Choosing the Right Mattress: Making a Smart Investment

14 Useful Sleep Studies from 2015 Worth Reading

Choosing the Right Mattress: Making a Smart Investment | Johns Hopkins Medicine

It seems every week, there’s coverage of some new study looking at the problems associated with too little sleep—and things that we should do to be getting more of it.

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But unless you’ve got endless amounts of time on your hands, it can be tough to keep up with all the new info. So we’ve done the work for you. Here’s a look at some of the most fascinating sleep studies published this year, and how they can help you achieve more quality shuteye—and better health.

1. Sleep interruptions are worse than short sleep

Eight hours of shuteye might not be all that restorative if you’re constantly being interrupted, suggests recent Johns Hopkins Medicine findings. After just two nights of poor sleep, subjects who were woken up several times throughout the night had worse moods compared to those who slept for less time overall but weren’t interrupted.

“When your sleep is disrupted throughout the night, you don’t have the opportunity to progress through the sleep stages to get the amount of slow-wave sleep that is key to the feeling of restoration,” explains lead study author Patrick Finan, Ph.D., an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.

2. Nighttime caffeine throws off your body clock

It’s no secret that downing a cup of coffee before bed makes it harder to fall asleep. But now, experts at the University of Colorado Boulder are learning more about why. They found that when subjects consumed the caffeine equivalent of a double espresso three hours before bedtime, the caffeine caused a 40-minute delay in subjects’ 24-hour biological clock.

The findings, published in Science Translational Medicine, might explain why caffeine-drinking night owls tend to go to bed later and wake up later. What’s more? They offer clues on how properly timed caffeine could help travelers fight jet lag and stay on a more normal sleep schedule.

3. Problems controlling your emotions could lead to insomnia

Are certain personality types more prone to insomnia than others? Maybe, according to new Swedish findings. Researchers surveyed more than 2,000 adults about their emotional regulation ( impulse control or emotional awareness) and sleep habits at the start of the study, and again six to 18 months later.

They found that survey-takers who had gotten worse at regulating their emotions over time were 11 percent more ly to develop insomnia compared to people whose emotion regulation had stayed the same.

The takeaway? “These findings… suggest that teaching people strategies for regulating their emotions might help prevent new cases of insomnia to occur and decrease the risk of persistent insomnia,” explains lead researcher Markus Jansson-Fröjmark.

4. Nature could be key to better sleep

Whether it’s a tree-lined park or a serene beach, the great outdoors can help some people avoid counting sheep. In a large-scale survey of over 255,000 people, researchers found those who reported the most nights of poor sleep were less ly to have access to natural spaces. The link was particularly strong for men and adults over 65.

People who lived near green spaces tended to be more active, and it’s well known that exercising regularly can help you sleep better.

“If there is a way for persons over 65 to spend time in nature, it would improve the quality of their sleep–and their quality of life–if they did so,” says study author Diana Grigsby-Toussaint, a University of Illinois professor of kinesiology and community health, as well as a faculty member in the University of Illinois’s Division of Nutritional Sciences.

5. You might need fewer sleep meds

There are plenty of reasons to avoid prescription sleep pills whenever possible. But sometimes, your doctor might decide that sleep meds might be the right way to temporarily treat your insomnia.

But you might need less medication than you think. A Sleep Medicine study involving 74 participants found that taking half of the standard amount of Ambien (5 mg instead of 10 mg) is effective as a maintenance dose.

“The full dose may or may not be required to get the initial effect, but certainly maintaining the effect can be done with less medication,” said the study’s senior author Michael Perlis, PhD, an associate professor in Penn’s department of Psychiatry and director of the Penn Behavioral Sleep Medicine Program. Still, always talk to your doctor before making any changes to your medication regimen.

6. Managing work stress could help you snooze better

Findings published in the U.S. National Library of Medicine offer up even more evidence for something that many overworked folks already know: When your job gets crazy, your ability to get a good night’s sleep takes a nosedive.

In a study of nearly 5,000 people, researchers found that higher work demands tend to result in sleep disturbances. The culprit?

No surprise here—it’s stress. If work is affecting your ability to sleep, it might be worth talking with your boss about finding ways to lessen your load. If that isn’t possible, brainstorm other ways that you can reduce your stress levels inside and outside of the office.

7. Napping can help you think more clearly

A full night’s sleep isn’t the only thing that can boost your brainpower. According to a recent University of Michigan study, taking a 60-minute nap can make it easier to solve difficult, frustrating problems and make you less impulsive.

The findings, researchers say, could be especially important for people who need to recharge while working long shifts, healthcare workers. Fortunately, we know that shorter naps can help those with standard 9-to-5 jobs work smarter, too.

8. Eating less at night can help you deal with sleep deprivation

Whether it’s a new baby, a tight project deadline, or a pet that wants to play all night, there will be nights when eight hours of quality sleep just isn’t achievable. In those cases, limiting the nighttime snacks can help minimize the unpleasant consequences.

Recent University of Pennsylvania research found that eating lighter at night helps stave off the lack of alertness and difficulty concentrating that tends to accompany a night of fragmented sleep.

Researchers still aren’t sure how eating less minimizes the affects of fragmented sleep. But if you know you won’t be getting much sleep, consider doing lighter fare soup or salad for dinner.

9. Certain types of exercise leads to better shuteye

You know that being active is important for sleep—but more intense forms of exercise might be more effective. Recent University of Pennsylvania findings show that vigorous workouts bicycling, running, or weight lifting are associated with better sleep than just walking.

If a daily stroll around the block hasn’t done much to help you sleep better, consider ramping up the intensity. Try alternating walking with jogging, or take a fast-paced bike ride around your neighborhood. Come bedtime, you might end up snoozing more soundly.

10. You should deal with your insomnia right away

Taking steps to address insomnia as soon as it starts is more effective than waiting until it transforms into a chronic problem, says a recent study. The fix is actually easier than you would expect.

When adults who had been suffering for insomnia for less than three months underwent an hour of cognitive behavioral therapy, 60 percent reported improvements within one month, and 73 percent reported improvements within three months.

An hour of therapy for better sleep? Seems worth it to us.

11. Kids sleep better with a nighttime routine

If bedtime has turned into a battle with your little one, you might want to think about instituting a nightly routine, according to recent research from the American Academy of Sleep medicine.

In a study of more than 50 families with children between the ages of 3 and 5, experts found that having a regular bedtime helped kids fall asleep faster, wake up less throughout the night, and sleep longer. And those who also had a consistent bedtime routine— a bath or a story before bed—slept an hour longer each night and had fewer behavior problems during the day.

12. Melatonin can help you sleep better in a noisy environment

Whether you live in a bustling city or have roommates who love staying up late, taking melatonin can help.

When Chinese researchers studied the sleep quality of 40 healthy adults who were forced to snooze while listening to recordings of loud noises, those who took melatonin supplements slept better compared to those who used earplugs or eye masks. They felt less anxious in the morning, too.

13. Sleeping too much is really unhealthy

You know that logging eight hours of snooze time is essential for your health and well-being. But sleeping for longer than that appears to increase the risk for stroke by as much as 46 percent–especially among older adults, found a University of Cambridge study of more than 10,000 people.

What’s the connection? “We need to understand the reasons behind the link between sleep and stroke risk. What is happening in the body that causes this link? With further research, we may find that excessive sleep proves to be an early indicator of increased stroke risk, particularly among older people,” says lead study author Kay-Tee Shaw.

If you’re consistently sleeping for more than 8 hours a night, it might be worth setting an alarm to prevent oversleeping.

14. Mindfulness meditation promotes quality sleep

If you’re having trouble getting enough sleep, adopting mindfulness practices could make a difference, says a study published in JAMA. Compared to adults who underwent a standardized program designed to teach healthier sleep habits, those who incorporated simple mindfulness techniques into their routine reported fewer symptoms of insomnia, depression and fatigue.

Which just might make you wonder: What kind of sleep-related findings will we be in store for next year?

This article is for informational purposes and should not replace advice from your doctor or other medical professional.


A Scientists’ Guide to Better Sleep

Choosing the Right Mattress: Making a Smart Investment | Johns Hopkins Medicine
Apr 12, 2019 · 6 min readCredit: Burak Karademir/Getty Images

You already know that getting enough sleep each night is important for your health. Time spent sleeping is only part of the equation, though.

Yes, getting a full night’s rest is great, but only if it’s actually restful.

Those seven to nine hours aren’t as restorative if they aren’t uninterrupted, in line with your body’s natural rhythms, and balanced with the right amount of REM.

Better quality sleep isn’t something you can just will into being, says Dr. Vikas Jain, a sleep medicine specialist at Northwestern Medicine.

“One point I try to drive home to people is: Don’t put a ton of effort into your sleep,” he says. “Because the harder you try, the harder it will become.

You have to remember that sleep is something we want to come naturally. If you’re trying to force it, it’s going to become much more difficult.”

Below, eight sleep experts share their advice for the best ways to set up your bedroom to ensure you get a good night’s rest. Answers have been edited for length and clarity.

Think of your bed as an investment

Ideally, the bedroom has the best mattress you can afford. We’re on that surface for what should be a third of our lives, so investing in a mattress is critical. Take the time to shop around for your mattress and choose a company that makes research and development its focus.

In addition, you really want to invest in a nice set of sheets so that you’re instantly soothed and relaxed. You also want a pillow that’s supportive of your head, neck, and spinal column.

— Rebecca Robbins, postdoctoral fellow in the department of population health at NYU Langone Health

Wash your sheets often

When I’m talking with somebody about their sleep environment, one of the things I really advocate for is washing bedsheets. If you’re not doing it weekly, do it at least every two weeks.

In a National Sleep Foundation survey, one of the top things people said they d in their bedrooms was the smell of fresh, clean sheets.
— Dr.

Rachel Salas, sleep medicine specialist at Johns Hopkins University

Ban all screens

There are special receptors in the retina that are specifically there to help us differentiate between night and day, and those receptors are especially sensitive to certain wavelengths of white light, blue light, and green light.

Researchers have been studying this problem over the past decade, and a number of papers have been published showing that artificial light in the room—whether it’s from a phone, a TV, or a computer screen—becomes part of this alerting signal. So it’s important to keep your bedroom dark.

— Michael Twery, director of the National Center on Sleep Disorders Research at the National Institutes of Health

A nice thing about eliminating the TV altogether is that not only does it have the potential to impact your sleep, but then you have less temptation. If you watch TV in your living room, then you’re going to have more of a set time with which you say, “Okay, I better get to bed.”
— Dr. Vikas Jain, sleep medicine specialist at Northwestern Medicine

Add background noise

Loud background sound can help reduce noise that interferes with sleep. We recommend using white noise, as opposed to a sound that fluctuates—a white noise machine or a loud fan provides a constant sound that the mind can habituate to.
— Lisa Medalie, behavioral sleep medicine specialist at the University of Chicago

Keep a flashlight handy

I to tell my patients to sleep with a flashlight near them so if they have to get up in the middle of the night to go to the bathroom, they’re not turning on all the lights. The flashlight points downward, so it’s not activating them.
— Dr. Rachel Salas, sleep medicine specialist at Johns Hopkins University

Cool down

When your body temperature drops, this is one of the cues to your internal clock that it’s time to sleep.

Keeping your bedroom too warm can throw off this balance, so consider keeping it between 60 and 67 degrees for optimal sleep.

There are also cooling pads that can be placed on mattresses for more precise regulation of temperature during sleep.
— Dr. Vikas Jain, sleep medicine specialist at Northwestern Medicine

Sleep in a dark, cold place. Sometimes, people try to save money on air conditioning, and they’ll adjust the temperature before going to bed so it becomes warmer. But a lot of times, that can negatively impact your sleep.

If you don’t want the AC on, you can always adjust your temperature by getting a fan. Even in the winter, I’ll use a fan—not necessarily because I’m hot, but because it serves two purposes: One, I live in the city, so it acts as a white noise machine, and two, it’s for the temperature.
— Dr.

Rachel Salas, sleep medicine specialist at Johns Hopkins University

Think of light as a tool

Natural light is kind of a stimulator of our wake cycle, so getting natural light within about 30 to 60 minutes of waking up in the morning can be a good cue for wakefulness.

People who have a typical sleep schedule should open their windows or curtains in the morning and let the natural light come in.
— Dr.

Katherine Green, medical director for the University of Colorado Sleep Center

For those who have trouble waking up in the morning, we to see a light box in the bedroom. Exposure to light at the same time every day tells your brain it’s time to be awake by signaling the stopping of melatonin production. If you can find a light box with an alarm feature, it’s a great way to wake up.
— Lisa Medalie, behavioral sleep medicine specialist at the University of Chicago

Have a bedtime scent

The most helpful thing people can do is set up a routine that gives their body some environmental cues that it’s time for bed, and aromatherapy can absolutely be useful here.

For a lot of people, scents lavender, valerian root, and chamomile can be a cue. If you do it at the same time every day, that starts your bedtime routine and gives you a 20-minute period where you can wind down and get yourself ready for sleep.
— Dr.

Katherine Green, medical director for the University of Colorado Sleep Center

Clean up

If you have a messy room, then cleaning it is just another thing you could be thinking about in bed. It’ll just spark things you have to do, if you have laundry on the floor, for example, it’ll spark thoughts about one more thing you have to do.
— Dr. Rachel Salas, sleep medicine specialist at Johns Hopkins University

Eliminate distraction

The bed is allowed to have two types of activities: sleep and sex. That’s it. People should limit even eating in bed. And going on the computer in bed is one of the worst things you can do.

But, for some people, if they just read a book—not the Kindle or an electronic device, but a book, with a little bit of dim light—that’s okay.
— Dr.

Vsevolod Polotsky, director of the Polotsky Research Lab for sleep and breathing at Johns Hopkins University

Stick to a sleep uniform

Some people sleep in the nude; some people have pajamas on—whatever the case may be, something consistent is ideal. The brain really s being keyed in to that bedtime routine. So if you have a good bedtime routine and environment, you’re going to have better quality sleep.
— Dr. Rachel Salas, sleep medicine specialist at Johns Hopkins University

Create a space you’re happy to spend time in

Room colors should generally be soothing and create a relaxed atmosphere in the bedroom. It should be a comfortable, cozy den, with colors, furniture, bedding, and soft lighting that make the space special for you. You have to love your bedroom.
— Dr. Alex Dimitriu, founder of Menlo Park Psychiatry & Sleep Medicine

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Choosing the Right Mattress: Making a Smart Investment

Choosing the Right Mattress: Making a Smart Investment | Johns Hopkins Medicine

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Does the idea of a good night’s sleep feel it’s just a dream? Thesecret to a better rest might lie in your mattress. 

And because you’re (hopefully) spending the recommended eight hours per night on it, it’s an important investment.

The good news: There’s no right or wrong way to choose a mattress, and you have plenty of options to pick from. It’s all about personal preference, says Sara Elizabeth Benjamin, M.D. , a neurologist and sleep medicine specialist at the Johns Hopkins Center for Sleep .

“Choosing your mattress is really individualized, and degree of firmness is a really personal decision. The most important thing is to try it out,” Benjamin says.

When is it time for a new mattress?

Most adults need seven to eight hours of sleep to feel refreshed—and if you’re spending eight hours per night on your mattress, it’s going to wear out over time.

“Realistically, you should replace your mattress every ten years or so,” says Benjamin.

But pay attention to your body’s cues: If you’re suffering from aches and pains, you may need to replace your mattress sooner.

“If you feel more sore in the morning, that may be a sign that your mattress is wearing out,” Benjamin says. “If you’ve recently slept somewhere else, a friend’s house or hotel, and you feel you were more comfortable than in your own bed at home, you might realize that your mattress isn’t what it needs to be.”

A sound investment: how to choose the best mattress

buying a new car or finding just the right pair of jeans, you should choose a new mattress in person. Here’s how to do it.

  • Narrow your options body type . Some mattresses are recommended for people of a certain weight, so you make sure that your body type is appropriate for the mattress.
  • Take your time . “Lie down on the mattress for more than just a few seconds,” Benjamin recommends. Consider visiting the store at off hours when you know it won’t be crowded, so you don’t feel self-conscious about getting cozy for a bit.
  • Align with your partner . If you share a bed with someone and can’t agree on firmness, or if you or your partner have conditions  acid reflux where sleeping on an incline is important, look for mattresses that allow each side to be adjusted separately.
  • Ask about warranties and return policies . Benjamin warns that sometimes the mattress that seems perfect in the store isn’t the right fit once you get home. “You should ask about any long-term or short-term guarantees, because you’re not going to be lying in the store for as long as you’re lying in bed at night. There’s no way to know how a mattress will perform over time,” she says. “Some places may let you try out a mattress for a month, and if you don’t it, you can switch for a small fee.”

Spend sensibly

When it comes to mattresses, comfort is priceless, but the most expensive mattress isn’t always the coziest. “You don’t want to lose sleep over paying for a mattress,” Benjamin says. “You have to consider affordability.

There’s quite a range of prices, so you have to consider this as an investment: Decide on what’s an acceptable price to pay and be comfortable with that, too.

” After all, you don’t want anxiety over your mattress budget to keep you up at night.

Try It

If you and your partner have vastly different sleep preferences orneeds—such as a need for elevation due to sleep apnea or orthopedicissues—think creatively: “You should consider two extra-long twins and pushthem together,” Benjamin says. “That way you can each have your ownmattress.”


NASA, Hopkins has its own command center

Choosing the Right Mattress: Making a Smart Investment | Johns Hopkins Medicine

On July 25, 2017, Rodney Matthews had gotten off work and was headed to a day spa to buy his wife a birthday gift. He was checking out when he started experiencing minor pain in his chest. He barely made it to the chair. When he sat down, he could no longer feel his legs.

“My life was on the line and I didn't know what was going on with me,” said Matthews.

The woman at the counter called 9-1-1. Matthews called his wife and his mom letting them know he was going to the hospital. 

He remembers being picked up by the ambulance. 

“All I knew, from what I can remember, was saying ‘God, I don't want to die,’” said Matthews.

He only learned what was going on with him after he awoke following ten hours of surgery at Johns Hopkins Hospital in Baltimore.

Johns Hopkins medevac transported Matthews from Howard County General Hospital to Johns Hopkins

Matthews suffered an aortic dissection. A condition that kills 50 percent of people within 48 hours without surgery. For Matthews, every second and minute counted that day. 

“I could've been brain damaged, I could've been paralyzed, I could've been dead in a matter of just a few hours,” Matthews said.

If he had taken his motorcycle, which he thought about doing; if he was swimming, which he had planned on doing later; or if he was driving or on the metro when the tear in his aorta occurred, Matthews could’ve been dead on the spot.

It was by chance that Matthews was at the day spa when his medical crisis occurred, but it was the Johns Hopkins Capacity Command Center that made sure he received treatment as quickly as he did.

The system, powered by GE Healthcare, uses simulation modeling, optimization modeling, and predictive analytics to better manage the hospital capacity every minute of every day.

Scheulen on addressing emergency department boarding

The wall of computer monitors assess, predict, and inform operators of the status of every bed, operating room, machine, and personnel.

And the system worked perfectly back on that day in July.

“As the physicians were talking, bed managers knew he was coming, so they were finding a place, the lifeline transport team knew they were going to have to go get him, so they were dispatching the aircraft.

All of those things came together in perfect synchrony to get him here as quickly as he got here,” said Jim Scheulen, chief administrative officer of emergency medicine and capacity management for Johns Hopkins Medicine.

To optimize efficiency and increase coordination, Scheulen looked to NASA and air traffic control and realized he needed all the key people in the same room.

“What we're trying to do is get the right patient to the right bed at the right time and what the air traffic control system tries to do is get the right plane to the right airport in the right time and we're both trying to do it safely,” Scheulen said.

He said patients get to Hopkins faster and because of that they have better outcomes. And in the two years the center's been here, they've seen improvements.

“We've increased the number of patients we're able to take from outside hospitals, we significantly reduced our ED boarding time, which is a major issue with ED crowding and we have dramatically improved the number of cases we're able to do in our operating rooms, which means we're able to serve the community better than we have in the past,” said Scheulen.

It’s a leap forward but not a solution to a problem plaguing emergency departments all across the country, particularly in Maryland where emergency room wait times are the worst in the country.

ER wait times


The red numbers flashing across the screens are meant to trigger alarm, but here, they’re a common theme.

“They're running at 97 percent occupancy. Neuro is 99 percent full. Medicine is overcapacity so that means there are patients in the ED, there are patients in procedure areas waiting to go to beds,” said Scheulen, interpreting the numbers on the monitors.

He said since they can't add beds, they're trying to deal with the influx as best they can by working to turn beds over faster. The system even added environmental services staff into the equation.

“We may have staff on this floor but the pressing need is for three beds on this floor, so let's move some staff down, have them help out and clean these other beds and then go back to their regular duties,” said Scheulen.

Never before has Scheulen seen numbers these.

Some screens update within a matter of seconds and the oldest piece of information is three minutes.

“We are able to tell the status of every bed in the hospital every minute,” said Scheulen.

The predictive models are constantly learning and are even able to show hospital capacity in the future.

“We are 96 percent sure that at six o'clock two days from now, two mornings from now, we're going to be at a census of 186 in the department of medicine,” said Scheulen.

 Scheulen: “We are able to tell the status of every bed in the hospital every minute”

While Scheulen and his team only see numbers, they know the people behind them are real and require their help. They don’t treat them medically, but their key role helps patients Rodney beat the odds. 

“Every day I come in here and I ask people, ‘how many lives have you saved today?’ And their answer is typically, ‘all of them.

’ And while it's a light-hearted joke, I think everybody who works here understands that we're here and what we do impacts patients every minute of every day.

And I think it's a great source of pride for the people who work here that they really do impact patient's lives. Look at what happened to Rodney,” said Scheulen. 

The Johns Hopkins Capacity Command Center was the first command center in the world at one time. There’s now one in Toronto. GE Healthcare also said it expects to open 5-10 command centers across 30 hospitals this year.

Scheulen said everyone who is considering opening a center has visited the Capacity Command Center in Baltimore.

And while they're not for every hospital, for large systems Hopkins, Scheulen believes this model is the future of health care.