What should I be looking for

A question my patients often ask me is whether I think they need a new bed. Is their bed the cause of or contributing to their musculo-skeletal condition?

Certainly if the symptom pattern is such that you are aware of discomfort in bed at night or waking regularly in the morning with pain and stiffness it is worth considering whether your bed is a contributing factor. It may also be that on a recent holiday or occasion sleeping in a different bed has left you feeling that your bed is contributing to your symptoms. In my experience it is unlikely to be causing the problem but could be a contributing factor. 

Depending on the quality and type of bed you have, they can last anywhere between 5 and 15 years. Some retailers suggest a quality latex mattress could last upward of 20 years if properly maintained.

If you think that your bed may be a problem it is worth stripping it right back to the mattress and having a look. Does the mattress carry an impression of where you sleep? Is the impression still the same later in the day? If the answer is yes your mattress has stopped providing you with the support you need overnight.

It can definitely be a confusing experience to go shopping for a new bed. There is a lot of jargon and sales pitch to wade through and a very wide price range to choose from to get the right bed for you. Hopefully the information here can help you to navigate your way to a good purchase.

Sleep Systems

There are essentially 3 sleep systems on the market:

1. Continuous Spring (Bonnell spring) Mattress

The South Australian brand Sealy makes only continuous spring mattresses ranging through low to high prices. Another term you may hear for them is an “active mattress” because there is a flow of movement from one spring to the next. If partner disturbance is an issue for you, you probably will not want a continuous spring system.

On the other hand if you have significant problems with mobility (e.g. Parkinson’s disease, stroke, significant arthritis) you can find this system makes it easier for you to move around in the bed (akin to a trampoline).

2. Pocket Spring Mattress

These mattresses have isolated individual springs and their selling point is the significant reduction in partner disturbance. There is decreased springiness to the mattress and it offers less assistance to turning and moving in bed. Pocket spring mattresses are usually zoned into different spring resistance for different areas of the body to facilitate optimal spinal alignment. Some manufacturers will also offer dual system mattresses individualized on each side for the different requirements of both partners. It is worth noting that the springs are the same but the “fillings and fibres” around the springs differ to give the different feel of the bed. The feel of the bed is usually described as firm, medium or plush and has nothing really to do with the springs.

3. No spring mattresses

These include latex, memory foam, Amerisleep and waterbeds. They each need to be considered separately as they all have different properties.

Latex Mattresses 

People who use them love them and swear by them and Choice Magazine endorse them but here are some of the hurdles I came across:

There are few retailers in Adelaide selling latex mattresses any more. Some retailers cited problems with the latex coming in from China being of inferior quality resulting in warranty problems for the retailer.

According to the literature there are two processes for producing latex foam. Latex is a liquid rubber substance that is processed into a foam product. One of these processes produces a 100% natural foam product while the other is mixed with a synthetic latex product. The positive qualities normally associated with latex mattresses seem to relate specifically to the pure, natural latex products. These include

• Hypoallergenic
• Mould and mildew resistant
• Durability
• Fire retardant
• Non-toxic

The negatives seem to relate to the product incorporating the synthetic latex product including

• Heat retention
• Ridging and depressions in the mattress

It is also important to remember that latex is a very heavy product and therefore fairly difficult to rotate and flip the mattress.

If you are looking to purchase a latex mattress I would suggest you look at the 100% natural latex products which seem to be mainly available interstate at present.

Tempur Memory Foam Mattress

A synthetic foam produced in a somewhat toxic environment involving petrochemicals.

Amerisleep

Another natural memory foam type product produced from the soya plant. Advantages include

• All natural
• Durability
• Good warranty
• Good heat dispersal
• The memory foam responds to pressure, not heat (those that respond to temperature are slower to respond and susceptible to room temperature)

Water beds

You would need to do your own research here!

Pillow-top or no Pillow-top?

A pillow top is a layer of foam over the spring system. All mattresses have a degree of pillow-top incorporated into the mattress. Some mattresses have an extra pillow-top fixed to the top of the mattress. When you are selecting the feel of your mattress: soft, medium, firm you are essentially choosing your pillow-top. 

The spring system doesn’t vary. When it comes to the mattress failing it is usually the fibers and foams that fail not the springs. The longevity of a mattress is enhanced by rotating and flipping the mattress. A mattress with a pillow-top fixed on one surface can only be rotated and not flipped which clearly has the potential to reduce its longevity.

How much do I need to pay for a good mattress?

Choice Magazine did a large study of consumer satisfaction in relation to bed pricing. They found that essentially as long as you don’t buy a very cheap mattress (under $500) consumer 

satisfaction did not increase with increased spend. Consumers were just as satisfied with the low end of the superior range as with the high end of the superior range. They also warn that there is a lack of transparency in the mattress-manufacturing sector. Even though mattresses are relatively cheap to make and all mattresses utilizing the same sleep system are remarkably similar the mark up from manufacture to retailer is often extremely large and both the retail store and manufacturers are making a great deal of profit. They note that significant discounts are common and you should never pay the full advertised price for a bed. Discounting can commonly be as much as 50% off the original price. A manufacturer will also sell the same bed in different retailers under different names so it becomes very difficult to compare prices between stores on essentially the same product.

What about money back guarantee?

There are a number of retailers who offer 30 day returns if you are not satisfied with the comfort of your new bed. Check to make sure this means money back guarantees not that you must choose another mattress from the same retailer.

Differentiating the retailers

Below is a sample of some of the retailers available in Adelaide:

Galligans

• Removable pillow-top (allows flipping and rotating and can be replaced when it fatigues)

Snooze

• “bed-MATCH”- (a devise that matches your body and sleep style to the appropriate mattress firmness) may appear to be a bit of a gimmick but does have some science to it.
• Dual system mattress for mis-matched couples (physically of course!)
• 15% off for RAA members

Regal Sleep

• beds designed with physiotherapists
• heavy discounts apply with health professional referral
• 15 year warranty
• 30 day money back guarantee

Elite Bedding

• mattresses can be rotated and flipped

Beds and Dreams

• only retailer of Amerisleep mattress

Koala Mattresses and other Online retailers

• bed in a box option meaning they are delivered compressed, vacuum packed in a box. These are foam and latex with no springs. They generally have a 100-day trial with money back guarantee and are priced very reasonably around the $1000 mark. Good customer satisfaction rating.

Where does all this leave you?

Decide which sleep system you prefer

• continuous spring
• pocket spring
• no springs

Remember you don’t need to go to the top of the range but you would be wise to spend upwards of $1000 on your mattress.

Haggle and don’t ever pay the advertised price and remember the bed costs considerably less to make than the retail price.

Consider the warranty and money back guarantee.

It makes sense to rotate and flip your mattress to reduce stress on the materials and increase the lifespan of the mattress. Most manufacturers recommend doing so seasonally.

It is also important to test the stability of the edge of the mattress for sitting on. It should feel firm and supportive under your thighs without digging in or giving way. It should feel comfortable to get up from sitting without strain.

When you lie on the bed you should be able to move around and roll over without effort. 

If you sleep with a partner you are best to go together to test the different options.

 This research has been put together by 

Louise Young – Physiotherapist

Eastern Sports and Spinal Care