Composition of a high-quality mattress

Understanding mattress features
Choosing a new mattress that is comfortable, supportive, high-quality and high-value is important for patients with low back pain. Major sales, rebates, promotions, special features and advertising can make shopping for the right mattress a challenge.

However, by understanding the physical composition of a mattress, patients can accurately evaluate and compare mattresses. Some mattress stores will offer cutaway views of mattress interiors, a good way to gauge mattress quality. When this option is not available, patients should be prepared to ask questions about the interior of the mattress.

Key components of a good mattress
The following physical components are the important features of most high-quality mattresses.

Mattress springs and coils provide back support. A common type of mattress contains spring coils in various arrangements to give firmness for back support. The wire in the coils comes in different thicknesses, where a lower gauge number denotes thicker, stiffer wire and a firmer mattress (2). More steel coils may indicate a higher-quality mattress, but patients should still use their own judgment for what mattress is best suited to provide support and help alleviate their low back pain.

Mattress padding provides comfort. In addition to the spring coils in a mattress, the padding on top of the mattress is another factor that can indicate quality. Mattress padding is usually made of materials including polyurethane foam, puffed-up polyester or cotton batting (2). Extensive mattress padding is often more expensive, but patients may find it more comfortable and more effective in alleviating their low back pain.

Middle padding in a mattress: This type of mattress padding is just below the quilted top layer and is usually made with foam. When looking at a cross-section of the mattress, softer foams feel almost moist to the touch while firmer foams won’t spring back as quickly (1). The next layer of mattress padding is made of cotton batting that may vary in thickness across different mattresses and even within one mattress. This causes the mattress to feel firmer in some areas rather than others, such as increased firmness in the middle of the mattress (2).

Insulation mattress padding: Thispaddinglies on top of the coil springs so that they cannot be felt from on top of the mattress and also protects the coils from damaging the top layers of the mattress (2).

Mattress ticking and quilting: The outer layer of a mattress consists of ticking, which is usually a polyester or cotton-polyester blend in a good-quality mattress. The mattress quilting attaches the ticking to the top layers of padding. Shoppers should examine the quality of stitching on the mattress quilting, looking for consistent, unbroken stitches (2).

Mattress foundations: The mattress foundation or box spring adds another level of back support to the mattress. Foundations usually consist of a wooden or metal frame with springs. A plain wooden frame may make mattresses feel harder than a frame with springs. A wood mattress foundation should only be purchased if the wood has no cracks and is straight. The Better Sleep Council recommends that purchasing a foundation and mattress as a set maximizes the life of the mattress (1).

Foam mattresses: Other types of mattresses are constructed from memory foam or latex foam. They can be purchased in different densities. Some foam mattresses are made of multiple layers of foam adhered together while others have a foam core in the center. Foam mattresses come in various degrees of firmness to give patients greater selection for back support and back comfort.

Asking questions, requesting written product information and examining each mattress thoroughly will help patients become more educated consumers. By following the practical guidelines for selecting a new mattress, patients will be well-equipped to find the best mattress for sleep comfort, back support and reducing low back pain.

References:

The Better Sleep Council. "Bed Basics." 2003. www.bettersleep.org/OnBetterSleep/bed_basics.asp.
ConsumerReports.org. "Mattress sets." December 2002.
www.consumerreports.org/main/detailv4.jsp?CONTENT%3C%3
Ecnt_id=21179&FOLDER%3C%3Efolder_id=21135&ASSORTMENT%3C%3East_id=333143.

By: J. Talbot Sellers, DO
August 19, 2004