What’s the Best Type of Mattress?

Buying a new mattress can be expensive and daunting if you’re not sure what to look for… So I’m going to tell you exactly what I recommend (and don’t recommend) to patients who ask me what type of mattress is best. I’ll also share some additional mattress-buying tips which could save you up to $1,000 or more!

The “best” mattress I know of probably isn’t one you’re interested in… That’s because it costs about the same price as a supercar ($150,000). From there, ultra-premium quality mattresses run anywhere from $4,000 to $15,000.

Fortunately a good night’s sleep doesn’t have to be steep. The recommendations I give to people are much more affordable.

Before I go into that, I must say that “comfort” is highly subjective. People can be comfortable resting in really cockamamie positions… So the recommendations I’ll make are based on my clinical knowledge of the spine, comments patients have shared with me over the past 12-years, and personal experience.

To begin, here are four types of mattresses I wouldn’t buy:

1. Waterbeds:  Good mattresses allow for proper spinal alignment. Sleeping on a giant bag of water that’s always moving can’t do this for you. Waterbeds were actually invented in the late 1800’s to help prevent invalids from getting bedsores.

2. Air Mattresses:  I’ve sat through the “pitch” at Select Comfort stores in the mall, and can confirm that the last bed they show you is much more comfortable than the first (sales trick). But at the end of the day, you’re still sleeping on a glorified air mattress. Several patients have complained to me about “Sleep Number” type beds and regret buying them.

3. Pillow Top Mattresses:  These seem luxurious at first, but the material inside a “pillow top” is extremely flimsy and can break down in a few weeks. Eventually an indentation forms around where you sleep, and this can compromise spinal alignment. Mattress makers are fully aware of this, so they’ve started sewing a second pillow top on the opposite side of the mattress for you to flip… That’s their way of admitting the problem. It’s a trap, don’t fall for it!

4. Tempur-Pedic Mattresses:  I like memory foam, but there are four reasons I wouldn’t buy an entire mattress made out of it. First, the sheer number of patients who’ve complained about the visco-elastic material’s recovery time is alarming. Many describe the problem as feeling like they’re sleeping in a ditch. Second, this photo taken from one of their TV commercials makes me question the company’s understanding of the spine. They claim Tempur-pedic mattresses provide “perfect alignment,” but the blue dots I placed along the model’s spine aren’t aligned at all! The third reason involves the price tag ($1,200-$6,000). Purchasing an off-brand memory foam mattress topper can be just as relaxing for a fraction of the cost ($150 or less). Lastly, it’s because I don’t sleep in Outer Space (these beds were invented in the 1970’s for astronauts). If you absolutely insist on buying a memory foam mattress, get this one. It’s a new form of “gel” memory foam that solves some of the heat retention problems of standard memory foam.

If you’re looking for an affordable new mattress…

First, determine if you really need a new mattress. If your current bed doesn’t dip or sag, you can save a lot of money by adding a high quality memory foam mattress topper.

Be careful though, people make two mistakes when buying these. The first is buying the thickest topper they find. Since these are sold in different sizes (from 1.5-inches to 6-inches), it’s tempting to assume that 6″ is best… but it’s not! The second mistake is buying the toppers conveniently sold at Walmart, Target, and Bed Bath & Beyond. Save your money; these toppers are over-priced and wear out very quickly.

Here’s what you should know about memory foam mattress toppers:

Density is more important than thickness. Every topper comes with three measurements: Size, thickness, and density. Pick the size you want (twin, queen, king), then buy the heaviest density you can afford. The denser the memory foam is, the longer it will last and the more resistant it is to wear-and-tear. Quality toppers can last for 3-4 years. Cheap ones won’t even make it 3-4 months!

A good rule-of-thumb is you want the density weight to be greater than thickness. Toppers that are 4″ thick with 2-lbs of density aren’t nearly as good as a 2″ topper with 4-lbs of density. I recommend buying a 2-3″ pad, with 4+ pound density. Anything higher than that runs the risk of being too thick. Full memory foam mattresses are typically 6-8″ of pure memory foam, but that’s what creates the “sleeping in a ditch” effect I mentioned earlier.

If this sounds confusing, don’t sweat it. Here’s the kind I have at home.

Doing this can delay the immediate need to buy a brand new bed, so try it before embarking on a mattress mission.

Still want a brand new mattress? Here’s what I suggest:

If you’re on a tight budget, don’t assume you have to spend $600+ dollars on a mattress. When sawed in half, there’s not a significant difference between $300 and $600 mattresses. The $600 options probably have a pillow top and more touch-friendly fabric… but the “bones” of the bed will be eerily similar. So you’re not missing much if you wish to purchase a “wallet-friendly” mattress.

Just buy the heaviest mattress you can afford; something that doesn’t dip, bend, poke or squeak. The firmer the better. Then purchase the type of memory foam topper I described above. Your new economy mattress will feel much more expensive than it is…

Now, if you’re willing and able to spend more money on a higher quality mattress, I have three different recommendations.

First, take a look at Simmons Beautyrest. They’re very well-built and reasonably priced. I like them because they offer the right amount of firmness without being stiff, are surprisingly heavy, and promote healthy spinal alignment. Here’s the kind I have at home.

Next, consider a Casper mattress. This company is taking the mattress world by storm, shipping mattresses that defy the laws of physics when they arrive on your doorstep. (If you’d like to save some money, there’s an alternative/cheaper version made by Tuft & Needle).

Finally, you can now get mattresses made entirely of latex. Here’s the best latex mattress that I’ve found – it has consistently high reviews on Amazon.

Mattress Buying Tip #1:  When purchasing a bed, the last person you want advice from is the guy hoping you buy it. Peer through the window of a free-standing mattress store and you’ll quickly notice that these are relatively low-volume businesses. Salesmen might work an entire shift and not have a single customer. So when someone does walk through the door, it’s “do-or-die” time. They have mouths to feed and might desperately need that sale!

Mattress Buying Tip #2: Standard bed construction isn’t nearly as complex or intricate as the price tag indicates. I’ve spent time with manufacturers who build beds from scratch and they’ll be the first to tell you (if they’re being honest) how unsophisticated bed-building is… So remember this when you’re ready to buy. Consider going directly to a local mattress maker instead of an overpriced chain store. Skipping the middle-man can save you a nice chunk of change.

Mattress Buying Tip #3: Depending on where you live, it’s possible to find $1,000+ beds at discount mattress stores on clearance for as little as $200 if you know where to look and how to sniff out bargains.

Mattress Buying Tip #4: Prices are negotiable. Buying a bed is like buying a car… Don’t pay sticker price! The mark-up varies between different models and manufacturers, but these bedding stores need to move their inventory. It’s not a flea market, but you certainly have the right to make them an offer. They might say no, but they could also say yes!

Mattress Buying Tip #5: If you’re waking up with back or neck pain, it might not be your mattress that needs replacing. Your pillow or your sleep position could be the culprit. In either case, if you’ve never had your spine checked, I recommend you consult with a chiropractor. Even a $60,000 Hasten’s bed can’t fix a misaligned spine.

Mattress Buying Tip #6: Latex memory toppers are now available (as opposed to memory foam). Latex conforms to the shape of your body, creating up to 33% more pressure relief than other types of foam. Talalay latex is 4x more breathable than polyurethane and memory foam. It’s a bit pricier than memory foam, however.


FANTASTIC blog post! I may repost this on my site (with full credit and backlinks to you) if you don’t mind.

I think I will do the same.

This is some great information you have put together in your article about mattresses. Sleeping on a good mattress is so vital the back. We do wake up sometime with a cramp in the neck or the head feeling heavy and it is definitely a good idea to take a look at the mattress we sleep on. With a vast variety of mattresses in the market, it is difficult to select the right one. Sometimes we are held back due to the price tag attached to a mattress we think might be good for us. Your recommendations would certainly help. The bottom line is that the spine should be comfortable and a mattress should be chosen bearing that in mind.


Exactly what I was looking for. Had a couple of follow up questions:

– You mentioned the Simmons Beautyrest mattess as an inexpensive quality mattress, what should I expect to pay for one?

– Are there any other inexpensive brands you would recommend?

– When shopping for a memory foam mattress topper, you mentioned avoiding Target, Walmart & Bed Bath and Beyond. What about Costco? I saw a couple options over there in the $100 range. I don’t remember the specs or brand off-hand, but based off their website it’s either NovaForm or Nature’s Sleep.

– I live in a desert – Las Vegas. Is there a such thing as a mattress that helps you keep cool?

– I would also like to repost this on my blog in it’s entirety (with links) if that’s ok with you?

    Hi Jay, I’m glad you liked the article. In answer to your questions…

    – Brand new, in a queen size, you can probably expect to pay between $900-1200. I know some people have lucked out and found “old-but-unsold” (never been used, but 2-3 generations old, and transferred around the country to discount mattress stores) Simmons mattresses for as low as $200-300.

    – There are cheaper models… not one I can recommend though. The bones of a mattress are quite bare at lower cost points. They’ll be much more “springy” and unsupportive the cheaper they get.

    – Costco would be fine as long as they have the proper thickness-to-density ratio… If pound-density is not on the label, it’s probably not worth buying.

    – There’s a new concept in memory foam technology that incorporates a gel substance. Supposedly, it improves the heat issue and helps keeps you cooler during the night. I haven’t used one of these “next generation” toppers yet, so I can’t comment on whether or not that’s actually true, but I’m looking forward to checking one out soon. I’m inclined to think it’s more of a marketing spin than anything else though.

    – You have my blessing to re-post the article. Thank you very much for sharing it with your readers.

Thanks for the information. I am looking at purchasing a new mattress, and my chiropractor recommends getting the firmest mattress possible. I am a side-sleeper, and from what I read on most of the mattress sites is that if you sleep on your side you want the mattress to be a little softer so that your midsection sinks slightly lower and your spine is aligned.

My chiropractor says that even if I sleep on my side I should get the firmest mattress possible. She is also averse to memory foam because it traps heat and causes inflammation. I am looking at the Sealy Postur-Pedic Firm and Ultra Firm mattresses. U.S. Mattress recommends for side-sleepers a mattress softness rating of 7-10 (the firm and ultra-firm are 2-4). Can you give any insight on what the best mattress hardness would be for side-sleepers?

    Justin, I don’t have any specific number for you. Comfort is rather subjective. What may be supportive for one person, but not be sufficient for another.

    I suggest trying out several beds and making sure that you’re well supported while resting on your back/side. If there’s any dip or sag, move along.

I am a true believer that you have to have the right mattress to get the sleep needed. I shopped around many stores, and I found that my favorite is the Sterns & Foster Ultra plush firm without the pillow top. It was reasonably priced at $1200. I have been sleeping better than ever!!! I had a tempur pedic mattress before and never had a good night sleep. I am loving my Sterns & Foster. I highly recommend people giving it a try or at least looking at them when they are out shopping for a mattress!!

Hi Dr Tanase, I have a Serta Vera Wang Latex foam pillow-top mattress that is causing my husband back pain. would it be worth trying to remove the pillow top (or flip the mattress) and use a different topper before we try buying a new mattress? This one was a wedding gift from my parents and cost almost $1000 on clearance two years ago. We would love to sell it and then buy a new one, but a aren’t sure how best to do this, or whether the amount of money we could get out of it would be worth the hassle of selling. Any ideas or tips? Thank you!

    Hi Alice, assuming the bed is the problem (and that there’s not another reason for your husband’s back pain) try flipping it first. See how he feels after a week or two. If there’s no change, replacing it with something without a pillow-top wouldn’t be a bad idea.

Thank you for your devoted blog. I am from S.Korea and currently live in Seoul. (Sorry for my poor English) I have been searching for a mattress because I will move to a new house in 2 months. My current mattress is a spring one and I used it for about 7 years. I can’t see what happen inside the mattress but I am sure that it might be broken long time ago. 😦
Too many mattresses of online stores make me confused and the “specialists” of mattress are dying to advertise them madly. Brands you’ve mentioned are about 2 times more expensive here than your country :(((((( That’s why I had a problem to make a decision.
But I got bumped into your blog, and am very satisfaction. Thank you again!!!!!
I will decide by taking your comments, Dr. Adam!

Greg N Kim Swartz Monday at 22:58

Dr. Adam,
Thank you very much for your very informative blog. Here it is years later helping others.
Reading through this has helped me to NOT move forward with purchasing a sleep-number bed and explore a dense memory foam topper, since neither of us see dipping in the mattress.

Thank you very much!

Hi Dr. Adam,

I have a Tempur-pedic Grand Bed and have pretty bad lower back and hip pain most mornings. I’m going to eat the cost and buy a new mattress so I’m looking at a Simmons BeautyRest World Class series after one was recommended to me. They’re quite a bit more than the Simmons you recommend; do you see any advantages to spending more? Thanks so much for your excellent article!

Hello, very useful article.

What is you view on combined mattress: over the foam they put 1 layer of latex and 1 layer of memory foam vice-versa?
(Like this example – https://hec.su/cOmc)

If you agree with this, which option do you recommend? Latex over memory foam or memory foam over latex?


    Hi Andrew, the “Lucid” mattress you asked about has a 3″ memory foam top, 2″ latex, then 10″ of base foam. My recommendation is to trim that down a bit. The latex layer is the preferred contact surface. You might actually prefer sleeping on something without the memory foam top (like this Casper mattress – https://hec.su/cOmf).

Hello, very informative article. I just bought a new mattress last week, it is a Steinhafels Dream plush mattress. This is their brand that they make themselves. I had a pillow top before. i have been waking up with terrible neck pain and headaches (I get tension headaches and occasional migraines that I am on daily meds for so this isn’t new for me). Is this part of the break in process, should I give it more time? Tomorrow will be a week. Or is this a red flag that this is not the mattress for me? This didn’t happen when I bought my pillowtop. I think the issue may be that it is thicker in the middle rounding down at the edges of the mattress.

Peggy Issel Tuesday at 17:04

Dr., I am so happy to read this article. I have neck pain almost every morning, and have been wondering which mattress to buy. I would love to buy the mattress you suggest, the Simmons Beauty Rest Recharge World Class Manorville…but my question is do you have to buy a box spring as well? On Amazon it doesn’t suggest that or offer one. Is it all in one unit now? Thanks for all the good advice.

Thank you so much for this article it’s a huge resource!
I tend to like firmer mattresses but have really wide hips, which makes most firm beds force my spine into a 90 degree angle. My husband and I just got a new bed, highly rated and well made, but it’s proving too firm and having this problem all over again, with added neck pain! What sort of topper would you recommend for my wide hips on this firmer bed? (The mattress is 13″ with individually wrapped coils, thick layer of dense foam, layer of memory foam)

What do you know about the saatva mattress?

cathinWendy Friday at 09:47

I’m a new viewer, so wanted to comment on the memory foam toppers. I started buying them years ago after I was waking up with back pain, and basically could barely step out of bed. I kind of feel like the memory foam screwed up my back even more. I developed mild scoliosis and the pain switched from my back to my legs & hips. Even though I tried using a thin topper – 2 inch, that didn’t really give me the support I needed. I found buying a firmer mattress, then using a good quality egg crate topper worked much better for my back. I feel like my back needs to actually sink into the actual mattress, and the topper just support the curves (I am a side sleeper). Am I right in feeling that memory foam just isn’t right for some people’s spines?

Angelique Morales Saturday at 00:21

Hi Dr. Tanase,

Do the same rules apply to a Latex topper that you mentioned for the Memory Foam? Density weight greater than thickness?

Thank you for this article. I lost it and had to search around for it now that I’m ready to buy.


I’m interested in getting the memory foam mattress topper recommended above, but it doesn’t come with a cover. I understand that a cover can help to sleep more comfortably with it (especially cooler) and prevent damage to the topper. Any suggestions of how to compensate for it not coming with a cover? Thanks.

Do you recommend having a boxspring or using a platform bed frame instead? What are the pros and cons of each?

I bought a new medium-firm innerspring mattress a few months ago that has a foundation – not box spring. I had a all latex bed before with a box spring mattress and I never had any problems. 2 weeks into using this new innerspring bed I developed back pain upon wakening that would resolve when I get up. Tried various memory foam and latex Toppers and same thing after several months – waking up with mid-back pain. I recently stayed in a couple different cabins on vacation and both beds never cause me problems. Back pain returned when I came home. For a while I was wondering if it’s the mattress that was causing me problems, but it couldn’t be the solid wood foundation? Is it better to try a box spring under the mattress or is it better just to buy a whole new mattress all together? I’m stuck in a rut because I know foundations are better for latex Beds which I may upgrade to if the box spring doesn’t work and they’re so heavy I don’t know how I’d get them to and from. Can you offer your advice on where I should start? Like I said I’ve used two different memory foam Toppers and it has a soft latex topper on there right now that’s been there for 2 months.

    Kristina, box springs are designed to support innerspring mattresses. Foundations are firm surfaces that provide the ideal support foam mattresses depend upon… So it sounds as if your current set up is backwards.

Julie Dionne Thursday at 08:39

Nice blog post! I really liked the advices!
I would like to know if a foam mat (like a thick yoga mat or the puzzle foam mat for kids) with a good matress topper (high density) would be a good way to sleep. Maybe just in camping or all the time, could it be good too?
It’s solid but would be soft with the topper.
Thanks 🙂

Is a Casper adjustable bed with hybrid (foam/spring) mattress OK to use for both sleeping and watching TV on the bed? Watching TV sitting up on a regular bed and using a pillow for back cushioning is killing my spine.

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