As important as it is to doctors of chiropractic that the ideal mattress properly support the spine, sleep doctors insist it should also relieve pressure under the hip and shoulder areas to effectively promote levels three and four deep, healing sleep. Research shows that even moderate levels of pressure make the sleeper toss and turn which occurs at level one, near wakefulness. The more you toss and turn, the less time is spent at deeper levels of sleep. To combat pressure points, manufacturers add comfort layers to the modern mattress made primarily from different types of foams.

Comfort Index

The Comfort/Pressure Relief Index was constructed using a computerized pressure point mapping system from the medical industry. It ranks how effective the different materials used in mattresses are at reducing a pressure point. Generally speaking, the firmer a mattress, the less pressure relieving it will be; the softer the mattress the more pressure relieving. That is, if you increase support, you reduce comfort.

When new, all mattresses will feel pretty good and by using different combinations of foams, a manufacturer can make them feel remarkably different, thereby, giving the buyer an assortment of comfort levels to choose from. Most mattresses are purchased based upon this "feel" test and price. The ideal mattress would have complete pressure relief in the hip and shoulder areas and firm support for the spine everywhere else. It's this combination of comfort and support that makes mattress construction tricky. One relatively new mattress material, a 100% co-polymer gel (also know as Intelli-Gel®) performed better than any of the foam materials at delivering absolute pressure relief.

Mattress Durability

Most patients buy a mattress thinking it will last for the entire warranty period. But in reality it's more like a car. The car will last, but the tires it comes with wear with use until they need to be replaced. It's much the same with the foam used in mattresses. Durability testing shows that after about three years of use, when foams are used, the cushioning part of a mattress is completely different than when new and by years 5 to 8, it has failed completely. (Source: Leggatt & Platt)

The Durability Index rates the wear factor of the materials used in mattresses. There is a standard industry test for mattress materials. It is called the rollator test and consists of a 6-sided roller weighing 230 pounds that is rolled back and forth over a mattress 200,000 times. This test simulates the amount of wear that will occur as the mattress is slept on during the course of its life. Leggett & Platt, the leading supplier of mattress materials conducted rollator testing on the different types of mattress materials for this index.

It was found that the traditional polyurethane foam used in virtually every retail mattress suffered an astounding 49% rate of change during the test. Popular memory foam showed a 17% change. Latex showed 23%, foamed gels showed a 14% wear while co-polymer gel showed a 4% change, making it the most durable material.

Interestingly, about half of the total wear for these foams occurred during the first 10% of use, meaning that beds that use foam in either the comfort or support layer quickly lose their ability to support and cushion properly. The impact of sleeping on a "worn out too soon" mattress presents a serious concern for both you and your patient. A mattress that fails to provide adequate support at night works against the effort you make during the day to align the patient. That and the poor quality of their sleep makes your work more difficult and, in some cases, impossible.

Add the fact that, unless properly educated, the patient will continue to sleep on this failing mattress thinking it is still okay and that it is their age, overall conditioning or your lack of skill that is really the problem; failing to understand that their mattress is hurting rather than helping them get better.

Mattress Material Safety

Doctors concerned with nervous disorders and allergies want the ideal mattress to contain non-toxic, hypoallergenic, safe materials. When in bed, the patient's respiratory system and brain are very close to the surface of the mattress. Mattress materials are not regulated or rated for safety and manufacturers aren't required to reveal all the materials they are using in a mattress. Research shows than many patients experience problems when they buy a new mattress. Their complaints range from headaches and rashes to more serious issues. For more information on the harmful health effects of different mattress materials visit www.chem-tox.com.

Many of your patients will just go natural to avoid synthetic materials and fire blockers. Unfortunately, its not that simple when it comes to the ideal mattress. Although natural latex is being used in some mattresses, the quality is inconsistent. It can be improved by chemical processing and re-foaming, but then it becomes less natural. Wool is also being used, but a fairly high percentage of people are allergic to both wool and natural latex. Organic cotton is a good, natural, hypoallergenic, non-off gassing material. Co-polymer gel is also good. It is non-toxic, hypo-allergenic, anti-microbial and anti-fungal. It comes from the hospital industry where it is the material of choice for serious wound care patients.

Why Should You Become a Sleep Wellness Expert?

Your patients are already making the connection between proper support, sleep and their health. They respect your opinion as an expert in alignment, support and pain relief. They are confused about mattresses and asking for help. Until recently, the research was not available for you to offer informed advice, but now, it is. Retail mattress companies are misleading your patients and the problem is growing. Research-based, wellness quality sleep products are beginning to come to market. Aligning your practice with these products can increase overall patient care, their satisfaction levels and practice revenue.

Shawn Clark is the EVP/Co-founder of Advanced Comfort Technologies, Inc., a company founded in 1998 to develop sleep wellness mattresses. ACTI's preferred method of distribution is through Doctors of Chiropractic. For more information about sleep and mattress research visit www.intellibed.com.