Today’s post is indirectly related to weight loss, but when the scale just won’t budge – you have to think outside of the box!

As a chiropractor, I get a surprising amount of questions about sleep and mattresses in particular.  Unfortunately, there is no perfect mattress – but here is some sage advice to help you with your beauty sleep.

First things first, do you need a new mattress?

If you are asking this question, the answer is a resounding YES!  On a serious note, no matter what the warranty may be on your mattress – if it is over 7-8 years old, it is time to consider replacing it, and if it is 10 ears old, it really must be replaced.   There are very, very few exceptions to this.  Period.  Over time, dust mites, dirt, dead skin, dried sweat, and other nasties that you don’t want to envision yourself sleeping on all build up within your mattress.  In addition, springs wear out and foam and padding materials break down, all resulting in less than ideal sleeping situations. Older mattresses can collapse, creating a hammock effect which puts your spine in an unnatural position for 8+ hours each night.  Other considerations that it may be time to replace your mattress:

1.  You frequently wake up stiff and achy.  You have moderate joint pain, or feel  unrested  upon waking.

2.  You have chronic back pain that isn’t responding to treatment.

3.  Your mattress has lumps, bumps, or divots.

4. You often find yourself sleeping in an alternative spot, ie. your favorite chair, the couch, the guest bed, etc. as opposed to wanting to go to bed.

5. Your mattress creaks, squeaks, crinkles, or otherwise makes noise.  This is an audible sign of material breakdown.

I have found that people often scrimp when it comes to buying a mattress, but you can’t put a price on a good night’s sleep.  Remember, you spend 8 hours a night on this contraption.  An investment in your mattress is an investment in yourself.  People spend tens of thousands of dollars on a car that they spend 30 minutes a day in, but they balk at spending $1000 on a mattress that they will spend 8 hours a night in for the next 8 years.

365 days in a year times 8 years is 2,920.  Figure out how much a good night’s sleep is worth to you.  Is it a dollar a night?  50 cents?  Two dollars?  etc.  If two people are sharing the mattress, divide your figures in half to get real-world estimates.  Mattresses vary tremendously from brand to brand, and even within brands.  Quality is of key importance, because a mattress purchase is an investment in YOU and your health.  A $400-$500 bargain mattress that leaves you in constant pain, or breaks down in 2 years is not the bargain you thought it was.

The importance of a good night’s sleep

Several studies have linked weight and sleep.  One published last year by the Canadian Medical Association Journal,  entitled Adequate Sleep to Improve the Treatment of Obesity1

found that participants that slept fewer than the 8.5 hours per evening lost 55% less fat than the participants sleeping 8.5 hours per night.  Furthermore, in a 6 month controlled study, women that slept over 7 hours per night and had better subjective sleep quality, had a 33% better chance of successful weight loss.  I have had patients with poor sleep patterns who have had complete weight loss plateaus, so it is one of the things I always ask about when someone is looking to lose weight.

Furthermore, there is a well known connection between sleep and mood.  Not only does sleep affect mood, but mood affects sleep – which creates a vicious downward cycle of ever increasing stress, exhaustion, and depression.  Studies have found that 15-20% of people diagnosed with insomnia will develop major depression. 2   In another study people with insomnia were 20 times more likely to develop panic disorder (a type of anxiety).3.

You do virtually all of your wound healing and repair while sleeping, and children grow when they are sleeping, so sleep is one of the most crucial biological functions.  Your brain processes, decompresses, and organizes your thoughts and experiences during sleep, so we know it is necessary for all higher order mental functioning.  Now add  stress, anxiety and weight gain as possible side effects for not having enough high quality sleep and you should have more than enough motivation to replace that mattress you’ve been schlepping around for far too long.

Types of mattresses and their pro’s and con’s

Traditional Innerspring Mattresses – the majority of mattresses fall into this category.  These consist of a series of metal coils tied together and layered between layers of cotton and padding.  You will see references to “coil count”, with the higher coil counts being associated with firmer mattress levels, additional expense, and longer shelf-life.  Comfort levels and lifespan very considerably based on the materials used in construction.  Most Innerspring mattresses have some sort of pillow-top on them now, which prohibits you from flipping or rotating your mattress – thus shortening its lifespan.  Additionally, pillow tops are frequently the first part of a mattress to break down, leaving obvious lumps, sags, hammocking, or central humping of the mattress.

Individual Pocket-Coil Mattresses – some manufactures individually enclose each coil in its own sewed pocket as opposed to tying them together to make a large supportive framework as seen above.  Each coil is capable of independent movement, which means that one sleep partner’s movements will not translate to another when they roll over or shift positions.  The same issues with pillow top breakdown are seen with these mattresses.

Memory Foam Mattresses – Made of heat or pressure sensitive foam, and designed to relieve pressure points where the body touches the mattress, foam mattresses can be a godsend for people with fibromyalgia or a strong history of joint pain.  The down side, memory foam mattresses are often amongst the most expensive.  They frequently run hot, so if you like to be cool while you sleep – you may find these too hot and sweaty.  Memory foam also comes in several grades and densities, ranging from super-compliant to incredibly firm, so one person’s perfect fit, is another person’s misery.  Foam itself is prone to both off-gassing (if you are sensitive to chemical odors) or physical break down, although these problems tend to be lesser with the better established foam manufacturers.  Make sure to purchase at least 5lb memory foam so it doesn’t collapse and break down too quickly.

Latex Mattresses – barely squeak by with their own category.  They are very similar to memory foam mattresses.  Obviously not a good choice for those with a latex allergy, and amongst the most expensive of mattress types, latex mattresses in general have the longest lifespan of any mattress type.  If a high density foam is purchased, you should not have major divots or humping issues, and the mattress can be flipped or rotated – further extending its lifespan.  Most tend to be fairly firm.

Adjustable Air Mattresses – You know the ones, where you ‘select your number’.  Early models had issues with mold growing in the baffles and spontaneous deflation in the middle of the night.  A quick google search will show you that many people were unhappy with the level of customer support offered to them.  Now, I have heard that the latest models do not have these issues, and that the mold possibility has been eradicated.  Just to be safe, I would stick to the higher level models because they do have thicker and more supportive layers.  There are knock-offs now too, but their reviews have been haphazard.

Futon Mattresses – Are not just for lumpy college folding-couches.  Futons, particularly the high-end 10″+ thick,  hand made ones are divine to sleep on.  You can get these made organically, which is fantastic for people with environmental sensitivities.  They are quite firm, hold up very well, can be rotated and flipped with abandon.  They also breathe very well.  Downside – there is no spring, so coital actions require more energy.  Also, if you sweat, or have an accident, these are quite difficult to dry or clean.

Action Steps You Can Take Now

Comfort level is very subjective, and maybe you aren’t ready to toss your bed to the curb yet.  I am a huge advocate of mattress toppers.  Both lambs wool and foam toppers can temporarily rescue most mattresses, and buy you comfort and time.  When looking at toppers, try to fin one at least 2″ thick, and remember that the are TEMPORARY.  They are expected to be disposable, and you should replace them after a year or two.

If you purchase a new firm mattress, you can markedly extend its life and comfort level by using silk, wool,  or foam toppers.  People with rheumatoid arthritis and fibromyalgia swear that sleeping on a lambs wool topper reduces their joint and muscle pain.  Also, by using disposable toppers, you can readily replace the part of a mattress that wears out the fastest, allowing you to extend your mattress dollars considerably.  Without these toppers, mattresses that are too firm will create unnecessary pressure points where your body comes in contact with the bed.  Diabetics in particular need to make sure that they do not have pressure points in their sleep and this can further impair their blood supply to already compromised tissues.

Also, your mattress was meant to be used with a mattress pad.  Get a fitted cotton pad and use it.  Invest in good sheet sets.  If your sheets have shoddy elastic, or they pill, or do not fit your mattress perfectly, get a new set.  Cotton and bamboo sheets are the best in my opinion.

Dr. Miranda’s tips for Mattress Shopping

  1. Don’t go by price.  Many mattresses are made by the same manufacturers and just private labeled.  In fact, I had an older model Stearns & Foster pillow top mattress set that retailed for over $4k, but within a year of buying it, I saw my exact same mattress bearing a different brand label (and by exact same – it was identical, right down to the fabric, trim, and stitching) at Costco for $700.
  2. Look at construction.  Number of layers, spring count, types or thicknesses of foam, etc.  These are all indicators of quality.
  3. Plan on dedicating a significant amount of time to mattress shopping.  Physically lay down in your preferred sleep position on each one that you are considering, and spend a few minutes there.  You may feel silly, but you will never see any of those shoppers again, and you don’t want to make a rushed judgment.
  4.  Remember that men usually prefer a firmer mattress than women, so both parties should be present when choosing their new mattress.   Leave the kids and any distractions at home!
  5. Ask the salesman to leave you alone while you shop. You will tend to rush if they are hovering over you.
  6. Ask about warranties and get them in writing.  Unfortunately most mattress warranties are not worth the paper they are written on, with exclusions for removing the tags, getting marks on the mattress, or actually using the mattress.  Know what you are buying, what the exclusions are, and what the fees are for service calls.  Ask what percentage of warranties they uphold or honor, right down to the number of beds they replace per year.  Also – get it in writing if you will be responsible for restocking fees, shipping the replacement mattress to your home, shipping the old mattress from your home, or any other handling fees.
  7. Encase your mattress with a waterproof and dustmite proof case.  You never know when you may need this protection, but when an incident occurs — you will be thankful you did.
  8. Replace your box spring when you replace your mattress.  I recommend the low-profile box springs that have come out in recent years.  They lower the sitting edge of the bed a few inches, which makes it easier to get in and out of bed if you have health issues.
  9. Remember that most mattress companies will allow you to return your mattress within a specific time frame, usually 15-30 days.  So, if you get one home and really hate it – return it.


Mattresses have a definite shelf life, and even ones that say 25 YEARS have been proven to only last 7-10 tops and after 7-8 years the springs and resilience of the materials have broken down to the point where they will contribute to your discomfort.  We have already established that when it comes to sleep both quality and quantity are very important.  If you are dealing with chronic pain or chronic stress, or if you are doing everything right but still not losing weight, you need to have a look at your mattress.

A lot of people ask me what we sleep on, and we replaced a high-quality futon mattress with a 20″ Stearns & Foster model back in late 2006.  We kept that mattress far longer than we should have, because it broke down prematurely.  Recently, after great debate, we replaced the Stearns & Foster with a Tempurpedic model.  So far, we are really enjoying the reduced pressure points it provides.  Between that and the lack of conductive motion – we are easily sleeping longer and getting up less frequently throughout the night.  A win-win in my opinion.

Copyright (c) 2014  Miranda Jorgenson.  All rights reserved. This material may not be published, broadcast, rewritten or redistributed in whole or part with out the express written permission of the author.  You are welcome to  share this link or print this page and use in its entirely.

       1.       First published September 17, 2012, doi: 10.1503/cmaj.120876 CMAJ September 17, 2012 cmaj.120876)



2.       Breslau, N. et al., Sleep Disturbance and Psychiatric Disorders: A Longitudinal Epidemiological Study of Young Adults, Biological Psychiatry. Mar 1996; 39(6): 411–418.


3.       Neckelmann, D. et al., Chronic Insomnia as a Risk Factor for Developing Anxiety and Depression, Sleep. 2007; 30 (7): 873-880.

 Image courtesy of David Castillo Dominici at