has been identified as possible cause for inappropriate sleep in adults. Previously, the quality of mattresses and bedding systems has been correlated to the pain perceived by individuals. However, there is controversy in the literature regarding the type and characteristics of a mattress that best serve the purpose of decreasing spinal pain, and improving spinal alignment and quality of sleep. This study gathered the best available evidence in the literature related to this matter through conducting a systematic review of controlled trials that were published since the year of 2000. In those trials, mattresses were subjectively identified as soft, medium firm, firm, or custom inflated. Articles examining the effect of temperature alterations of mattresses on promoting sleep quality and reducing pain were included as well. Twenty-four articles qualified for inclusion into this systematic review. The methodological quality of the reviewed clinical trials was deemed moderate to high according to the PEDro scale. Results of this systematic review show that a mattress that is subjectively identified as a medium-firm mattress and is custom inflated (self-adjusted) is optimal for promoting sleep comfort, quality, and spinal alignment. Evidence is not sufficient yet regarding the appropriate temperature of the optimum mattress; however, warm temperature has been recommended by authors.

Keywords: Ergonomics; Mattress design; Pain; Sleep quality; Spinal alignment.

Publication types

  • Review