Opinion » Antidote

Your Preference Under the Sheets

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We've noticed that our sleep has become more and more restless over the last year and suspect our mattress is wearing out. The body-shaped divot on each side was another clue. Since we are going to buy a new mattress, we're wondering which you think would be best for our backs: an air mattress (like the Sleep Number), a foam mattress (like Tempur-Pedic), a box spring and coil, a waterbed or maybe a hammock.

—Rebecca and Steve

The only people I've known to have slept in a hammock every night were Gilligan and the Skipper. Say what you will about the sleeping arrangements, they never complained about their backs. Most of the complaining heard on the island was about Gilligan himself, who skillfully screwed up every possible rescue—an unwise strategy meant to assure the show's longevity. It's a wonder the guy got any sleep at all, with the rest of the castaways just one fermented coconut away from tossing him into the nearest volcano.

With the exception of watching sitcom reruns on Nickelodeon, the single activity in which we spend the most time is sleeping. The bed we choose has an enormous effect on our physical comfort even during waking hours. Improper or restless sleep increases muscle fatigue and actually diminishes our ability to deal with pain. On a too-soft mattress, muscles work needlessly hard to simply support our frame while our joints may be stretched into damaging positions by the deep relaxation of sleep. If too firm, discomfort and poor circulation lead to frequent turning and that can upset the important sleep cycle. Worse yet, impulsive tag removal may lead to sleepless worry of imminent arrest.

The common wisdom that firm mattresses are best for your back has been refuted by a 2003 Spanish study published in the journal Lancet. More than 300 adults with chronic low back pain were randomly divided into two groups and given either a medium-firm or firm mattress. Ninety days later, evaluation revealed that the somewhat softer group had significantly less pain in bed, on rising and throughout the entire day. A second myth busted: orthopedic and therapeutic beds are often nothing more than plain vanilla mattresses marketed to the wellness-oriented baby boomer—you will find no staff of physicians underneath the pillow-top. And, I'm still not certain what a Sleep System is, though I fear it requires a weekend seminar and a confidentiality agreement.

Of the choices you mention, the most common is the standard coil, or innerspring mattress. Improved technology has led to redesign of the coils, box springs, and even the outer upholstery resulting in a huge variety of firmness and cushioning. The drawback to the typical set-up is the difficulty in choosing the proper support ideal for both of you. A psychedelic classic—the waterbed—has had a similar technology makeover leading to a near waveless industry standard. Waterbeds, perhaps unexpectedly, now have a great reputation for back support across all model types.

Up the scale of engineering, Select Comfort's Sleep Number bed uses air filled chambers rather than coils or springs to provide variable support. An ingenious little pump lies under the bed to fill the chambers below the cushiony top to your personal preference; double beds have two independent settings. The Sleep Number may be a bit gadgety for some, but an even higher tech/lower gizmo alternative is the Tempur-Pedic. The very expensive viscoelastic memory foam of which the entire bed is made is temperature sensitive. It fairly quickly conforms to your shape, providing even support for most body types. The few negative opinions that can be found are usually about either the steep price or the initial slab-like feeling of the mattress when the bedroom is chilly. A less pricey compromise is a thick, widely available memory foam mattress pad.

The consensus of every independent expert I can find, as well as Consumer Reports, is that the very best bed is the one that feels most comfortable to you—guidance not quite as straightforward as I endeavor to give. Perhaps the recommendations of others could be helpful. Ginger prefers a waveless waterbed; Mary Ann sticks with a Sealy Posturpedic; the Professor remains intrigued by his Sleep Number; and the Howells, of course, demand the Tempur-Pedic. Hammocks are best left to the Skipper and his Little Buddy, whose sleeping arrangements I've already mentioned. If I must discuss them again, I'll be forced by the columnists code to make a too easy joke about Brokeback Island—and nobody wants that.

Dr. Ed Rabin is a chiropractor practicing at Life Chiropractic Center in Boise. Send your S.S. Minnow collectibles and health-related questions to theantidote@edrabin.com (on the Web at www.edrabin.com).