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Background <p>Sleep quality is influenced by several modifiable environmental factors, including the sleep surface. Low back pain, morning stiffness, shoulder discomfort, and muscle tightness on awakening may indicate inadequate bedding support. This systematic review evaluated whether mattress characteristics influence spinal alignment, sleep quality, and low back pain.</p> Methods <p>A systematic literature search and qualitative synthesis were conducted for studies published from 1999 to 2023. PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, PsycINFO, ScienceDirect, and Google Scholar were searched using terms related to mattress ergonomics, pain, vertebral-column alignment, sleep, and quality of life. Eligible studies evaluated adult or young-adult populations and reported outcomes related to low back pain, spinal alignment, pressure distribution, sleep comfort, or sleep quality. Methodological quality and risk of bias were appraised using literature evaluation and grading of evidence (LEGEND) and Critical Appraisal Skills Programme (CASP) tools.</p> Results <p>A total of 47 studies were included. The evidence most consistently favored medium-firm mattresses over very firm or very soft surfaces. Medium-firm support was associated with better pressure distribution, improved sleep quality, reduced morning stiffness, and low back pain intensity. Zonal support, air-adjustable systems, customized designs, and thermal microclimate optimization showed potential benefits, but heterogeneity in materials, outcome measures, follow-up duration, and participant characteristics precluded meta-analysis.</p> Conclusions <p>Medium-firm mattresses represent the most defensible general recommendation for adults with nonspecific low back pain or morning stiffness. Mattress selection should also consider body habitus, age, sex-related anthropometry, preferred sleep position, and thermal comfort. Smart and adaptive mattress systems are promising but require larger, methodologically rigorous clinical trials before routine recommendation.</p> Level of evidence <p>Level III according to the Oxford 2011 Levels of Evidence.</p> Review registration <p>Not registered.</p> Trial registration <p>Not applicable.</p>

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Mattress impact on lifestyle and back pain: a 25-year orthopedic literature review guideline

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月10日

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  • Caggiari Gianfilippo,
  • Petrucci Filippo,
  • Pescia Stefano,
  • Arbau Alessandro,
  • Fidanza Andrea,
  • Ciatti Corrado,
  • Puddu Leonardo,
  • Delrio Giulia,
  • Caria Elisa,
  • Pinna Ilaria,
  • Doria Carlo

摘要

Background

Sleep quality is influenced by several modifiable environmental factors, including the sleep surface. Low back pain, morning stiffness, shoulder discomfort, and muscle tightness on awakening may indicate inadequate bedding support. This systematic review evaluated whether mattress characteristics influence spinal alignment, sleep quality, and low back pain.

Methods

A systematic literature search and qualitative synthesis were conducted for studies published from 1999 to 2023. PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, PsycINFO, ScienceDirect, and Google Scholar were searched using terms related to mattress ergonomics, pain, vertebral-column alignment, sleep, and quality of life. Eligible studies evaluated adult or young-adult populations and reported outcomes related to low back pain, spinal alignment, pressure distribution, sleep comfort, or sleep quality. Methodological quality and risk of bias were appraised using literature evaluation and grading of evidence (LEGEND) and Critical Appraisal Skills Programme (CASP) tools.

Results

A total of 47 studies were included. The evidence most consistently favored medium-firm mattresses over very firm or very soft surfaces. Medium-firm support was associated with better pressure distribution, improved sleep quality, reduced morning stiffness, and low back pain intensity. Zonal support, air-adjustable systems, customized designs, and thermal microclimate optimization showed potential benefits, but heterogeneity in materials, outcome measures, follow-up duration, and participant characteristics precluded meta-analysis.

Conclusions

Medium-firm mattresses represent the most defensible general recommendation for adults with nonspecific low back pain or morning stiffness. Mattress selection should also consider body habitus, age, sex-related anthropometry, preferred sleep position, and thermal comfort. Smart and adaptive mattress systems are promising but require larger, methodologically rigorous clinical trials before routine recommendation.

Level of evidence

Level III according to the Oxford 2011 Levels of Evidence.

Review registration

Not registered.

Trial registration

Not applicable.