Abstract Purpose To determine the efficacy of decreasing spinal curvature – when sleeping laterally – in reducing low-back pain (LBP) and improving sleep quality in people with chronic LBP. Secondly, to investigate whether sleeping positions, nocturnal movements, and skin temperature are related to pain in people with chronic LBP. Methods Sixteen subjects with chronic LBP (50% female, mean age 45.6 ± 13.1 years) slept for one night on their own mattress, followed by three nights on an experimental mattress – designed to reduce spinal curvature in lateral sleeping positions – and then a final night again on their own mattress. Sleep positions, nocturnal movements, skin temperature, and room temperature were measured throughout the five nights. Numerical pain ratings for pain while lying, pain on rising, stiffness on rising, sleep quality, and mattress comfort were recorded for both mattresses. Results The experimental mattress was associated with 18% (p<.05) lower pain scores while lying and a 25% (p<.01) higher comfort rating. Pain on rising, stiffness on rising, and sleep quality were not different between own and experimental mattress. The relationship between sleep positions and pain scores was non-significant, but pain when rising was positively correlated with nocturnal movement (p<.05) and skin temperature was negatively correlated with pain while lying (p<0.05). Conclusion Pain while lying in bed decreased and comfort was higher for the experimental mattress compared to the participants’ own mattresses. Effects of mattress support on sleeping position and low-back pain | Sleep Science and Practice | Springer Nature Link Skip to main content Advertisement BMC journals have moved to Springer Nature Link. Learn more about website changes. Effects of mattress support on sleeping position and low-back pain Research Open access Published: 10 May 2022 Volume 6 , article number  3 ( 2022 ) Cite this article You have full access to this open access article Download PDF Save article View saved research Sleep Science and Practice Aims and scope Submit manuscript Effects of mattress support on sleeping position and low-back pain Download PDF Abstract Purpose To determine the efficacy of decreasing spinal curvature – when sleeping laterally – in reducing low-back pain (LBP) and improving sleep quality in people with chronic LBP. Secondly, to investigate whether sleeping positions, nocturnal movements, and skin temperature are related to pain in people with chronic LBP. Methods Sixteen subjects with chronic LBP (50% female, mean age 45.6 ± 13.1 years) slept for one night on their own mattress, followed by three nights on an experimental mattress – designed to reduce spinal curvature in lateral sleeping positions – and then a final night again on their own mattress. Sleep positions, nocturnal movements, skin temperature, and room temperature were measured throughout the five nights. 2007 ; Miyazawa 1976 ). Several studies have found that sleeping on a medium to firm mattress can help alleviate back pain and improve sleep quality (Kovacs et al. 2003 ; Jacobson et al. 2008 ). Sleeping surfaces that promote a neutral spine can reduce LBP possibly by decreasing tensile stresses in spinal structures (Haex 2004 ). One example is a zonal mattress – a mattress with stiffness varying along its length to optimally support different parts of the body – which is designed to promote a neutral posture. However, evidence in the literature to corroborate this is scarce. This study investigated the efficacy of decreasing spinal curvature – using a zonal mattress – in reducing LBP and improving sleep quality. The second aim was to investigate whether sleeping positions, nocturnal movements, and skin temperature are related to pain. Materials and methods Subjects Table 1 shows demographics of the sixteen participants along with reported frequency of night-time LBP in nights per week. Participation was voluntary, and a questionnaire was used to determine the eligibility of all potential participants. The questionnaire also collected relevant information regarding participant characteristics, LBP history, sleeping disorders, and sleeping habits. Pain while lying and skin temperature were negatively correlated on both mattresses ( r(14)=-.601, p<0.05 ) (Fig. 4 ). The relation between skin temperature and time spent in the sleep positions was not significant. Fig. 4 Full size image Relation between skin temperature (°C) and pain while lying Discussion The first aim of the study was to investigate the efficacy of an experimental mattress – designed to reduce spinal curvature in lateral sleeping positions – in reducing LBP and improving sleep quality. The study shows reduced pain while lying and better comfort with the experimental mattress. Conclusion In subjects with LBP, an experimental mattress – which promoted spinal neutrality in lateral sleeping positions – resulted in less pain during lying and a better comfort rating while pain on rising, stiffness on rising, and sleep quality approached significance. Evidence of sleep positions relating to pain scores was inconclusive, thus further research is needed to examine potential underlying mechanisms. Evidence of turns per hour relating to pain when rising was detected. This suggests that increased nocturnal movements are associated with LBP. 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