Three secrets to a good night's sleep

By Dorothy Foltz-Gray
Health.com

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Whenever I tell friends that my mattress is decades old and that I have low-back pain, their eyes pop open. This repeated facial expression has prompted me to think that, yes, there could be a connection. Another clue is an experience I had recently when sleeping on a fabulously comfortable hotel mattress. My husband tried to pry my fingers from the mattress corners, but I wouldn't budge. I wanted to live there. Time for a new mattress.

That's just what the Better Sleep Council, the educational arm of the International Sleep Products Association in Alexandria, Virginia, told me. Achy mornings and satisfying sleeps away from home are big hints that my mattress is soooo over. In fact, if I go by my warranty, my mattress was over some time ago. Though warranties may be good for 10 years or so, they typically cover defects, not comfort or support.

And comfort is what begins to sag after five to seven years. "A worn mattress is like an old running shoe," says Bert Jacobson, a professor of health and human performance at Oklahoma State University. "It loses its support and its comfort." (Health.com's mattress-shopping guide )

It also fails the all-important neutrality test. According to chiropractor Scott Bautch, an ergonomics expert and past president of the American Chiropractic Association's Council on Occupational Health, "The goal is for your spine to be neutral. If your mattress allows your spine to curve up or down, that's not healthy for blood circulation or for resting your muscles."

Trouble for 7 in 10

Americans know a thing or two about unhealthy rest. Seven out of 10 of us have trouble sleeping (and I'm definitely one of them, as I've come to think of 3 to 4 a.m. as reading hour), according to the National Sleep Foundation survey. Pain, pregnancy, menopause, or insomnia can make sleep a childhood memory. And not getting a full snooze -- seven to nine hours a night -- makes for less-than-pleasant breakfast chatter. More serious is the effect of sleeplessness on health: It wobbles thinking and may up the risks of obesity, diabetes, viral illnesses, heart disease, and depression. (Health.com: Identifying sleep disorders)

Of course, mattresses don't work miracles, says Clete Kushida, M.D., director of the Stanford University Center for Human Sleep Research. "The small contribution mattresses make is a surface that doesn't cause pain and stress to muscles, that allows you to lie comfortably." Still, even if a good pallet isn't a medical breakthrough, to these achy bones, lying comfortably sounds advanced. Sounds simple, too.

Mattress shopping, however, is another matter. During my initial foray into a local mattress store, I realized I would have to lie down on many mattresses. Under fluorescent lights. In front of suited salesmen who talked nonstop. On my first try, I wore a skirt and, as I flopped from one side to another, I thought more about skirt length than mattress comfort.

I wasn't happy with the salesman's questions, either. Did I like a soft or hard bed? Did I want a queen or a king? Foam or coil? Did I want to spend a nice chunk of my sons' college fund or go cheaper? I didn't, I realized, have the slightest idea.

It's good to know what kind of mattresses are out there, but the only thing that really matters is comfort, says Scott D. Boden, M.D., director of the Emory Orthopedics and Spine Center in Atlanta, Georgia. "And no one mattress is for everyone."

Goldilocks had a handle on this, of course. She was all about trying something new. My husband, it turns out, was not. Just as it took a long time to introduce the habit of eating in bed to my spouse (he has since gotten used to feeling slightly breaded as he sleeps), the idea of a new bed was met with resistance. He finally agreed to the mattress, but not the shopping.

Such balking is not uncommon. "Women are the primary mattress purchasers," says Leona Wightman, vice president of merchandising for Serta International in Hoffman Estates, Illinois. "They're the ones who are suffering." Most women average less than seven hours of sleep and, according to the National Sleep Foundation, have more trouble falling and staying asleep than their spouses.

Be prepared for the hunt

So, I'm on my own. As I trot from store to store -- in long pants this time -- I am determined to find bliss. I slip off my shoes and climb aboard one mattress after another. I test one that combines coils, foam, and two-sided air chambers. The air's easy to lose (just the touch of a button at the head of the mattress), but I have to climb out of bed to get what looks like a tiny hair dryer to reinflate it. I jump on coil ones, sometimes sinking, sometimes with a thunk. I try memory foam. First the salesman lets me stick my hand inside a simulated foam mitt so I can feel how cool it is. Then, while I'm in a fetal position, he's slamming his competitors, letting me know I'd be one gullible fool to buy what they dish out. I lie on my back. "How many stores have you been to?" he asks.

Despite the weird social exchange, I register one thing: I love two beds. One's a coil system as stuffed as fruitcake (coils, foam, air, pillow top) for around $2,200. The other is a memory-foam model that makes me feel cushioned in just the right position, not too little, not too much -- except for a $2,400 price tag, which strikes me as a bit high. But as mattress guru David Perry, executive editor and mattress writer for Furniture Today, a weekly trade publication in Greensboro, North Carolina, puts it, "How wonderful it would be to have a heavenly cocoon. What would you pay for that experience? What price do you put on a good night's sleep?" Well, according to Furniture Today, 56 percent of us are willing to plunk down $1,000 or more for that piece of peace.

I head to the next dealer, and, as if I am headed into space, we find my perfect sleep number, airwise. To find it, a sales-man asks me to say when I feel well-supported as he releases air from the mattress by remote control. I have 20 air options, he explains -- which, he says, is like having 20 beds. We look at a screen image of my body on the bed, the red spots high-pressure areas. I'm on my back. I never sleep on my back, but today it helps me feel polite. My lower spine, where it chronically hurts, is bright red on the screen. The sales guy cranks my sleep number up until my whole spine is scarlet. Although the bed is very comfy, I don't like having so many choices. When I climb into bed, I'm done with selection.

Then I do what may be my lifetime's one moment of brilliance: I call the hotel with the dream bed that got me on this hunt in the first place. Done deal, right? Uh-uh. Mattress manufacturers name hotel beds differently than retail beds, even if the mattresses are basically the same. Not eager to open a hotel, I call a shopkeeper who sells the same brand. He finds its retail equivalent and, presto!, within a week a big, fat mattress arrives. I love it. My husband loves it. Like Goldilocks, I've finally found the bed that's "just right."

Pick the perfect pillow

Like your mattress, your pillow is an important part of the most critical hours of the day. And many of us are snoozing (or not) on a lousy excuse of a pillow. For starters, the average lifespan of a pillow is two years; after that, it can't provide the support you need for sleep. Frequent washing takes its toll, too, and can take a year off of a pillow's life.

Then there are all the choices. How do you know which pillow's just right for you? We shipped 20 pillows to our expert, Jeffrey Goldstein, M.D., an assistant professor of orthopedic surgery and a spinal-surgery specialist at New York University Hospital for Joint Diseases. He tested fluffy, flat, water-filled, down, and foam to find the best fit for your sleeping style. Whether you're a side, back, or tummy sleeper, supporting your neck in its most natural position is what really matters, Goldstein says. Here are his tips for pillow bliss.

Back sleepers. "They'll be more comfortable with a medium-firm pillow."

Side sleepers. "They will rest easier with a medium-firm pillow that cuddles and supports the neck."

Tummy sleepers. "A soft pillow with a gentle slope is best for stomach sleepers."

Baby your spine

The key to a restful night? Put it in neutral. When it comes to sleep, neutral means a position that supports the funky way your spine is shaped -- forward curves at the neck and lower back and a backward sway in the middle. Just as there's good standing posture, the neutral position is good sleeping posture. That's why there's all the fuss over finding a mattress and pillow that keep your spine correctly aligned and stress-free. "Imagine holding your wrist backward for a period of time. It's unnatural and uncomfortable," says Roger Smith, a Harvard Medical School sleep expert. "Without the proper support, your spine feels the same way." Here's how to find neutral.

Back sleepers. If you have lower back pain, a small flat pillow under your knees may help your back curve naturally.

Side sleepers. A pillow between your knees can help to keep the pressure off of your hips.

Tummy sleepers. If you must sleep in this back-unfriendly way, a flat pillow under your tummy can help keep the spine's natural curves.

Additional reporting by Valerie Kramer Davis. Contributing Editor Dorothy Foltz-Gray uses her bed as sofa, study, and dining room. Oh, and now she sleeps there, too.

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