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A great night’s sleep is a wonderful thing. It allows the body and mind to rest and to recharge for the next day. Unfortunately, there are often quite a few things which can stand in the way of a good night’s sleep. One of those is a good mattress and a good pillow.

What is best? Firm? Soft? Medium? Foam? Spring? The confusion about buying a good mattress is compounded by the lack of clarity when trying to compare different brands, since there is no consistency in label. Each of the major mattress manufacturers has its own unique model designation, so it is almost impossible to compare brands. On top of that there is the issue of foam versus spring mattresses.

All things being equal, choosing a mattress is a very personal decision. Some of us are side sleepers, some are back sleepers and others are belly sleepers. The truth is that during a night of sleeping, we all move around from side to side, or side to back or to belly.

However, despite moving around, we do come back to the position that we find most comfortable. So because each of us has a personal sleeping style/position and a personal preference as to the firmness or softness of a mattress, it's hard to give firm recommendations that work for everyone.

Despite this, there are a few tried-and-true recommendations about choosing a mattress. Perhaps the first is that in buying a mattress, unless you have had the exact same mattress before, it is wise to consider more than just a quick trial in the store.

You should ask the merchant what the trial-and-return policy is. It is preferable to be able to have the mattress in your home for a few nights' trial, and to be able to return it if the mattress is uncomfortable.

Regarding which is better: foam or traditional spring, or a hybrid of foam and springs. It really boils down to personal preferences. The main benefits of a foam mattress is its ability to contour more to the body profile of the sleeper. But because of this feature, they can be hard for those among us who turn more frequently at night, since it takes more effort to turn on the softer foam mattress.

Another downside to a softer foam mattress is that for those patients with an arthritic back, it can make their back pain worse, due to a lack of support. For those patients with a “bad back,” a 2003 study showed that a medium firm mattress was better than a firm mattress. So for patients with a bad back, neither a soft or firm mattress seems ideal and it is the Goldilocks mattress, medium firm, that works best.

Perhaps the mattresses which allow for adjustability in firmness would seem to be the best compromise between soft and firm. The main downside to this type of mattress is the cost, as they are routinely more expensive than non-adjustable mattresses.

The same sense of personal preference also governs pillows. A good pillow is one that allows the neck and head to be in a straight or normal alignment with the body, whether lying on your side or back. There are countless pillows on the market, all touting their supposed benefits. A pillow that is very contoured and made for a certain sleeping style, whether side or back sleeping, is perhaps not the best, since it might limit changing positions as we sleep.

Once the “right” mattress or pillow is discovered, the next important rule is to remember that they have a usable lifespan, and they need to be changed out at regular intervals, as both pillows and mattress can get flat and become less useful.

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Dr. Dwight S. Tyndall, FAAOS, is a minimally invasive spine surgeon practicing in the Region at DrSpine.com. His column, which appears every other week, covers a wide range of health and medical issues.

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