The > Health > The Consumer: Rest Easy on Pricey Mattress? Not Always

good night's sleep is fast becoming one of the most precious commodities money can buy.

Mattresses costing ,000 to ,000 are now common, and many people are spending as much as ,000 to ,000 on handmade beds crafted with materials like cashmere, Joma wool from New Zealand and Belgian damask.

Mattress boutiques like Duxiana (specializing in ,000 to ,500 Dux beds) and McRoskey Airflex (with mattresses in the ,000 to ,000 range) are increasingly popular in New York, San Francisco and other cities.

Many high-end beds are said to be scientifically designed to provide an ideal night's sleep. But very little research has been done to show which mattresses work best.

Aside from studies conducted by bed makers themselves, the literature consists mainly of one Spanish study of people with low-back pain, published in The Lancet last year.

This 90-day trial simply indicates that medium firm mattresses ease pain more than firm ones do.

Sleep comfort is clearly a health concern, and not only for people with lower back pain.

"It becomes an issue when you get into middle age," said Dr. Clete Kushida, a neurologist who is the director of the Stanford University Center for Human Sleep Research.

"Children and young adults can get a good night's sleep on virtually any surface,'' he added, "but as one ages into the mid-40's, sleep becomes more fragmented, it takes longer to fall asleep and it's harder to stay asleep."

In the absence of hard data, many doctors offer consumers advice based simply on their own observations.

Dr. Noah Finkel, an orthopedic surgeon in Huntington, N.Y., said it was possible to find a comfortable and supportive queen- or king-size mattress and box spring set for 0 to ,600.

ConsumerReports.org advises spending at least 0 for twin-size, 0 for full, 0 for queen and ,000 for king.

"The most expensive mattresses are probably best for enjoying while you're awake in bed, as opposed to when you're sleeping," said Dr. David N. Neubauer, associate director of the Johns Hopkins Sleep Disorders Center in Baltimore.

Ideally, the bed should enable the sleeper to lie on his or her side with a straight spinal column.

"Your spine should look the same when you're lying down as it does when you're standing up," said Dr. Scott Bautch, a chiropractor in Wausau, Wis.

That means the shoulders and hips should press into the mattress, and the mattress should rise up to meet the narrower waist and knees. Super-firm mattresses are rarely ideal, doctors say, because the hips and shoulders cannot sink in enough to keep the back straight.

A too-soft mattress, on the other hand, can act like a hammock, forcing the body into a curled position.

Curvier people, whose hips are much wider than their waists, may find themselves more comfortable on softer mattresses with cushy pillow tops, while thinner people may prefer firmer beds, Dr. Bautch said.

Back pain may govern a person's choice, said Dr. Robert Gotlin, director of orthopedic and sports rehabilitation at Beth Israel Medical Center in New York.

People with pain in the spinal disks feel worse if they flex forward at the waist, so if they sleep on their backs, a softer mattress will be a problem, and they should try something firmer.

People with back pain caused by arthritis, on the other hand, feel worse if they lean backward, so if they sleep on their backs, a softer bed may feel better.

Many doctors say the choice of coil springs, water, air, latex or memory foam (the material used in Tempur-Pedic beds) is a matter of personal taste.

But Dr. Bautch has observed that his patients have more trouble adapting to latex or memory foam.

When shopping for a mattress, it pays to try them out for 5 to 10 minutes each.

How long a mattress lasts depends on how well it is made (Hastens beds, costing ,000 to ,000, come with a 25-year warranty) and on how heavy the people are who use it. Some doctors say a mattress should last 8 to 10 years, but Dr. Bautch says no more than 5 to 7.

"Do the marble test," he said. "If you drop a marble onto the mattress and it rolls to where your hips go, it's not protecting you anymore."

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