Let’s start with a simple acknowledgement: Firm mattresses are excellent for sleepers who are seeking relief from back and joint pain, or simply prefer a more supportive feel. While many top mattresses are categorized as medium-firm, a true firm mattress is especially important for back and stomach sleepers who require extra attention to their natural spine alignment.
But with so many great options on the market today, how should you decide which firm mattress will be right for you? Well, you’ve come to the right place. In this comprehensive guide, Michael Breus, Ph.D, the Sleep Doctor, weighs in on the best mattress options that will address your specific sleep needs. With help from the team at Mattress Advisor, each of the mattresses selected in this article underwent hours of rigorous testing in their mattress lab based in Raleigh, North Carolina. Tests follow 14 criteria points that mattresses have to meet, and are rated on a scale of 1-10, with ten signifying a perfect score. Find out about the Sleep Doctor’s picks for the best firm mattress.
Each product we feature has been independently selected and reviewed by our editorial team. If you make a purchase using the links included, we may earn commission.
We’ll outline some of the primary selling points of each of these mattresses. But before we do that, let’s focus on some of the main factors to keep in mind while shopping for a firm mattress.
Something that can’t be overstated is that not all firm mattresses are created equal. In fact, just because you’re concentrating your research on the upper end of the firmness scale, that doesn’t mean all the products you see are going to be similar. There’s a lot of variation in materials, edge support, motion isolation, pressure relief and of course, price point.
One of the main reasons to choose a firm mattress is because you struggle with back pain. According to the American Chiropractic Association, about 80 percent of adults will deal with lower back pain at some point in their lives. For about 20 percent of adults, that pain becomes a chronic occurrence.
Switching to a firmer mattress may help to alleviate some of this pain. The reason for this has everything to do with pressure relief and support. When you lay down, your body weight naturally presses down on certain joints and pressure points, including your lower back and hips. This can exacerbate pain and stiffness, when not properly supported. A pressure relieving mattress will actually help to distribute your body weight more evenly, meaning your pressure points won’t be under as much strain while aligned. For many people this can help mediate chronic back pain.
“Overall I am often recommending a firm bed, especially for my patients who suffer from back pain,” says Dr. Breus. “A firm bed will allow you to have a consistent sleep posture, or healthy sleep position. Softer models allow for too much flexibility, and lower support in many cases.”
Different people have different sleep positions; for example, you may prefer to lie down on your side, back, or stomach. Sleeping position is an important factor to consider any time you read a mattress review or shop for a new type of mattress.
“Once you have moved into the firmer range of beds, then you can help refine that choice by understanding the requirements of the bed based on your starting sleep position,” says Dr. Breus.
Statistically speaking, a majority of Americans prefer sleeping on their side. If that’s you, then we’d actually recommend thinking twice before purchasing too firm of a mattress. Most side sleepers want something more plush that will offer a contouring sensation for their body. A firm mattress may not have as much “give,” particularly at the shoulders and hips, which can cause soreness and stiffness.
For back sleepers, on the other hand, a firm mattress is highly recommended. A firm mattress will support the natural curve of the spine, and provide pressure point relief at the shoulders, hips, and heels.
Like back sleepers, stomach sleepers typically enjoy a firmer bed. Indeed, the firmness is needed to prevent a stomach sleeper’s back from curving up into a painful or unnatural position.
When it comes to combination sleepers, deciding where you fall on the firmness scale can be tricky. A combination sleeper is someone who changes their sleeping position multiple times throughout the night; for example, you may fall asleep on your back but wake up on your stomach. It really comes down to your dominant sleeping position. If you tend to alternate between back and stomach, a firm model may be just the thing. But if you know you spend a lot of the night on your side, we’d probably recommend something in the medium-firm range.
As you think about firmness level, also think about mattress type. Again, there are a number of options to choose from, and it really comes down to your comfort preferences, sleep position, and budget.
Memory foam mattresses have been very popular in recent decades. An all-foam mattress should give you a “sinking feeling” as your body is cushioned and hugged to sleep. Foam mattresses don’t creak or make noise like innerspring beds sometimes do, and they tend to offer great motion isolation, which makes them perfect for couples who share a bed. The downside: Memory foam often traps and retains body heat. Gel memory foam can sometimes alleviate this, and offer a cooler sleep experience, but you must understand the details of the materials, to find the right one.
If you see a mattress marked as a hybrid, it just means that it’s made from a combination of materials such as foam, innerspring coils and latex. Ideally, hybrid mattresses unite the best aspects of their source materials and give you the best of all possible worlds.
An innerspring mattress is made with a system of springs, or coils. Innerspring mattresses tend to keep you cool. They also offer some “bounce,” which is important for combination sleepers. The biggest downside is that they can sometimes be a little noisy. Overall innerspring mattresses tend to be on the firmer side.
Natural and synthetic latex are both cool and supportive, and an all-organic option is ideal for eco-friendly shoppers. A lot of the time, latex mattresses are on the pricey side, so that’s something to be aware of. They are great for side sleeping since they have a good bit of “give” in the material while still maintaining excellent support.
Mattress firmness can fall anywhere from “plush” to “firm,” with most products somewhere in between. Consider a scale of one to 10, where one is the softest option and 10 is the firmest. Most popular mattress models are in the five to seven range. Mattresses included in this roundup fall between an eight or nine on this scale.
As you get ready to invest in a new firm mattress, what are the best options for your sleep position, comfort preferences, and body type? Here are our top picks.
For those who prefer innerspring coils over polyfoam, consider the Saatva Classic. The Saatva is a truly top-of-the-line mattress product, with a reputation for extreme comfort. Have you ever stayed at a fancy hotel and been amazed by the high-quality mattress you slept on? Saatva tries to replicate that same effect.
The Saatva Classic is actually available in a plush, firm, or luxury firm option. The luxury firm option is about an eight out of 10 on the firmness scale. The Saatva Classic also comes with free white-glove delivery, setup and mattress removal. This means someone will actually set up your Saatva in your bedroom for you and take away your old bed, a perk especially for senior sleepers and those who may need setup assistance. It offers ample support for people who struggle with back pain. And finally, it’s robust and durable, offering plenty of support for heavyweight sleepers.
The Casper Wave Hybrid truly is a mattress that embodies the best of all worlds. It offers a memory foam comfort layer for comfort, plus an innerspring coil system for additional support, bounce and durability. There is even a latex foam layer, contributing some extra buoyancy.
There’s plenty to appreciate about the Casper Wave Hybrid, but we rate it one of the best mattresses for back pain thanks to its excellent pressure-relieving properties and responsiveness. Also note that it helps you maintain a neutral spine position through the night, which is especially good news if you’re a side sleeper. The Casper Wave Hybrid will help you wake up in the morning without feeling stiff or creaky.
If you’re looking for a mattress that’s made with organic materials, offering a minimal ecological footprint, the Awara deserves your consideration. This hybrid mattress combines a number of high-end natural materials, including Dunlop latex, organic cotton, and sustainably-sourced metal coils.
And that’s just for starters. The Awara mattress offers the firm support that back and stomach sleepers crave. Hot sleepers will love its latex construction, designed to absorb extra body heat to keep you cool. And it delivers excellent edge support designed to help keep you in the center of the bed. The Awara excels in many areas but doesn’t necessarily score well in the pressure relief category. Those who suffer from back pain may want to look elsewhere.
For those who want a really firm mattress at the upper end of the firmness scale, the Sleep Doctor recommends the Plank. This aptly named mattress is a product of the Brooklyn Bedding company. This memory foam bed is flippable, with each side offering a different firmness option. Rest assured that both of them are quite firm: One side of the mattress is about a seven out of 10, and the flipside is more like a nine.
There’s a lot to be said for the Plank’s durability and support, as well as its pressure point relief. If laying down on a firm surface is the only thing that helps your lower back pain, this may be the right product for you; it’s made to evenly distribute your body weight, promote healthy blood flow, and alleviate the symptoms of chronic pain. It also happens to be a good option for budget shoppers, available for a low price point.
Helix offers a number of different mattresses, varying in their firmness levels as well as their high-end-luxury features. The Helix Dawn, however, is the line’s best option for people who sleep on their stomachs.
Customer report that the Helix Dawn is a top pick for stomach sleepers, providing firmness and support needed to uplift pressure points and the lower back. Some other reasons to think about the Helix Dawn: Sleepers say it delivers on both motion transfer and edge support while sleeping cool. And it’s made with durability in mind, meaning it should last a while. The Helix Dawn is also available for a reasonably low price point.
Note: The complete results of the Mattress Advisor review of the Helix Dawn are coming soon.
If you deal with chronic pain in the hips, shoulders, or ankles, stiffness, or inflammation, you might benefit from the Puffy mattress. It’s pretty firm (about a seven out of 10), and rates highly with regard to pressure point relief.
The Puffy mattress earns the title “best memory foam” on this list thanks to its three layers: two memory foam and one base layer of dense support foam. It’s this construction that gives Puffy a reputation for delivering that all-enveloping feel that classic memory foam is known for. Also take into account the outstanding motion transfer properties which is a helpful feature for couples who share a bed together.
For those seeking a truly classic firm feel at an affordable price point, the best overall option is the Nectar. Its cushioning design is perfect for side sleepers and combination sleepers, yet there’s just enough rigidity here to work for stomach and back sleepers, too.
What makes the Nectar truly special is that it offers incredible value. It’s not only available at an affordable price point, but also there’s a year-long sleep trial and a lifetime warranty included in your purchase.
Nobody wants to wake up feeling sticky and sweaty, or to find their mattress so hot that they toss and turn and struggle to fall asleep in the first place. A lot of mattresses actually absorb and retain heat, especially if there’s a top layer of memory foam. If you’re especially heat-sensitive, or know that your body tends to run hot, the Brooklyn Aurora is designed to sleep cool. The Brooklyn Aurora is a luxury hybrid that comes in three firmness levels: Plush, medium, and firm. It’s made with an infusion of copper gel and scores high marks in spinal alignment, responsiveness, and motion transfer.
What about sleepers who aren’t totally sure whether they need a firm mattress or a plush one? The Layla allows sleepers to have both options thanks to its unique, flippable design. Give the firm side of the mattress a try, and if you don’t like it, the softer side is ready and waiting for you.
This hybrid mattress offers both foam and coil layers, which means it’s supple and supportive but also sleeps cool. It accommodates most sleeping positions and body types, though it’s not rated well for heavyweight sleepers who also prefer to lie on their stomachs. Thanks to its flexibility, this is a popular option in guest rooms and among kids and adolescents.
There’s not just one perfect mattress out there that works for everyone. All of us have our own unique preferences, and there are a lot of factors to juggle, from sleep position to body type. As you consider these questions on your search for a new bed, consider the options available on the Sleep Doctor’s list of highly recommended firm mattresses.
American Chiropractic Association, 2020. “Back Pain Facts and Statistics” American Chiropractic Association. https://www.acatoday.org/Patients/What-is-Chiropractic/Back-Pain-Facts-and-Statistics
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