Best Mattress for Back Sleepers

Back sleeping is the second most common sleeping position behind side sleeping. Its main benefit is that when you’re on your back, your body is naturally aligned over your spine. Maintaining this alignment is key for back sleepers, so your ideal mattress needs to support the hips and shoulders without putting too much pressure on them. Thus, an even sleep surface with some conforming but no sagging is usually the best bed for back sleepers.

What to Consider as a Back Sleeper

“Sleep position is important to consider because it can significantly impact your overall health, comfort and sleep quality,” says Sleep Medicine Physician Lulu Guo, M.D. “Different sleep positions have unique needs when it comes to mattresses and accessories to ensure proper support, comfort and alignment.”

Dr. Guo goes on to say choosing the right firmness is crucial for any sleep position. “For back sleepers,” she says, “medium firm mattresses may be the most ideal as they provide enough support for spinal alignment while offering some cushioning for comfort. Whereas for side sleepers, a softer mattress may work well to provide cushioning for the shoulders and hips while still providing support. Lastly, firmer mattresses may be most suitable for stomach sleepers to prevent the hip from sinking too low causing misalignment of the spine.”

Spine Alignment

Spinal alignment refers to how well the spine lines up to its natural shape. Maintaining good spinal alignment overnight can help reduce aches and pains, contributing to a better night’s sleep. Because of this, the University of Rochester Medical Center suggests that regardless of sleep position, sleepers should try to line up their ears, shoulders, and hips to maintain proper spinal alignment. 

One benefit of back sleeping is that your body is naturally centered over your spine.This makes it easier to maintain proper spinal alignment, as long as your mattress provides enough support to the shoulders and mid-section to prevent them from sinking too deeply. Back sleeping may also reduce the risk of developing wrinkles or breakouts on your skin and can alleviate lower back pain for some sleepers.

Sleep Apnea and Other Conditions

While back sleeping has some clear benefits, it isn’t ideal for all sleepers. Those who suffer from sleep apnea or are prone to snoring may find their conditions aggravated by sleeping on their backs. People with acid reflux or gastroesophageal reflux disease (GERD) may also notice increased symptoms when sleeping on their backs, especially for sleepers with extra weight in their midsections that adds pressure in that area. 

Predominant side sleeping, more specifically left sided sleeping, is recommended for the second and third trimesters of pregnancy. Pregnant women often find that sleeping on their backs can contribute to back pain due to the extra weight in their midsections. Laying on the back can also compress a major vein which can decrease blood flow to the fetus and the mother’s organs.

Back Sleepers With Back, Neck, and Shoulder Pain

Improper alignment can contribute to aches and pains. If your mattress doesn’t have the right balance of contouring and support, your muscles may work overtime to try to improve your body’s alignment. Since these muscles can’t fully relax, you may wake up with more aches and pains. If you do experience aches and pains in the morning, it may be worth looking at a new mattress.

How to Choose a Mattress for Back Sleepers

While many mattress companies claim their models are comfortable for all sleep positions, back sleepers have unique needs. Focusing on the most important mattress features can help you find a mattress that supports your spine while cushioning your pressure points. Below, we’ll detail key factors to consider when selecting the best mattress for back sleepers.

Firmness and Support

A mattress’s firmness influences how much the sleeper sinks in, how comfortable the mattress feels, and how supportive it is for certain body types. A 10-point firmness scale is commonly used to rate mattress firmness. In this scale, 1 is the softest mattress and 10 is the firmest.

Back sleepers often favor slightly firmer mattresses than their side-sleeping counterparts. This is because back sleepers require more support to maintain the natural alignment of their spines, but they don’t experience the same types of pressure points that side sleepers often do. Too soft of a mattress may cause a back sleeper’s hips to sink in too far, while too firm of a mattress may not allow their hips to sink in far enough. “Long term consequences of this causes misalignment of the spine and can cause low back pain,” adds Dr. Guo.

Body Weight

The right firmness level for you depends in large part on your body type. Most individuals between 130 and 230 pounds prefer a medium or medium firm mattress. Average-weight back sleepers usually gravitate towards the firmer end of this range since they don’t require as much conforming as side sleepers.

Sleepers who weigh under 130 pounds don’t apply as much force on a mattress, so any mattress is likely to feel firmer to them. Because of this, back sleepers in this range often prefer a medium or medium soft model.

Individuals who weigh over 230 pounds need more support than other weight groups. Too soft of a mattress may cause their hips to sink in excessively, misaligning the spine. These sleepers frequently favor a medium firm or firm mattress to give them extra support.

Contouring

Many mattresses contour to the body, adjusting to each sleeper’s unique shape. This can help support a back sleeper’s spinal alignment while relieving pressure points. Mattresses vary in how much contouring they provide, with softer mattresses and those containing foam offering the most. Back sleepers typically prefer a moderate level of contouring to fill in the space around their lower backs while not allowing for too much sinking.

Pressure Relief

Pressure relief is closely linked to contouring. When a mattress contours to a sleeper’s body, it distributes their weight more evenly. This can take the pressure off heavier body parts, like the hips and shoulders. While back sleepers don’t usually suffer from sharp pressure points like side sleepers, they may still appreciate a mattress that cradles their hips.

Quality Materials

Quality materials can impact how comfortable a mattress feels and how well it holds up over time. Mattress sagging is often a problem for back sleepers, and high-quality materials frequently resist sagging better than lower-quality alternatives.

Which Type of Mattress Is Best for Back Sleepers?

While individual models may have notable differences based on their materials, quality, and construction, there tend to be some similarities between models of the same type of mattress. Understanding the key benefits and features that are common for each type of mattress may clarify which type is best for you.

Hybrid

Hybrid models have a thick comfort layer of memory foam, polyfoam, or latex, though it may also contain wool, microcoils, or other materials. The support core uses pocket coils, which move independently of one another and minimize motion transfer, unlike those typically found in innerspring mattresses.

A hybrid’s balance of contouring and support make it a good fit for back sleepers. The generous comfort layer is engineered to conform to the sleeper’s body for pressure relief and the coil support core gives solid, even support, which can help promote proper spinal alignment for back sleepers

Innerspring

A substantial support core of coils serves as the main component of an innerspring mattress, and they may also have thin comfort layers. While these comfort layers may provide some cushioning, they’re usually not substantial enough for contouring and pressure relief.

High-quality innerspring mattresses usually have even support that can help keep a back sleeper’s spine straight. Thin comfort layers may cushion the sleeper’s pressure points, but they generally are not thick enough to allow a back sleeper’s midsection to sink in too deeply.

Latex

Latex mattresses are traditionally constructed of multiple layers of latex foam, which may be natural, synthetic, or a blend. Talalay latex is usually lighter and springier and is commonly used in comfort layers. Dunlop latex is generally denser and more durable, making it a popular choice for both comfort and support layers.

While memory foam compresses directly beneath the sleeper’s body, latex spreads the compression over a wider area. This cradles the sleeper without excessive sinkage, creating a balance between cradling and support that may make back sleepers feel like they are floating on the bed.

Airbed

Airbeds get their name from the air chambers they use to support the sleeper. Depending on the model, these air chambers can be emptied or filled using a pump, remote control, or app. Airbeds may also include comfort layers, though these are usually relatively thin. Comfort layer materials may include memory foam, polyfoam, latex, wool, and/or cotton.

Since the air chambers can be filled or emptied to change the feel of the mattress, back sleepers can adjust an airbed to get as close as possible to their ideal firmness. Some models also allow sleepers to adjust each side of the bed independently, which may make them a good choice for partners who have different firmness preferences.

Foam

Most foam mattresses are constructed of multiple foam layers, which usually include memory foam, polyfoam, or a combination of the two. Softer foams are traditionally used in the comfort layers to contour to the sleeper, while firmer support foams prevent them from sinking in too deeply.

All-foam models tend to shape to the sleeper’s body, providing a close hug that relieves pressure points. Firmer models give less hug, but they still usually contour enough for pressure relief. Back sleepers who like to sink into their mattress may appreciate this close conforming. “Firmer foam mattresses may have the dual benefit of conforming to the body yet have enough support for back sleepers for spine alignment,” says Dr. Guo.

Important Accessories for Sleeping on Your Back

Accessories can be the finishing touch to make your sleep surface more comfortable. While you might upgrade your accessories when you purchase a new mattress, sleepers on a budget may look to  them as a lower-cost alternative to replacing their mattress.

Pillows

While the right mattress can keep most of the spine aligned, your pillow is responsible for continuing that alignment into the neck and head. The wrong pillow can contribute to back and neck pain.

Pillow loft refers to how thick a pillow is. A pillow with too much loft may force a back sleeper’s head towards their chest. A pillow with too little loft may hyperextend the neck. The best pillows for back sleepers are medium-loft pillows that support the head, neck, and shoulders without lifting them up too far. Back sleepers often prefer memory foam or latex pillows that cradle the head to help them maintain proper alignment.

While many back sleepers favor a medium-loft pillow, those with medical conditions aggravated by lying flat may prefer a wedge pillow to elevate the upper body. Sleepers who suffer from sleep apnea, acid reflux, or frequent snoring may also benefit from this extra lift.

Sleeping Position	Pillow Loft Recommended
Back	Medium
Side	Medium or High
Stomach	Low

Many back sleepers also place a small pillow beneath their knees. “Placing a pillow under the knees can help with spinal alignment because, when laying flat, the lower back can arch excessively,” says Dr. Guo. “A pillow under the knees elevates the legs slightly, reducing this arch and keeping the spine in a more neutral position. Elevating the legs can also take pressure off the lower back, further promoting more relaxation during sleep.”

Mattress Toppers

A mattress topper is an extra layer that rests on top of the mattress to adjust the feel of the surface. While a mattress topper won’t completely overhaul your existing mattress, it may make it more comfortable.

Because mattress toppers are usually less expensive than purchasing a new mattress, they can be a convenient and affordable way to modify the sleep surface and try out different materials. Memory foam, polyfoam, and latex toppers can give you an idea of how a mattress that uses these materials might feel without the commitment of replacing your existing mattress.

While mattress toppers can add some cushioning and contouring, they don’t provide all the benefits of a new mattress. Most notably, they don’t usually provide significant support. If your hips are sinking in too deeply in your existing mattress, a mattress topper is unlikely to resolve the issue. A mattress topper also won’t make up for a mattress that is in bad condition or is sagging. However, a mattress topper may be a good choice for back sleepers who feel their mattress is a little too firm or who are experiencing pressure points.

How We Test: Your Comfort Is Our Science

Our industry-leading product testing team cares deeply about improving your sleep. Having a holistic understanding of a mattress’s role as part of a sleep system is paramount to our testing process. Since a bed’s comfort and feel depend largely on body weight and sleeping position, our testing team represents a wide range of body types, sleep positions, and comfort preferences.

In our Seattle-based Test Lab, we use an objective, hands-on process to evaluate mattresses across performance categories. The following are the key guidelines that inform our performance ratings. Our ultimate goal is to ensure you have all the information you need to make the best purchase decision for you.

How We Determine Our Overall Scores

To determine a mattress’s overall score, we assign weighted percentages to performance categories based on how important they are to the individual sleep experience. For instance, areas like pressure relief and temperature control tend to matter more to people than something like off-gassing, and because more people sleep on their side and back than on their stomach, we weigh those positions more heavily

Dive Deeper – Mattress Guides by Sleeper Type

If you want to expand your options beyond beds for back sleepers, you can read through our collection of mattress guides categorized by sleeping preferences.