What does it mean to say that a mattress provides "support"?

I have seen over and over statements like “The mattress did not provide me with enough support.” “This mattress doesn’t provide enough support for someone over 200 pounds.” “This mattress will provide you with good support.” “This mattress has luxurious comfort layers that you will love and the support that you body needs.”

I could go on and on and on and on… So what does “support” mean in the context of mattress comfort?

Hi Kai,

The word “support” is one of the most misused terms in the mattress industry and I can understand why it is so confusing. Even though it seems like a very simple question … it is actually one of the most complex questions in the industry and one of the basic parts of all mattress design.

In terms of it’s actual meaning in the context of mattresses … the first two definitions from the Free Dictionary would apply to mattresses. They are …

  1. To bear the weight of, especially from below.
  2. To hold in position so as to keep from falling, sinking, or slipping.

What this means in practical terms though (as opposed to how it is commonly used or misused) is the ability to support the spine and joints in their natural alignment while you are sleeping. This natural spinal alignment is a triple “S” shape that is the same as the shape of the spine when you are standing up straight with good posture. The natural alignment of the joints is in their non flexed and most relaxed position. The three spinal curves that need to be "supported"or maintained while sleeping are the recessed curve of the lower back (lumbar spine), the outward curve of the upper back (the thoracic spine) and the recessed curve of the neck (the cervical spine). The Lumbar and Thoracic support is the job of the mattress and the Cervical support is the job of the pillow.

If you are a stomach or back sleeper … the natural spinal alignment would look like this triple “S” shape (the shape of the spine when viewed from the side).

If you are a side sleeper … this natural alignment would look straight (the shape of the spine when viewed from the front or back)

The challenge with a mattress is that most people sleep in multiple positions so the mattress needs to keep the spine in alignment for the changing shape of the spine in different positions.

Because the spine and the bones of the body have protruding parts and recessed parts … there are also two “parts” to maintaining good spinal alignment (one for protruding parts and one for recessed parts).

The first part is to support the heavier and most weight concentrated parts of the body which tend to protrude. Each sleeping position has what is called “bony prominences” which are the parts of the body that “stick out”. On the side for example the main body prominences are the hip joints (at the lower part of the pelvis), the iliac crest (the upper bony part of the pelvis just below the waist), and the shoulders. These body parts carry the most weight and the “support” goal of a mattress is to stop them from sinking in too far (particularly the pelvis which carries the majority of the body weight) so that the spine remains in it’s natural position. If a mattress allows a certain part to sink in too much or not enough … it can lead to back pain or strain because the spine spends too much time in an unnatural position. It’s also important to make sure that the head is also supported in it’s natural position with the correct pillow and this is also an essential part of the “support” of your sleeping system. The parts of a mattress that are responsible for holding up the heavier parts of the body are the middle and lower layers of the mattress.

The second part is to support the more recessed parts of the spinal curves which are lighter. These are typically the waist or small of the back and the curve of the neck. Because these are lighter, they don’t need the same amount of support as the heavier parts of the body. The upper layers of the mattress are mostly responsible for this second part of support by filling in the gaps in the sleeping profile. If a mattress is too firm and doesn’t allow your heavier parts to sink in enough for these gaps to be filled in and supported, then there would be “air” underneath these recessed parts of the spine and they would tend to sag downwards and once again the spine would be out of alignment and this could also lead to back pain.

You can see visual examples of good and bad alignment here.

So “support” in the context of a mattress is the ability of a mattress to hold up your heavier parts to “stop” them from sinking in too far while at the same time to fill in the gaps in your sleeping profile so that your lighter more recessed parts are also supported in their natural position and don’t sag. This is why thinking in terms of “alignment” is much more accurate than thinking in terms of just “support” (which has two meanings in a mattress).

For those who like to sleep more “in” their mattress … good alignment is still possible because it is not about how soft or firm a mattress is but about how evenly you sink in to a mattress and the shape of the spine when your body is completely relaxed and comes to rest in each position. The benefit of better materials is that they can better adapt to the changes in sleeping position that are an important and natural part of sleeping so that alignment can be maintained in all sleeping positions and variations rather than just one.

For most people … the challenge is to “stop” the heavier pelvis from sinking in too far which can lead to lower back issues and at the same time to “allow” the lighter more prominent shoulders or upper back to sink in enough for the upper spine to also be in alignment and avoid upper back and neck stress and pain. The pillow also needs to support the head and neck in good alignment as well.

Of course materials that are firm enough to “hold up” the heavier body parts are by definition firm which means that they are also not pressure relieving and may not be soft enough to fill in the gaps. Materials that are soft enough to fill in the gaps and also relieve pressure on the body surface and joints by spreading the weight out over a larger surface area are by definition not supportive. The challenge with a mattress is to combine different layers, different materials, and sometimes different “zones” which are able to accomplish both of the two main functions of a mattress (Posture/alignment and Pressure relief) in the same mattress in all sleeping positions. The different variations of sleeping positions and the near infinite different body shapes and weight distributions of different people (along with the different levels of spine and joint flexibility and sensitivities and tolerances to both alignment and pressure of different people) is the reason that the “best” mattress can be very different for different people. Some people are so flexible and insensitive to pressure that they could sleep on a floor and call it the best mattress that they ever owned :slight_smile: Others have much less flexibility and are much more sensitive joint and surface pressure issues and they tend to need a mattress that is “perfect” down to the last fine detail to sleep well :unsure:

So in a single word … Support in the context of a mattress means “Alignment”.