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We’re all supposed to get about 8 hours of sleep per night, right? If you’re dealing with a chronic illness, you may require more sleep to feel functional and rested the next morning.

When we sleep, our body has a chance to repair itself, creating muscle tissue and releasing important hormones.

But whether you describe your chronic pain as stabbing, jabbing, aching, throbbing, burning, or something else entirely, sometimes it seems impossible to find a comfortable sleeping position.

Tossing and turning each night instead of getting restorative sleep can leave you uncomfortable, wide-eyed, frustrated — and in even more pain the next day.

Ultimately, a vicious cycle is born. A lack of sleep increases chronic pain, and chronic pain reduces your ability to obtain necessary sleep. Some doctors even think that fibromyalgia might be linked to sleep disorders.

In chronic illness communities, we categorize the chronic pain-poor sleep pattern as “painsomnia,” or the inability to get quality sleep due to the presence of pain. But there are some things those with chronic pain can do to break the cycle of uncomfortable, sleepless nights.

A mattress can make or break a good night’s sleep. Start by focusing on buying the right one for you and your body.

Many people with chronic pain have repeatedly been told they need to sleep on a firm mattress to reduce pain.

Although there isn’t a large body of research on the subject of chronic pain and mattresses, one 2015 study indicated that a hard mattress may not always be the best choice when trying to improve your sleep quality and decrease pain.

During the study, more than 300 people with low back pain slept on mattresses that were categorized as either “medium-firm” or “firm.”

Following the completion of the 90-day study, participants who had slept on medium-firm mattresses reported less pain while lying in bed and during waking hours than those who had slept on the firm mattresses.

Even though you might have been told to sleep on a firm or hard mattress, this may not be the best choice for all people with chronic pain. The firmness you choose is ultimately based on your preference, but you can also use your typical sleep position as a guide.

Tips on choosing the right firmness by sleep style

  • Side sleepers: A softer mattress or topper often works well. This puts less pressure on your one shoulder, arm, and hip.
  • Stomach sleepers: Medium or firm works well, so your hips and pelvis don’t sink below your shoulders, which can strain your spine.
  • Back sleepers: Any firmness works since your weight is distributed over a larger surface area.
  • Weight: Generally, the more weight you have, the firmer you want your mattress to be.
  • Preference: Ultimately, choosing firmness comes down to what feels best for your body.

In reality, a firm mattress might be more comfortable for some people, while a medium-firm mattress is better suited for others.

What works for you may be different from what works for someone else with chronic pain. But there are a few things to keep in mind.

Generally, a mattress that promotes the proper alignment of your spine and joints while you sleep is preferable to one that allows your spine to sag or your joints to rotate and twist.

If you wake up with elevated pain levels, that’s an indicator your mattress may be the culprit, and your spine could be lacking some much-needed support as you snooze.

If you’re uncertain whether you could benefit from a firmer mattress, an article from Harvard Medical School offers two pieces of advice:

  • Place a piece of plywood under your bed to minimize the movement you’ll encounter from the springs of your current mattress.
  • Try sleeping with your mattress on the floor.

Both of these options will allow you to see the affects a firmer mattress may have on your body before you invest the money.

You’ve probably heard you need to rotate or flip your mattress from time to time. But how often should you be doing it?

Well, that depends on the mattress and how long you’ve had it.

There are no set guidelines as to how often you should change the position of your mattress. Mattress companies may have specific recommendations ranging from flipping or rotating it every 3 months to once a year.

If your mattress has a pillow top, you probably can’t flip it over at all, but you may want to consider rotating it so that it wears evenly over time.

In the end, the best way to determine whether it’s time to reposition your mattress is to check:

  • how you feel while you’re sleeping on it
  • how much pain you’re in when you wake up
  • if it’s beginning to sag

If you notice an increase in any of these factors, it may be time to move your mattress around.

Before investing in a new mattress, try rotating or flipping your current mattress. To test out how a firmer mattress may feel before purchasing one, you can put your mattress on the floor for a night or put a piece of plywood under the mattress while it’s in the bed frame.

Studies have shown that some people with autoimmune conditions, such as rheumatoid arthritis and lupus, experience flares when they’re exposed to certain household chemicals.

Mattresses can give off a strong chemical odor (called off-gassing) and may contain several toxic ingredients including:

  • plastics, foam, and synthetic latex, which are usually made with potentially harmful petroleum-based chemicals
  • flame-retardant chemicals

Since those materials may exacerbate pain, many people with chronic illnesses prefer to sleep on a nontoxic mattress.

When looking for a nontoxic mattress, you’ll notice most of them are made of materials such as natural latex, organic cotton, and organic bamboo. That said, not all mattresses claiming to be organic are made equal.

Mattress companies often boast several certifications. This makes it difficult to know which brand to buy.

According to Consumer Reports, the two certifications with the most stringent qualifications are the Global Organic Textile Standard (GOTS) and, for mattresses that contain latex, the Global Organic Latex Standard (GOLS).

Another certification that Consumer Reports says is good is the Oeko-Tex Standard 100. This label doesn’t guarantee the mattress’ materials are organic, but it does set limits on the amount of harmful chemicals and volatile organic compounds that can be present in the final product.

Look for one of these certifications:

  • Global Organic Textile Standard (GOTS)
  • Global Organic Latex Standard (GOLS)
  • Oeko-Tex Standard 100

Also, buy from a transparent brand that lists all the materials contained in the mattress.

New mattresses can be pricey. Plus, there’s no assurance that the one you pick will ease your chronic pain or be the right firmness for you.

While you may be able to try it out in the store for a few minutes, how do you know if the decision you’re making will work for you in the long run?

When you decide to buy a new mattress, look for a company that offers a money-back guarantee. That way, you can test drive your bed for 30 days or more, knowing that you can return the mattress if you’re not satisfied.

But be sure to read the fine print — the money-back guarantee may only apply to certain mattress brands in the store.

  • Casper Hybrid: Casper is known for having three zones of support for proper spinal alignment. A hybrid also adds wrapped coils for additional support.
  • The Nectar: This mattress is a great value, and has two layers of memory foam to conform to your shape and distribute weight evenly to prevent aches.
  • Tuft & Needle Mint: The proprietary T&N Adaptive foam gives extra support to hips and shoulders where pressure can be high. It’s also Greenguard Gold and Certi-PUR certified for lower off-gassing.
  • The Purple: Purple has an innovative polymer cushion that allows for comfort, airflow, and great motion isolation. The feel is different and may not be for everyone, but some find it ideal for their chronic pain needs.
  • Layla Memory Foam: Layla mattresses can be flipped from a more firm side to a softer side to adapt to your specific needs. If you’re a side sleeper who needs more cushion on pressure points, just flip it to that side.
  • Zinus Euro-Top: This hybrid combines memory foam with inner springs and a microfiber top that caters especially well to back sleepers.

As you start exploring your options, pay attention to how you feel after you’ve slept on a bed other than your own, such as at a hotel or at someone’s home. If your pain improves, jot down the name of the mattress company, and, if possible, the model.

That’ll help you pinpoint the kind of mattress you need to get a good night’s rest and hopefully lower your pain.

Jenny Lelwica Buttaccio, OTR/L, is a Chicago-based freelance writer, occupational therapist, health coach in training, and certified Pilates instructor whose life was transformed by Lyme disease and chronic fatigue syndrome. She writes on topics including health, wellness, chronic illness, fitness, and beauty. Jenny openly shares her personal healing journey at The Lyme Road.