Sleeping

My Current Bed Recommendation

Recently revised after considerable research: A well-designed innerspring mattress will give good support for 10 - 15 years. You need one which is firm enough that your spine does not sag in a U shape, but not so firm that your weight is supported only at shoulder and hip, with the spine between unsupported and sagging. Take a partner when you're shopping, lie down as you would when sleeping, and have them look at the position. See Sleeping Position, below.

I would recommend against a pillow-top mattress. Although they feel great initially, the top material wears out much faster than the innersprings, and cannot be replaced. Better to buy a memory foam topper for softness, and replace it when necessary. What you're looking for is quality, high count springs- the 'lowest' model that has the higher count springs. As you go up the line in a particular spring count, you just get a cushier top.

I use a King Koil Spinal Guard, with a separate 2"  memory foam topper. The mattress was designed with the assistance of the International Chiropractors Association, and is relatively inexpensive for a quality mattress. The other major bed manufacturers also make good products. Never buy a used mattress!

Other Types of Beds 

A conventional foam bed can give good support, but only for 2 or 3 years, so I can't recommend them. The new memory foam beds have been reported to me as being hard to turn over on, and too warm (because you sink in). Some of the new, expensive foam beds are being touted as good for 20 years or more, but I haven't seen any such studies, nor have they been around long enough to provide the base of experience to confirm that durability.

Air beds, such as the Select Comfort, give good support and have the advantage of being able to vary firmness, even from one side of the bed to the other. I do not recommend waterbeds of any type. See discussion below.

Sleeping Position

It is best to sleep on your back or on your side. Stomach sleeping is hard on both the neck and the lower back. When sleeping on your back, your position should be the same as an erect standing posture. Ears, shoulder, and hips should be in a straight line. A pillow under the knees helps take pressure off of the lower back. When sleeping on your side, the spine and neck should lie in a straight line. A pillow between the knees will make for more comfortable sleep.

Pillows

Foam, fiberfill, down, orthopedic, buckwheat, water- I've tried them all. The type of pillow that will work for you depends not on the type of pillow but on the position your head ends up in. As I noted above, the pillow needs to support your neck while on your back, without throwing your head forward or letting it fall too far back. When sleeping on your side, the pillow needs to keep your neck in line with your spine.

I have recently been impressed by a shaped memory foam pillow from Costco that happens to fit my neck well- but it may or may not work for you.

A buckwheat hull pillow has the advantage of being able to change shape during the night as you switch between back and side sleeping, and provides customized support in both positions. This type of pillow takes about a week to get used to, because it's not "cushy" like your current pillow. They provide great support, though.

I'm currently sleeping on a professionally designed pillow called a ChiroFlow. It uses a water chamber to allow you to vary the height of the pillow. I haven't been able to get it not to 'slosh' a bit at night, but that doesn't happen to bother me and it supports me well in the proper position.

What doesn't work

Waterbeds keep the body in a "hammock" position which is hard on the spine. They often feel great at first, partially because they're soft, partially because they're heated. Get the same effect (and better sleep) with a good innerspring mattress, a topper if you like the softness, and an electric mattress pad if you like the warmth.

 Futons do not provide proper support. Avoid them if you can.

If your foam mattress is more than 4 years old, or your innerspring is more than 15 years old, assume it needs to be replaced.