Which mattress?

As an Osteopath I am often asked which mattress and pillow I would recommend.  Unfortunately, there is no golden egg, pillow or mattress as no one-size or type fits all.  However, there are some guidelines which should help steer you towards the right choice.

Pocket sprung, memory foam or both?

What type of mattress?  Pocket sprung, memory foam or a combination?

There is no hard and fast rule here, and there is nothing to suggest one type is any better than the other, despite what the marketers will tell you.  Each have their own merits, and personal preference has a large part to play.  Some people find the memory foam mattresses too hot, or uncomfortable, so there is no point opting for a mattress that ultimately gives you a worse night’s sleep because of the way it feels.

Pocket sprung mattresses come in a variety of designs, but broadly speaking the greater the number of springs the better.  This is because to fit more spring in they must be smaller, so the mattress is more responsive.  There is no such thing as an Orthopaedic mattress, this is a trade name, and not descriptive of the properties of the mattress itself.

Memory foam mattresses are also known as viscoelastic mattresses after the material they are made from.  Tempur are the best known as they are the original.  Once the patent ran out, other manufacturers started making them, and there are many on the market now.

A combination of pocket sprung with a memory foam top / topper is also widely available.  The thickness of the topper can vary, and sometimes the memory foam can be part of the make-up of the mattress and there will be a wool top layer.

How firm?

The aim is to have your spine in a neutral position when you are lying, so the mattress must accommodate your body shape.  This image, courtesy of the European Bedding Group, shows this nicely (same applies if you lie on your back).  It also shows how important the pillow is in maintaining a neutral neck – more about that below).

Each manufacturer has their own way of measuring firmness, so it can be a bit of a task to compare mattresses.  How firm is again down to personal preference combined with factors such as body shape and your weight.  How much of a difference is there between your waist and hip measurements for instance?  I read recently somewhere (*citation needed) that if you weigh less than 70Kg then you don’t tend to have the weight required to push a typical medium to firm mattress into shape (you won’t make enough of an indent in it so that your hips and shoulders sink in, and so you won’t be properly supported by the mattress in areas like your waist and low back).  The suggestion was that such people should opt for a soft-medium mattress.  This could be true of some mattresses, but it isn’t a global rule maybe.  And again, personal preference comes into it.  I have a patient who has fractured his pelvis twice and is full of metal plates and screws, but is only comfortable of the firmest mattress he can buy.

Some manufacturers offer a money back guarantee / 100 day trial, which could work for you, as long as you have space to store your old mattress during the trial should you need to send the new mattress back.  Also, it may be that you have to keep the protective wrapping on the mattress during the trial, which may make the mattress feel slightly different.

Which pillow?

Memory foam or feather?  Again, each have their merits.  Memory foam pillows can be manufactured into curved shapes to help support the shape of the head and neck.  To keep the neck neutral it is important to support the neck AND the head.  If, when lying on your side, you can feel space between your neck and the pillow, you aren’t supporting your neck.  But again, some people hate memory foam pillows and prefer feathers.

One or two pillows?

This depends on the breadth of your shoulders, the thickness of the pillow(s) and how firm your mattress is.  If you are supporting your neck and head in a neutral position then you are OK, be it with one or two pillows.  If you have broad shoulders and a firm mattress, you are going to need more pillow “depth” and someone with narrow shoulders on a soft mattress (see the image above).

So, after all of that, you can see there are a lot of factors to consider.  I haven’t been able to provide any specific answers to any of the questions, but hopefully the information here will help you make an informed decision.  What I do say it try lots of different mattresses (and spend at least 15 minutes on one before you decide to buy it, because it can take a while to get a true feel for it).  When trying a mattress, it is crucial that you try it on the same sort of base you are going to use it on.  If you have a sprung divan base, then there is no point trying and mattress on a wooden slatted base.

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