75yo w/Rotator Cuff Injury & 10-18 Wakeups Per Apple Watch

Hello everyone, hoping to get some good advice on a topper. I’m a 75yo fairly active guy trying to get a good night’s sleep. I’m 5’9” and 175lbs and I sleep on a Twin XL conventional inner coil mattress with pillow top sitting on a ¾” plywood base in my bedframe.

I suffered a rotator cuff injury to my right shoulder about 5 years ago and take cortisone shots for it every six months. Even so, my favorite sleeping position is on that side, and at the edge of the bed. I’m a hot sleeper as well and had a big name memory foam mattress a few years ago and couldn’t stand it.

My Apple Watch tells me I wake up anywhere between 10 and 18 times per night and lose around 1.5 to 2 hours of sleep. I know that I toss & turn a fair bit, and I typically wake up around 3 AM and only occasionally fall back to sleep, or just doze ‘till about 5:30. I’m literally shocked when I see others’ sleep scores and their wakeups are only 2-3 times per night vs mine at 10-18.

From the little I’ve read, it seems that a Talalay latex topper in the 2” to 3” range might help. I’m on a fixed income so I don’t have a lot of discretionary cash to play around with different options, and am hoping to nail the solution on the first try.

Hey Cribbj.

Welcome to our Mattress Forum. :slight_smile:

So sorry to hear about the rotator cuff and that it’s causing you issues with sleeping. Being able to be comfortable and supported on your side without crushing your shoulder may be remedied by a topper, given that you’re currently on a pillow top which, as a rule, doesn’t allow for a whole lot of cradling.

I think a 3" topper may be the right fit for you since it’s possible for you to “bottom out” through a 2" topper and end up in…exactly the same position you’re in now.

Are you working in a particular budget for this topper? Finding a place that also allows for exchanges could work out in your favor here, as well.

NikkiTMU

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Hello Nikki & thanks for the kind reply.

I don’t have a fixed budget for this, and I don’t mind spending a good amount of money to fix the issue, but I don’t have the resources to be trying different things and returning them if they’re not “right”.

I live in a very remote area and the nearest town is 1.5 hours away and doesn’t even have a UPS Store. So that’s another reason I’d like to try & “nail it” on the first attempt.

John

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Hey there John,

I was reading through the thread, and a few things came to mind. I’m probably a little more direct than Nikki (she’s the nice one around here! :grinning_face_with_smiling_eyes:), but there are quite a few variables that I’d want to understand before recommending a topper.

You may very well end up with a Talalay latex topper, but I think there are a few important questions to answer before spending money, especially if you’re hoping to get it right the first time on a fixed income.

First, how old is your mattress, and does it have any visible body impressions, sagging, or soft spots? Even if there aren’t any visible impressions, do you notice any softer or compromised areas when you roll across the mattress? Have you been rotating it regularly?

I’d also like to know exactly what mattress you have. For example, many Beautyrest innerspring mattresses use a high-density foam encasement around the perimeter. Since you mentioned that you prefer sleeping right at the edge of the mattress, it’s worth knowing whether your mattress has this type of construction. If it does, part of your body may be resting on the firmer edge foam while the rest is supported by the main comfort layers. Depending on your body type and sleeping position, that transition could contribute to pressure points or discomfort, particularly with an already injured shoulder.

A topper is designed to improve pressure relief, not correct a mattress that has lost its support. If the mattress has broken down, even an excellent Talalay topper will simply conform to those same low spots.

Second, when you say it’s a “traditional innerspring,” can you tell us a little more about it? Is it an older two-sided Bonnell or offset coil mattress that was originally designed to work with an active box spring, or is it a newer innerspring that was designed to be used on a rigid foundation? That distinction matters because many older innerspring mattresses relied on the flex of an active box spring as part of the overall comfort and support system. If one of those mattresses is now sitting on a sheet of ¾-inch plywood, the bed may feel considerably firmer and provide less pressure relief than it was originally designed to.

The plywood also makes me want to better understand your support system. Was it added because the original foundation failed, because your bed frame had widely spaced slats, or for another reason? If this is an older traditional innerspring that was designed to work with an active box spring, replacing that system with a rigid surface can change both the comfort and support characteristics of the mattress.

Along those same lines, I’d also want to know more about the support system underneath. Is the plywood sitting on top of an existing box spring or foundation, or is the mattress resting directly on the plywood? Has the foundation been inspected to make sure it’s still structurally sound and performing as intended? A support system can appear perfectly fine visually while no longer providing the characteristics the mattress was engineered to work with.

Your shoulder injury is another important factor. Since you prefer sleeping on that side, additional pressure relief may certainly help. A Talalay latex topper is often an excellent choice because it provides excellent pressure relief while maintaining good support and spinal alignment without the slow response and heat retention that many people experience with traditional memory foam. But I wouldn’t recommend a specific thickness or firmness until it’s clear that the mattress itself is still in good condition and is being properly supported.

I’d also encourage you to spend some time trying to transition to sleeping on your back, even if it’s only for part of the night. For someone with a chronic rotator cuff injury, back sleeping generally places much less stress on the shoulder than spending hours sleeping directly on it. I know changing long-established sleep habits isn’t easy, but even partial success can sometimes make a noticeable difference.

Once we know the age and condition of the mattress, the type of innerspring, and exactly what it’s being supported by, we can make a much more confident recommendation. A Talalay topper may indeed be the right answer, but it’s important to make sure we’re addressing the root cause rather than simply treating the symptom.

My approach has always been to diagnose the entire sleep system before prescribing a solution. A topper is an excellent tool for fine-tuning pressure relief while maintaining proper spinal alignment, but it isn’t a substitute for a mattress or support system that is no longer performing as designed.

Maverick

Hey Maverick, thanks for the reply & no worries about the directness. People say I’m pretty direct, when they really mean I’m just blunt…. I’m going to post my answers below the questions you asked to make this easier to read, albeit long.

First, how old is your mattress, and does it have any visible body impressions, sagging, or soft spots? Even if there aren’t any visible impressions, do you notice any softer or compromised areas when you roll across the mattress? Have you been rotating it regularly?

The mattress is about 3-4 years old and is part of a set I purchased when I relocated out here full time. I actually have (2) Twin XL’s put together to form a king because the tight spacing of the staircase in my home would not allow a full king mattress to pass. I do rotate the mattress regularly & swap it with the other Twin XL as I live alone. I don’t see/feel any sagging in either of them.

I’d also like to know exactly what mattress you have. For example, many Beautyrest innerspring mattresses use a high-density foam encasement around the perimeter. Since you mentioned that you prefer sleeping right at the edge of the mattress, it’s worth knowing whether your mattress has this type of construction. If it does, part of your body may be resting on the firmer edge foam while the rest is supported by the main comfort layers. Depending on your body type and sleeping position, that transition could contribute to pressure points or discomfort, particularly with an already injured shoulder.

It’s a no-name mattress from a store that went out of business. I liked it because I had previously purchased a Queen from this place and it slept really well. Sorry, but I can’t tell you anything more about its construction, and in fact, I simply guessed that it’s a conventional innerspring type.

Second, when you say it’s a “traditional innerspring,” can you tell us a little more about it? Is it an older two-sided Bonnell or offset coil mattress that was originally designed to work with an active box spring, or is it a newer innerspring that was designed to be used on a rigid foundation? That distinction matters because many older innerspring mattresses relied on the flex of an active box spring as part of the overall comfort and support system. If one of those mattresses is now sitting on a sheet of ¾-inch plywood, the bed may feel considerably firmer and provide less pressure relief than it was originally designed to.

Again, I really know nothing about its inner construction.

The plywood also makes me want to better understand your support system. Was it added because the original foundation failed, because your bed frame had widely spaced slats, or for another reason? If this is an older traditional innerspring that was designed to work with an active box spring, replacing that system with a rigid surface can change both the comfort and support characteristics of the mattress.

The bed itself came from Wayfair and after assembly, it creaked a LOT and I thought perhaps the creaking was contributing to my poor sleeping. I read where replacing the slats with a solid piece of ¾” plywood could help, so I did that, and it all but eliminated the creaking, but it didn’t seem to help my “sleep score”. It’s a storage type bed so the top of the mattress is sitting fairly high (34”) off the floor and adding a box spring would be prohibitive as I’d probably need a step stool to climb into the bed.

Along those same lines, I’d also want to know more about the support system underneath. Is the plywood sitting on top of an existing box spring or foundation, or is the mattress resting directly on the plywood? Has the foundation been inspected to make sure it’s still structurally sound and performing as intended? A support system can appear perfectly fine visually while no longer providing the characteristics the mattress was engineered to work with.

The mattress is sitting directly on the plywood, and the plywood is fastened to the bed frame.

Your shoulder injury is another important factor. Since you prefer sleeping on that side, additional pressure relief may certainly help. A Talalay latex topper is often an excellent choice because it provides excellent pressure relief while maintaining good support and spinal alignment without the slow response and heat retention that many people experience with traditional memory foam. But I wouldn’t recommend a specific thickness or firmness until it’s clear that the mattress itself is still in good condition and is being properly supported.

I feel both the mattresses are in fairly good shape, especially since I rotate both of them regularly & switch which one I sleep on.

I’d also encourage you to spend some time trying to transition to sleeping on your back, even if it’s only for part of the night. For someone with a chronic rotator cuff injury, back sleeping generally places much less stress on the shoulder than spending hours sleeping directly on it. I know changing long-established sleep habits isn’t easy, but even partial success can sometimes make a noticeable difference.

I’ve found that I start the night sleeping on my right side, however when I awake in the morning, I’m typically on my back if it’s been a “rough” night with lots of wakeups. When I’ve been dead tired and there haven’t been as many wakeups, I tend to wakeup the same way I went to sleep, ie on the right side.

Once we know the age and condition of the mattress, the type of innerspring, and exactly what it’s being supported by, we can make a much more confident recommendation. A Talalay topper may indeed be the right answer, but it’s important to make sure we’re addressing the root cause rather than simply treating the symptom. My approach has always been to diagnose the entire sleep system before prescribing a solution. A topper is an excellent tool for fine-tuning pressure relief while maintaining proper spinal alignment, but it isn’t a substitute for a mattress or support system that is no longer performing as designed.

I appreciate your thorough approach and time spent diagnosing the issue. Far better than throwing out an off the cuff recommendation, and I’m sure we’ll come up with a better solution.

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John,

Thanks for taking the time to answer all of the questions in such detail. The additional information helps narrow down the possibilities quite a bit.

One thing I would still be interested in knowing is whether anyone has actually taken a look at you while you are lying on your side on the mattress. Many times, simply observing your posture and alignment can reveal things that we cannot determine from descriptions alone. The way your head, neck, shoulders, hips, and spine are positioned can tell us a lot about where pressure may be developing.

For now, let’s assume your overall alignment is reasonably good and that the mattress is not the primary issue.

The next area I would look closely at is your pillow. You mentioned that you are primarily a side sleeper but often end up on your back. That combination can make pillow selection a little more challenging because the requirements are different for those two positions.

Based on your height and build, you probably do not need an extremely high-loft pillow, but as a side sleeper you do need enough loft after compression to maintain proper support for your head and neck. If the pillow compresses too much during the night, your head can drop toward the mattress, which can change your spinal alignment and increase the amount of stress placed through your shoulder. With an existing rotator cuff issue, small changes in alignment can make a noticeable difference.

I have spent a lot of time experimenting with pillows myself, and as you can see from my pillow collection, I have cycled through quite a few of them. Sometimes I will try a pillow simply because someone claims it is the greatest thing ever made. The reality is that many of these pillows are variations of similar designs. Adjustable shredded foam pillows such as Coop, Saybrook, Wonderpillow, and others are generally variations of the same basic concept. The same applies to many solid latex pillows. They come in different firmnesses and lofts, but the important factor is whether the pillow works with your body, your sleeping position, and your particular pressure points.

One thing I have learned is that the “best” pillow is very personal. I recently experienced this myself. I developed significant discomfort in the area where my neck meets my shoulders and around my trapezius area. My normal go-to pillow, the Oxygen-Pillow, which is one of the most supportive pillows I have used, was not resolving the issue. I tried some of my memory foam pillows, including a fairly expensive Tempur-Pedic pillow that I had previously liked, thinking that I needed something softer and more conforming. Nada.

What actually helped was a very different type of pillow: a lofty, firmer horsehair pillow. What I needed was not more softness. What I needed was a pillow that maintained its loft, limited excessive sinking, and kept my head in a stable position throughout the night. It was a good reminder that sometimes the solution is not what we initially assume it will be.

For that reason, I would not rely on only one pillow. Having two or three different options available can be very useful. Your needs can change depending on whether you have muscle tension, inflammation, slept in an unusual position the night before, or simply need a slightly different level of support on a particular night.

I would also experiment with some additional support for your upper body. Since you sleep close to the edge of the mattress, consider placing a pillow or body pillow on the side opposite where you sleep. Even a standard pillow can be used to simulate this. Supporting your upper arm can reduce stress on the shoulder, help prevent your upper body from rolling forward, and keep you from rotating too far out of alignment during the night.

The fact that you naturally end up on your back after a difficult night is also interesting. That suggests your body may already be trying to find a position that reduces stress on the shoulder. You may want to experiment with making back sleeping easier by using a pillow configuration that supports that transition rather than fighting it.

At this point, based on everything you have described, I am actually less convinced that the mattress itself is the primary issue. The mattresses are relatively young, they are rotated regularly, and you are not describing obvious soft spots, sagging, or deterioration. That does not completely rule out the mattress, but it does make me want to explore the other components of the sleep system first.

Before adding a topper, I would like to see you explore all the other options for reducing pressure points from a different angle. A topper can certainly be an effective tool, but it is only one component of the overall sleep system. My preference is always to diagnose the source of the pressure first and then use a topper to fine-tune the feel of the mattress rather than using it as the first solution.

If we address pillow fit, sleeping position, arm support, and alignment and you are still experiencing shoulder pressure, then we can address the type of topper characteristics would actually be beneficial.

Maverick

One thing I would still be interested in knowing is whether anyone has actually taken a look at you while you are lying on your side on the mattress. Many times, simply observing your posture and alignment can reveal things that we cannot determine from descriptions alone. The way your head, neck, shoulders, hips, and spine are positioned can tell us a lot about where pressure may be developing.

For now, let’s assume your overall alignment is reasonably good and that the mattress is not the primary issue.

I think the alignment is OK, however since I live alone, getting a pic would be difficult. I have a super smart dog, but he’s not checked out on my iPhone….

The next area I would look closely at is your pillow. You mentioned that you are primarily a side sleeper but often end up on your back. That combination can make pillow selection a little more challenging because the requirements are different for those two positions.

Based on your height and build, you probably do not need an extremely high-loft pillow, but as a side sleeper you do need enough loft after compression to maintain proper support for your head and neck. If the pillow compresses too much during the night, your head can drop toward the mattress, which can change your spinal alignment and increase the amount of stress placed through your shoulder. With an existing rotator cuff issue, small changes in alignment can make a noticeable difference.

I sleep on a Better Homes & Garden pillow that is definitely NOT a high loft type. I would actually call it “understuffed”. I typically rest my shoulder on it and pass my right arm under it as a starting position when I lie down. That’s the most comfortable & least painful position that puts me to sleep. For sleep aids, I’ll pop a couple of extra strength Tylenols to help with the pain and a Benadryl to speed up the drowsiness.

For that reason, I would not rely on only one pillow. Having two or three different options available can be very useful. Your needs can change depending on whether you have muscle tension, inflammation, slept in an unusual position the night before, or simply need a slightly different level of support on a particular night.

I’ll try a few other pillows and see, however when I’ve been caught away from home overnight, I typically wake up with a stiff neck from the hotel pillows which are higher loft than mine.

I would also experiment with some additional support for your upper body. Since you sleep close to the edge of the mattress, consider placing a pillow or body pillow on the side opposite where you sleep. Even a standard pillow can be used to simulate this. Supporting your upper arm can reduce stress on the shoulder, help prevent your upper body from rolling forward, and keep you from rotating too far out of alignment during the night.

I’ll try this as well

If we address pillow fit, sleeping position, arm support, and alignment and you are still experiencing shoulder pressure, then we can address the type of topper characteristics would actually be beneficial.

OK Maverick, I’ll try your suggestions & report back. Much appreciated again!!

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I’m sorry, but I am laughing out loud. The stiff neck from hotel pillows had me :rofl:. Hotel pillows are the worst!

We just stayed at a 4.5-star hotel in Omaha, the bed was a BeautyRest, which sounded promising, but it was awful. The pillows? Polyfill. Even worse.

We have yet to stay at a hotel where the mattress and pillows were actually comfortable. We’ve tried the Ritz in NYC, Andaz in San Diego, Opal Grand in Delray, and Alfond Inn in Winter Park, horrible, horrible, horrible, and somehow even more horrible. The hotels were great though.

It got to the point where I had a mattress and pillows shipped to my daughter’s house in Florida for our visits. I had a DLX Classic sent because it was cheaper to buy a new mattress and finally sleep comfortably than to keep paying for a few nights at an Orlando hotel and wake up miserable.

I think of the pillow as a “mattress for your head” they need to have structure, support, comfort and a good cover. When it comes to shredded pillows, or any refillable pillow type, be certain to look at the fill. I find that pillows that use fill that are uniformly cut and piece that are symmetrical. Here are some examples of fill that are symmetrical. (Cube Pillow), (Latex Noodle Pillow) (Helix Comfort Adjust Pillow), These are a few examples of non solid, one piece pillows, but pillows with fill that the fill pieces are uniform and symmetrical.

Pillows like the Latex Cube Pillow, Noodle Pillow, and Helix ComfortAdjust Memory Foam Fill Pillow are designed with intentionally uniform, equal and symmetrically shaped and processed support fill materials rather than leftover or randomly cut foam pieces. A latex cube pillow uses consistently sized 1" latex cubes to create a balanced mix of support, airflow, and adjustability; the noodle pillow uses uniform latex foam “noodle” shapes that compress and shift predictably; and the 'S" shaped memory foam fill pillow uses controlled foam pieces engineered to provide a more consistent contouring feel and allow for more airflow to keep a memory foam pillow cooler to sleep on. Compared with pillows filled with random shredded pieces of mixed sizes, densities, and shapes, these designs offer more even pressure distribution, fewer hard or overly soft spots, better neck and head support, improved durability, and a more predictable sleeping experience because the fill behaves consistently instead of settling unevenly or creating lumps and gaps over time.

I’m sorry, but I am laughing out loud. The stiff neck from hotel pillows had me . Hotel pillows are the worst!

It seems the cheaper the hotel, the more overstuffed their pillows are. I traveled a lot in my former career and I found that Marriott mattresses and pillows were the most comfortable for me of the usual domestic business hotel chains and Meridien were the best internationally. These days I hit the Super 8’s and Motel 6’s more than the others, and they’re truly awful.

I think of the pillow as a “mattress for your head” they need to have structure, support, comfort and a good cover. When it comes to shredded pillows, or any refillable pillow type, be certain to look at the fill. I find that pillows that use fill that are uniformly cut and piece that are symmetrical.

Pillows like the Latex Cube Pillow, Noodle Pillow, and Helix ComfortAdjust Memory Foam Fill Pillow are designed with intentionally uniform, equal and symmetrically shaped and processed support fill materials rather than leftover or randomly cut foam pieces. A latex cube pillow uses consistently sized 1" latex cubes to create a balanced mix of support, airflow, and adjustability; the noodle pillow uses uniform latex foam “noodle” shapes that compress and shift predictably; and the 'S" shaped memory foam fill pillow uses controlled foam pieces engineered to provide a more consistent contouring feel and allow for more airflow to keep a memory foam pillow cooler to sleep on. Compared with pillows filled with random shredded pieces of mixed sizes, densities, and shapes, these designs offer more even pressure distribution, fewer hard or overly soft spots, better neck and head support, improved durability, and a more predictable sleeping experience because the fill behaves consistently instead of settling unevenly or creating lumps and gaps over time.

Thanks, I’ll keep those in mind for future purchases as I travel on this new quest for a good night’s sleep.

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Look on the winked website they have what hotels use their mattresses on the site. Maybe you could finally sleep on a comfortable bed at a hotel

Thanks, I’ll check them out. I should be making a run to our “major city” of 60,000 people in a week or so. :joy:

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I’ve now slept on three or four different types of mattresses and half a dozen pillows and did a DIY “sleep study” with a Wyze security camera and I think I found the problem.

A couple of years ago I had shingles and one of the side effects are occasional shooting pains in muscles or joints and they’re such sharp and shooting pain that they will cause an involuntary whole body spasm.

I still have these pains occasionally, and in researching them, they can occur more frequently during sleep due to changes in cortisol levels and my Wyze camera confirmed this. I was having 2-3 spasms per hour while sleeping and evidently my Apple Watch interpreted these as wake ups.

So the next step will be to get onto medication that will suppress these pains & spasms while I sleep.

I do want to thank everyone and especially Maverick for their suggestions and advice!

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Cribbj,

Great job taking the time to investigate this so thoroughly. Using the camera to actually observe what was happening during sleep was a really smart step, and it sounds like you may have uncovered a very plausible explanation for what has been going on.

Hopefully working with your doctor to find a treatment that reduces those nerve pains and spasms will make a real difference in your sleep quality. It must be frustrating to have something happening during sleep that you weren’t even aware of, but identifying the pattern is a big step forward.

Wishing you the best as you work through the next steps. I hope you’re able to get some truly restful nights again soon, and please keep us updated on how things go!

Remember, we are always here to help when you need it.

Maverick