One of the first things patients with insomnia start to wonder about is their environment being a factor in their sleep disorder. An uncomfortable bed? Too much light? Noise? A bed partner who moves a lot? Sometimes these factors can cause chronic sleep problems, but the reality is that in most cases, they don’t.
Despite what you might think, there’s not that much well-controlled research that has analyzed how mattress type affects sleep quality. Most of the studies out there involve small samples of either completely healthy patients, or those who have pain. In the research that has been conducted, the results are not completely clear. Some participants prefer a soft mattress; others find a hard surface better for sleep. In essence, the research is inconclusive and for now, we stress that personal preference reigns supreme.
What we do know, though, is that a person tends to sleep well when they’re properly conditioned (over time) to an environment. For example, some hikers, campers and even those in some jungle cultures tend to sleep well on a mat on the ground, provided they sleep there on a regular basis. They’ve grown accustomed to it. Sleep may then be disrupted when a sudden change in the sleep environment happens, such as staying in a hotel or at a friend’s house.
I like to tell my patients to consider changing their mattress if they’re uncomfortable at night. In our culture, we’re more willing to spend thousands of dollars on a new car instead of investing in a new mattress. Most people spend much more time sleeping than driving! Consider replacing your mattress if it is too hard, too soft, sags in the middle, has springs poking out, or causes you to have back or neck pain when you wake up.
However, if you have chronic insomnia, the environment may be an aggravating factor, but not the cause, of the problem. Don’t expect a change in the mattress to solve all of your sleep problems.
What factors should you consider when deciding whether to get a new mattress? First start with the age. If your mattress is 15+ years old, sleeping in a new bed may help. As noted earlier, personal preference is key. Although some people find a firm mattress helpful for a bad back, most people prefer a softer surface. Try out the various mattresses at the store, and make sure they have a good return policy. The higher the pricetag doesn’t necessarily guarantee a better night’s sleep. Purchasing a $60,000 mattress doesn’t mean you’ll get the best sleep ever. Go by what feels best and most relaxing for you and remember that many people sleep very well on inexpensive beds.
Most people who sleep well tend not to focus on their environment around them. For example, they sleep well despite repetitive outside noise like airplanes, trains and city streets. Sudden noises (such as thunder) can wake people, but consistent nightly noise isn’t much of an issue as the sleeper eventually gets used to it. Those who have chronic insomnia tend to become more aware of anything that might be a “threat” to getting good sleep: the ticking clock, light from the cable box, a snoring bed partner. Someone with chronic insomnia then tends to focus and sometimes obsess on these sleep threats, causing one to stay up even later due to the anxiety that's created.
If your bed is comfortable and you do not sleep well, then look at factors other than the bed before spending lots of money on a new mattress. Good sleep hygiene practices include:
These measures can all be helpful for obtaining sound sleep, but they are not the cure for chronic insomnia. If the above suggestions do not significantly help you sleep better, a clinician who specializes in cognitive behavior therapy for insomnia (CBT-I) may be your best bet. CBT-I is a nonpharmacological approach to treating insomnia that is considered the gold standard method by sleep specialists. I always recommend patients consider (or even try) CBT-I before turning to medications as many patients begin to notice improvements in their sleep in as few as 2-4 sessions. Referrals for certified CBT-I specialists can be found at: