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What is a mattress with adjustable firmness and how do they ease hip, neck and back pain?

Eve Davies
7–9 minutes
(Image credit: Sleep Number)

Sleeping on a mattress with the wrong firmness level for your sleep position and body weight can lead to neck, hip and back pain. The pressure build up caused by sleeping on a bed with the wrong tension can leave you feeling stiff and sore in the mornings. However, mattresses with adjustable firmness can offer just the right support, even as you shift positions during the night.

But what is an a mattress with adjustable firmness and how exactly do they help keep pain at bay? Unlike a traditional mattress, a mattress with adjustable firmness can change its tension in accordance with your sleeping position. This can be done through a click of a button or via inbuilt sensors that detect the position change.

If you are looking to buy a new mattress, there are some great options in our best mattress of 2024 guide. But if you're curious about how an adjustable mattress can benefit your sleep, we'll outline the pros (and any cons ) here. We'll also pick out top-rated adjustable mattresses that you can shop today, plus run through what you can expect to pay for this sleep tech.

What is a mattress with adjustable firmness?

Mattress firmness refers to how soft or hard a mattress feels when you lay on it. It can differ between manufacturers and different sleepers have different perceptions of firmness. That said, there are three main firmness levels – soft, medium-firm and firm – each of which accommodates different sleep needs depending on sleep position, body weight and whether you bed share.

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The stand-out feature of a mattress with adjustable firmness is that they offer a range of firmness levels and can change between different levels at the push of a button. Often, you can even choose a different firmness for one half of the bed to the other, so couples with different preferences are both accommodated for.

Each mattress with adjustable firmness will differ in terms of material and support. However, vulcanized air chambers that can increase and decrease in pressure in accordance with your sleeping position and weight is a common feature. Alongside adjustable firmness, the best smart mattresses offer responsive firmness and sleep tracking to provide personalized sleep reports.

How do mattresses with adjustable firmness work?

Mattresses with adjustable firmness typically have air chambers that are emptied or filled using manual controls (a remote or app). When these chambers are full the mattress feels firmer, when they are emptied it is softer. Additionally, the mattress might have layers of foam that can be adjusted.

Like many of the best smart beds , advanced adjustable firmness mattresses have integrated sleep tracking and responsive adjustments so you don’t have to worry about getting uncomfortable during the night.

If you move, the firmness will increase or decrease in line with your new position to ensure you get the support you need to sleep peacefully. No more tossing and turning to find a position that alleviates your aches and pains.

How does an adjustable mattress ease hip, neck and back pain?

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The World Health Organization estimates 619 million people worldwide live with lower back pain. Sleeping in the best position for back pain (widely considered to be on your side with a pillow between your knees to promote proper spinal alignment) and on a supportive sleep surface are key to alleviating this pain.

Guidance from chiropractors now tends to steer back pain sufferers towards medium-firm mattresses. However, firmness is subjective and those who change sleeping positions throughout the night would especially benefit from a mattress that can adjust firmness accordingly.

Mattresses with adjustable firmness options have different zones, allowing you to adjust the firmness of specific areas of the mattress, such as the head, shoulders and hips, which is especially beneficial for those who experience pain in those areas. Mattresses with responsive adjustment are even better as they ensure you get effective lumbar support all night long.

Who are adjustable mattresses best for?

1. Combination sleepers

Different sleep styles benefit from different firmness levels. Side sleepers usually find pressure on the shoulders, knees and hips meaning they struggle to get comfy on firmer beds.

Conversely, stomach and back sleepers need a firmer sleep surface to prevent the spine dipping which can lead to pain in the long term. This can pose a predicament for people who like to switch up their sleep style, making adjustable mattresses a great solution.

Adjustable firmness smart beds, such as Sleep Number’s i8 , are particularly good for combination sleepers as the mattress detects your sleep position and adjusts firmness accordingly to make sure you have a comfortable, undisturbed night’s sleep.

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The big draw of beds with adjustable firmness is that you can adjust the overall firmness on each side. Couples and bed sharers who sleep in different positions will be glad to hear mattresses with adjustable firmness usually offer dual firmness control.

While traditional beds feel the same from one side to the other, adjustable mattresses often feature two firmness zones that you can adjust via the mattress’ remote or mobile app. You and your partner can personalize the feel separately, depending on each of your sleep styles. No need for uncomfortable compromise.

3. Those experiencing joint pain

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Adjustable firmness mattresses are useful if you suffer from back or joint pain and want a bed that can change to meet your needs. With the power to adjust the firmness of specific areas of the bed, these mattresses offer personalized support that can help alleviate your individual pressure points, decreasing pain and improving sleep quality.

And with responsive adjustments, you don't have to worry about getting uncomfortable in the night – if you move, the firmness will increase or decrease to support your new position. Additionally, as joint pain changes over time, an adjustable firmness mattress allows you to modify the support level without having to splash out on a new model.

3 top-rated mattresses with adjustable firmness options to shop

How much do mattresses with adjustable firmness cost?

Due to their integrated technology, mattresses with adjustable firmness are a little more expensive than other mattresses. But their features make them worth the investment, particularly if back, hip or neck pain is affecting your sleep quality.

Saatva and Sleep Number are both luxe brands so the high price tags on their adjustable firmness mattresses are expected. However, most of the best luxury mattresses sit around the $1,500 to $2,000 price point for a queen size, so paying extra for personalized firmness and a nightly sleep report doesn’t seem a bad deal.

That said, the Sleep Number c1 is incredible value considering the features it offers. If you're shopping for a new mattress, check out this month’s best mattress sales to get the best value.

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Eve Davies is a Sleep Staff Writer at Tom's Guide. Her role includes covering sleep tech and sleep health news and features, in addition to mattress reviews and buyer's guides for sleep accessories. Eve is a PPA-accredited journalist interested in the relationship between good sleep and overall health. When not writing about sleep for Tom's Guide, Eve enjoys writing about health and fitness, food and culture.

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