What Mattress Is Best, By Science?
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The Foundations of Good Sleep
You probably know the importance of good sleep for good health. If not, here’s a quick refresher:
- Why You Probably Need More Sleep
- How Sleep-Deprived Are You, Really?
- The 6 Dimensions Of Sleep (And Why They Matter)
You should also definitely check out this quite famous book on the topic:
Why We Sleep – by Dr Matthew Walker
What helps, to get that good sleep
We’ve covered this a little before too, for example:
- Safe Effective Sleep Aids For Seniors
- Sleep Better With Better Air
- How To Nap Like A Pro (No More “Sleep Hangovers”!)
How to level-up from there
One of the biggest barriers to good sleep for many people is obstructive sleep apea:
Healthier, Natural Sleep Without Obstruction!
We covered (in the above article) a whole lot of ways of mitigating/managing obstructive sleep apnea. One of the things we mentioned as beneficial was avoiding sleeping on one’s back, and this is something Mayo Clinic’s Dr. Somers agreed with:
Back Sleeping, And Sleeping Differently After 50
“But side-sleeping is uncomfortable”
If this is you, then chances are you have the wrong mattress.
If your mattress is too firm, you can get around it by using this “five pillow” method:
Click Here If The Embedded Video Doesn’t Load Automatically
If your mattress is too soft, then sorry, you really just have to throw that thing out and start again.
The Goldilocks mattress
While different people will have different subjective preferences, the science is quite clear on what is actually best for people’s spines. As this review of 39 qualified scholarly articles concluded:
❝Results of this systematic review show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment❞
~ Dr. Gianfilippo Caggiari et al.
Read in full: What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature
Note: to achieve “medium-firm” that remains “medium firm” has generally been assumed to require a memory-foam mattress.
How memory-foam works: memory-foam is a moderately thermosoftening material, designed to slightly soften at the touch of human body temperature, and be firmer at room temperature. This will result in it molding itself to the form of a human body, providing what amounts to personalized support for your personal shape and size, meaning your spine can stay exactly as it’s supposed to when you’re sleeping on your side, instead of (for example) your hips being wider meaning that your lumbar vertebrae are raised higher than your thoracic vertebrae, giving you the equivalent of a special nocturnal scoliosis.
It will, therefore, stop working if
- the ambient temperature is comparable to human body temperature (as happens in some places sometimes, and increasingly often these days)
- you die, and thus lose your body temperature (but in that case, your spinal alignment will be the least of your concerns)
Here’s a good explanation of the mechanics of memory foam from the Sleep Foundation:
Sleep Foundation | What is Memory Foam?
An alternative to memory foam?
If you don’t like memory foam (one criticism is that it doesn’t allow good ventilation underneath the body), there is an alterative, the grid mattress.
It’s very much “the new kid on the block” and the science is young for this, but for example this recent (April 2024) study that concluded:
❝The grid mattress is a simple, noninvasive, and nonpharmacological intervention that improved adults sleep quality and health. Controlled trials are encouraged to examine the effects of this mattress in a variety of populations and environments.❞
~ Dr. Heather Hausenblas et al.
Read in full: Effectiveness of a grid mattress on adults’ sleep quality and health: A quasi-experimental intervention study
However, that was a small (n=39) uncontrolled (i.e. there was no control group) study, and the conflict of interest statement is, well, interesting:
❝Heather A. Hausenblas, Stephanie L. Hooper, Martin Barragan, and Tarah Lynch declare no conflict of interest. Michael Breus served as a former consultant for Purple, LLC.❞
~ Ibid.
…which is a fabulous way of distracting from the mention in the “Acknowledgements” section to follow, that…
❝Purple, LLC, provided financial support for the study❞
~ Ibid.
Purple is the company that invented the mattress being tested. So while this doesn’t mean the study is necessarily dishonest and/or corrupt, it does at the very least raise a red flag for a potential instance of publication bias (because Purple may have funded multiple studies and then pulled funding of the ones that weren’t going their way).
If you are interested in Purple’s mattress and how it works, you can check it out here ← this is a link for your interest and information; not an advertisement or an endorsement. We look forward to seeing more science for this though, and echo their own call for randomized controlled trials!
Summary
Sleep is important, and while it’s a popular myth that we need less as we get older, the truth is that we merely get less on average, while still needing the same amount.
A medium-firm memory-foam mattress is a very good, well-evidenced way to support that (both figuratively and literally!).
A grid mattress is an interesting innovation, and/but we’d like to see more science for it.
Take care!
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The New Menopause – by Dr. Mary Claire Haver
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The author is most famous for “The Galveston Diet”, which book is astonishingly similar in its content, chapters, format, etc to Nikki Williams’ “It’s Not You, It’s Your Hormones” which came out a few years previously but didn’t get the same marketing.
Nonetheless, this time Dr. Haver has something new to add, and we think it’s worth a read.
The general theme of this book is a comprehensive overview of the menopause, experientially (subjective to the person going through it) and empirically (by science), from start to finish and beyond. This book’s more about human physiology, and less about diet than the previous.
Dr. Haver also discusses in-depth how estrogen is thought of as a sex hormone (and it is), to the point that people consider it perhaps expendable, and forget (or are simply unaware) that we have estrogen receptors throughout our bodies and estrogen is vital for maintaining many other bodily functions, including your heart, cognitive function, bone integrity, blood sugar balance, and more.
(in case you’re wondering “why don’t men fall to bits, then?”, don’t worry, their testosterone does these things for them. Testosterone is orders of magnitude less potent than estrogen, mg for mg, so they need a lot more of it, but under good conditions they produce plenty so it’s fine)
But, the amount of testosterone available to peri/postmenopausal women is simply not enough to do that job (and it’d also result in a transition of secondary sex characteristics, which for most people would be very unwanted), so, something else needs to be done.
Dr. Haver also discusses in detail the benefits and risks of HRT and how to get/manage them, respectively, with the latest up-to-date research (at time of going to print; the book was published in April 2024).
Bottom line: if you want to know what’s going on with your peri- or post-menopausal body and how it could be better (or if you want to know what’s going on with someone else approaching/experiencing menopause), then this is a top-tier book.
Click here to check out The New Menopause, and know what’s going on and what to do about it!
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How Not To Get Sick: A Cookbook – by Dr. Benjamin Bikman and Diana Keuilian
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We’ve previously reviewed Dr. Bikman’s excellent “Why We Get Sick”, and if you haven’t read that yet, we recommend doing so.
Nevertheless, you don’t need to have read it to benefit from this one, which is about cooking with those learnings (from the other book) in mind.
Before getting to the recipes, we get a section recapping what we learned previously, as well as adding some more general lifestyle advices beyond the kitchen. The science is also expanded a bit, to include such things as the two-way relationship between insulin and aging, as well as the interplay with other metrics of health, including blood lipids, for example.
The authors then provide a plan, in the three stages: reverse (insulin resistance), prevent (insulin resistance), maintain (insulin sensitivity).
The recipes themselves, of which there are 70, are of course tailored to do the above three things; they’re also quite diverse, albeit if you are vegetarian or vegan, you should know in advance that most of these recipes are not.
Bottom line: if the above doesn’t apply to you, and you would like to improve your insulin sensitivity, this book can indeed help.
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When the Body Says No – by Dr. Gabor Maté
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We know that chronic stress is bad for us because of what it does to our cortisol levels, so what is the rest of this book about?
Dr. Gabor Maté is a medical doctor, heavily specialized in the impact of psychological trauma on long term physical health.
Here, he examies—as the subtitle promises—the connection between stress and disease. As it turns out, it’s not that simple.
We learn not just about the impact that stress has on our immune system (including increasing the risk of autoimmune disorders like rheumatoid arthritis), the cardiovascular system, and various other critical systems fo the body… But also:
- how environmental factors and destructive coping styles contribute to the onset of disease, and
- how traumatic events can warp people’s physical perception of pain
- how certain illnesses are associated with particular personality types.
This latter is not “astrology for doctors”, by the way. It has more to do with what coping strategies people are likely to employ, and thus what diseases become more likely to take hold.
The book has practical advice too, and it’s not just “reduce your stress”. Ideally, of course, indeed reduce your stress. But that’s a) obvious b) not always possible. Rather, Dr. Maté explains which coping strategies result in the least prevalence of disease.
In terms of writing style, the book is very much easy-reading, but be warned that (ironically) this isn’t exactly a feel-good book. There are lot of tragic stories in it. But, even those are very much well-worth reading.
Bottom line: if you (and/or a loved one) are suffering from stress, this book will give you the knowledge and understanding to minimize the harm that it will otherwise do.
Click here to check out When The Body Says No, and take good care of yourself; you’re important!
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Surgery won’t fix my chronic back pain, so what will?
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This week’s ABC Four Corners episode Pain Factory highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain.
The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain.
One in five Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated A$139 billion a year, including $12 billion in direct health-care costs.
The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work?
Opioids and invasive procedures
Treatments offered to people with chronic pain include strong pain medicines such as opioids and invasive procedures such as spinal cord stimulators or spinal fusion surgery. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm.
Spinal fusion surgery and spinal cord stimulators are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual.
Addressing the contributors to pain
Recommendations from the latest Australian and World Health Organization clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as:
- education
- advice
- structured exercise programs
- physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.
Pain education is central. Monkey Business Images/Shutterstock Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain.
The interventions have minimal side effects and are cost-effective.
In the RESOLVE trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move.
In the RESTORE trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it.
Why isn’t everyone with chronic pain getting this care?
While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session can cost $90–$150.
In contrast, Medicare provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions.
Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs.
Access to trained clinicians is another barrier. This problem is particularly evident in regional and rural Australia, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited.
Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The rate of opioid use, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas.
So what can we do about it?
We need to reform Australia’s health system, private and public, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments.
Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian trial, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain.
Advocacy and improving the public’s understanding of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.
Christine Lin, Professor, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Fiona Blyth, Professor, University of Sydney; James Mcauley, Professor of Psychology, UNSW Sydney, and Mark Hancock, Professor of Physiotherapy, Macquarie University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Calisthenics for Beginners – by Matt Schifferle
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For those who are curious to take up calisthenics, for its famed benefit to many kinds of health, this is a great starter-book.
First, what kind of benefits can we expect? Lots, but most critically:
- Greater mobility (as a wide range of movements is practiced, some of them stretchy)
- Cardiovascular fitness (calisthenics can be performed as a form of High Intensity Impact Training, HIIT)
- Improved muscle-tone (because these are bodyweight strength-training exercises—have you seen a gymnast’s body?)
- Denser bones (strong muscles can’t be built on weak bones, so the body compensates by strengthening them)
A lot of the other benefits stem from those, ranging from reduced risk of stroke, diabetes, heart disease, osteoporosis, etc, to improved mood, more energy, better sleep, and generally all things that come with a decent, rounded, exercise regime.
Schifferle explains not just the exercises, but also the principles, so that we understand what we’re doing and why. Understanding improves motivation, adherence, and—often—form. Exercise diagrams are clear, and have active muscle-groups highlighted and color-coded for extra clarity.
As well as explaining exercises individually, he includes three programs, increasing in intensity. He also offers adjustments to make exercises easier or more challenging, depending on the current condition of your body.
The book’s not without its limitations—it may be a little male-centric for some readers, for instance—but all in all, it’s a very strong introduction to calisthenics… Enough to get anyone up and running, so to speak!
Get started with “Calisthenics for Beginners” from Amazon today!
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What Menopause Does To The Heart
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World Menopause Day: Menopause & Cardiovascular Disease Risk
Today, the 18th of October, is World Menopause Day.
The theme for this year is cardiovascular disease (CVD), and if your first reaction is to wonder what that has to do with the menopause, then this is the reason why it’s being featured. Much of the menopause and its effects are shrouded in mystery; not because of a lack of science (though sometimes a bit of that too), but rather, because it is popularly considered an unimportant, semi-taboo topic.
So, let’s be the change we want to see, and try to fix that!
What does CVD have to do with the menopause?
To quote Dr. Anjana Nair:
❝The metabolic and clinical factors secondary to menopause, such as dyslipidemia, insulin resistance, fat redistribution and systemic hypertension, contribute to the accelerated risk for cardiovascular aging and disease.
Atherosclerosis appears to be the end result of the interaction between cardiovascular risk factors and their accentuation during the perimenopausal period.
The increased cardiovascular risk in menopause stems from the exaggerated effects of changing physiology on the cardiovascular system.❞
Source: Cardiovascular Changes in Menopause
See also: Menopause-associated risk of cardiovascular disease
Can we do anything about it?
Yes, we can! Here be science:
- Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association
- Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use
This (in few words: get your hormone levels checked, and consider HRT if appropriate) is consistent with the advice from gynecologist Dr. Jen Gunter, whom we featured back in August:
What You Should Have Been Told About The Menopause Beforehand
What about lifestyle changes?
We definitely can do some good things; here’s what the science has to say:
- Mediterranean diet: yes, evidence-based
- High soy consumption: mixed evidence, unclear. So, eat it if you want, don’t if you don’t.
- Supplements e.g. vitamins and minerals: yes, evidence-based.
- Supplements e.g. herbal preparations: many may help, but watch out for adverse interactions with meds. Check with your pharmacist or doctor.
- Supplements; specifically CBD: not enough evidence yet
- Exercise: yes, evidence-based—especially low-impact high-resistance training, for bone strength, as well as regular moderate-intensity exercise and/or High-Intensity Interval Training, to guard against CVD.
For a full low-down on all of these:
Revealing the evidence-based lifestyle solutions to managing your menopause symptoms
Want to know more?
You can get the International Menopause Society’s free downloadable booklet here:
Menopause & Cardiovascular Disease: What Women Need To Know
You may also like our previous main feature:
What Does “Balance Your Hormones” Even Mean?
Take care!
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