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While research on the benefits of a firm mattress is limited, some people may prefer to sleep on a firm mattress to support spinal alignment and relieve aches and pains. Choosing the right mattress for an individual’s health needs and personal preferences can help support restorative sleep.

Sleep is as vital for human health as eating a nutritious diet and being physically active. Systems throughout the body repair themselves during sleep. If people do not get the sleep they need, they miss out on these important, whole-body maintenance processes.

Learn more about why sleep is important for health.

Purchasing the right mattress for their physical conditions and sleeping styles can help people get the rest they and their bodies need. One of the first decisions to consider is whether to choose a soft or firm mattress.

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There are three basic sleep positions; back, stomach, or side. Back or stomach sleepers tend to prefer firm mattresses, as they support proper spinal alignment in those positions.

Back pain can cause sleep issues. For some time, people believed that those with back pain should sleep on firm mattresses. However, firm mattresses might not be the best choice for everyone.

Firm mattresses may help keep the body in alignment when people sleep on their back or front. Good spinal alignment prevents excess pressure and stress on different parts of the body and connective tissue. For some individuals, a firm mattress could prevent or reduce aches and pains.

Learn more about using firm mattresses for back pain.

A review of controlled trials found that medium-firm, adjustable mattresses were the best at improving sleep quality and comfort and promoting healthy spinal alignment.

Learn about adjustable mattresses for back pain.

Who should avoid firm mattresses?

Side sleepers may find a firm mattress uncomfortable. This is because the resistance a firm mattress provides can prevent proper spinal alignment in these individuals, causing discomfort and strain on the joints.

Learn about the best mattresses for side sleepers.

In contrast, people with lower body weight may prefer soft or medium-firm mattresses, as a firm mattress may prevent the body from sinking in comfortably.

Learn about the best soft mattresses.

Key factors to consider when choosing a mattress include:

  • Allergies: Individuals with allergies should double-check that a mattress is suitable for them. Many companies sell hypoallergenic mattresses that do not contain any allergens. People should also consider allergies when purchasing pillows, sheets, and other bedding items. Learn about choosing the best mattress for allergies.
  • Sustainability: The mattress industry contributes to waste and landfills. To minimize environmental impact, choose a mattress that uses eco-friendly materials, or buy from a brand that is transparent about its sustainability practices. Learn about eco-friendly mattresses.
  • Additional services: Look for companies that provide convenient services such as delivery and installation. Some brands also offer to remove old mattresses, usually at an extra cost. Learn about how to recycle a mattress.
  • Partner preferences: People who share a bed may wish to discuss different preferences to choose the best mattress for each person.

Medical News Today’s methodology

MNT chooses mattresses, sheets, pillows, and other bedding that meet the following criteria:

  • Certifications: MNT will choose products that have CertiPUR-US or other certifications. This means that the products are low in pollutants and free from heavy metals and volatile organic compounds.
  • Size: MNT chooses products that are available in various sizes.
  • Materials and fill: MNT selects products comprising different materials and fills, such as memory foam and latex, to suit a range of sleep and lifestyles.
  • Budget: MNT features products available in a wide range of budgets.
  • Firmness [only applicable to some products]: MNT selects mattresses that are available in a range of firmness options to suit most people’s sleeping styles.
  • Sleep trials: MNT chooses companies that offer sleep trials for their mattresses.
  • Shipping: MNT will include shipping information, such as where the company delivers to and whether shipping is free.
  • Warranties and return policies: MNT will include products that carry warranties and clear returns policies.

Please note that the writer of this article has not tried these products. All information presented is purely research-based.

Below is a selection of firm mattresses that might be worth considering.

Plank Mattress

Firmest mattress

The manufacturer, Brooklyn Bedding, describes this mattress as one of the firmest mattresses available. It is suitable for people looking for a mattress that will not sink.

This mattress is also flippable, with each side featuring a different level of firmness. It has a 7-inch (in) base layer of high-density foam and a 2-in layer of comfort foam for additional support.

The company offers a 120-night trial period and free shipping with this product, which also comes with a 10-year warranty.

This mattress is available in a wide range of sizes, including options for recreational vehicles (RV). The queen size retails from $1,249.

Learn about RV mattresses.

Saatva Classic Mattress

Best firm hybrid mattress

This hybrid mattress combines pocketed innerspring coils with a 3-in Euro pillow top consisting of fibers and foam. Saatva claims it is breathable, durable, and supportive.

People can choose from three levels of firmness, heights of 11.5 in or 14.5 in, and sizes ranging from twin to California king, including split king.

The company offers free in-room delivery and set-up, plus a 180-night trial and a 15-year warranty.

The queen-size mattress retails for $1,695.

Learn more about Saatva mattresses.

Serafina Pearl Cool Comfort

Best firm cooling mattress

This mattress comprises gel memory foam, which reportedly provides a cool sleep and relieves pressure points. The gel memory foam can help dissipate heat, making this mattress suitable for hot sleepers.

Learn more about gel memory foam mattresses.

This 14-in mattress features three layers and lets users choose the level of firmness they want, including firm, medium, or plush. The company also offers a 20-year warranty on this product.

These mattresses do not contain ozone depleters, heavy metals, or flame retardants, while the foam is CertiPUR-US certified.

The mattress is available in queen size for $829.99 and king or California king for $999.99.

Learn about the best cooling mattresses.

Casper Original Mattress

Best supportive firm mattress

The breathable top layer of the Casper Original Mattress has thousands of perforations to allow for airflow and heat dissipation. Zone support promotes healthy spinal alignment, while two foam layers offer firm support.

This mattress is available in all-foam or hybrid foam and spring models. The foam is CertiPUR-US certified, so it is free from ozone-depleting chemicals and phthalates and low in volatile organic compounds.

With the purchase of this mattress, Casper also offers free delivery, a 100-night risk-free trial period, and a limited 10-year warranty.

This mattress is available in various sizes — the queen size retails from $1,295.

Learn more about cooling mattresses.

Cocoon Mattress

Best firm memory foam mattress

Sealy makes this mattress using its proprietary PerfectFit memory foam, which provides support by adapting to a person’s shape. This may suit people who prefer a more medium-firm feel.

The mattress features three additional layers of memory foam and a cooling cover. It may benefit hot sleepers by offering a cooling sleeping surface.

It is 10 in high and suitable for users up to 500 pounds. Sealy also offers a 10-year limited warranty and free shipping and returns with this mattress.

This mattress is available in a range of sizes — the queen size retails for $1,239.

Learn about the best memory foam mattresses.

The following are common questions and answers about firm mattresses:

Who may benefit from a firm mattress?

Back and stomach sleepers may prefer firm mattresses for supporting spinal alignment.

Individuals who do not want to feel like they are sinking into a mattress may benefit from a firm mattress. For example, people with excess weight may prefer the support that a firm mattress provides.

Who should avoid a firm mattress?

Side sleepers may prefer softer mattresses, as they allow a person’s shoulders and hips to sink into the mattress while keeping the spine level. A firm mattress may cause shoulder and neck pain in side sleepers.

People with a low body weight may feel uncomfortable on a firm mattress, as the body will not sink evenly into the material. Therefore, a medium-firm or soft mattress may be preferable.

Can a firm mattress treat back pain?

There is no definite evidence that a firm mattress can prevent or treat back pain. However, some people may prefer a firm mattress for spinal support.

According to 2015 research, individuals with back pain may benefit from a medium-firm, adjustable mattress. However, a mattress cannot replace other forms of treatment for back pain, such as physical therapy.

People who have sleep difficulties due to back pain should speak with a doctor about management and treatment options.

Many people have previously believed that a firm mattress is best for someone with back pain, but research does not fully support this position. A medium-firm, adjustable mattress may be better for individuals with back pain.

Back or stomach sleepers may prefer a firm mattress, as these can aid proper spinal alignment in these positions. People with excess weight may also prefer the support that a firm mattress provides.

Sleep is essential for health and finding a mattress that suits personal taste, physical characteristics, and sleep styles can help individuals enjoy restful and restorative sleep.