Is sleeping on the floor medically approved?

June 29, 2009 8:16 AM

Hard medical evidence about sleeping on a hard, flat surface?

There's a good discussion of the anecdotal pros and cons of sleeping on the floor already, but I'd like to know if anyone can point me to something more scholarly / Government health department guidelines or anything vaguely authoritative?

posted by KMH to Health & Fitness (2 answers total)

This article might be a good place to start:

Biomechanical effects of a lumbar support in a mattress.

It's not exactly what you're looking for, but it has some other potentially helpful studies cited in the references section.
posted by tipthepizzaguy at 9:20 AM on June 29, 2009

So a quick PubMed search turned up the following (my highlights):

This study is pretty good:

Lancet. 2003 Nov 15;362(9396):1599-604.
Effect of firmness of mattress on chronic non-specific low-back pain: randomised, double-blind, controlled, multicentre trial.
Kovacs FM, Abraira V, Peña A, Martín-Rodríguez JG, Sánchez-Vera M, Ferrer E, Ruano D, Guillén P, Gestoso M, Muriel A, Zamora J, Gil del Real MT, Mufraggi N.
Scientific Department, Kovacs Foundation, Palma de Mallorca, Spain. [e-mail]

BACKGROUND: A firm mattress is commonly believed to be beneficial for low-back pain, although evidence supporting this recommendation is lacking. We assessed the effect of different firmnesses of mattresses on the clinical course of patients with chronic non-specific low-back pain. METHODS: In a randomised, double-blind, controlled, multicentre trial, we assessed 313 adults who had chronic non-specific low-back pain, but no referred pain, who complained of backache while lying in bed and on rising. Mattress firmness is rated on a scale developed by the European Committee for Standardisation. The H(s) scale starts at 1.0 (firmest) and stops at 10.0 (softest). We randomly assigned participants firm mattresses (H(s)=2.3) or medium-firm mattresses (H(s)=5.6). We did clinical assessments at baseline and at 90 days. Primary endpoints were improvements in pain while lying in bed, pain on rising, and disability. FINDINGS: At 90 days, patients with medium-firm mattresses had better outcomes for pain in bed (odds ratio 2.36 [95% CI 1.13-4.93]), pain on rising (1.93 [0.97-3.86]), and disability (2.10 [1.24-3.56]) than did patients with firm mattresses. Throughout the study period, patients with medium-firm mattresses also had less daytime low-back pain (p=0.059), pain while lying in bed (p=0.064), and pain on rising (p=0.008) than did patients with firm mattresses. INTERPRETATION: A mattress of medium firmness improves pain and disability among patients with chronic non-specific low-back pain.

This study is so-so:

Spine. 2008 Apr 1;33(7):703-8.
Better backs by better beds?
Bergholdt K, Fabricius RN, Bendix T.
Back Research Center, Part of Clinical Locomotion Science, Backcenter Funen, Ringe, Denmark.

STUDY DESIGN: A "randomized"/stratified, single-blinded, parallel-group study. OBJECTIVE.: To evaluate 3 structurally different mattresses relative influence on patients with chronic low back pain (CLBP). SUMMARY OF BACKGROUND DATA: In several advertisements, it is proclaimed that certain mattresses have a positive effect on LBP, and especially a hard mattress is commonly believed to have a positive effect. METHODS: One hundred sixty CLBP patients were randomized to 1 of 3 groups, having a mattress/bed mounted in their sleeping room for 1 month. The beds were: (1) waterbed (Akva), (2) body-conforming foam mattress (Tempur), and (3) a hard mattress (Innovation Futon). At baseline and after 4 weeks, a blinded observer interviewed the patients on LBP levels (0-10), daily function (activities of daily living, 0-30), and on the amount of sleeping hours/night. RESULTS: Because of dropout of 19 patients before baseline, the analyses were performed on 141 patients. During the 1-month trial period another 27 patients stopped ahead of time, which were accounted for by "worse case" as well as "no-change" analyses. Both the waterbed and the foam mattress seemed superior to the hard mattress, especially when using the probably most relevant "worst case" data. There were no relevant difference between the effects of the water bed and the foam bed. CONCLUSION: The Waterbed and foam mattress' did influence back symptoms, function and sleep more positively as apposed to the hard mattress, but the differences were small.

FWIW, I searched the following terms in PubMed: "sleeping AND mattress AND hard AND back"
posted by scblackman at 9:35 AM on June 29, 2009