Everyone deserves a good night’s sleep, especially when they’re dealing with a long-term condition like AS. Fatigue is a common component of the condition,1 often coupled (oh the irony) with short, interrupted or poor-quality sleep.2

This AS Life has already written about painsomnia and tactics for good sleep; now it’s the turn of beds. It may not be a topic to get pulses racing, but it’s an understandably common topic on AS forums and social media.

This article tries to sift through the huge amount of information out there and put it into an AS context. It’s no substitute for advice your doctor might offer or, above all, trying things out for yourself. Although there seems to be few golden rules, hopefully this article offers a few pointers for inexpensive (or not-so-inexpensive) ways to make nap time a bit more comfortable.


First, the bedding basics

Before you start, find out what works for you. What’s bad about your sleep now and what changes could help? If you’re going all-out on a new bed, what size works best for your bedroom and budget? How high will it be? Choosing a bed that lets you get in and out of it with as little discomfort as possible is a big plus with AS. And the base? Obviously a big factor is the height of your bed, as well as the support it offers for whatever goes on top.

Mattress matters

Starting from the budget to the frankly extortionate, there is a bewildering range of mattresses out there to choose from. Fortunately, the wonderfully named Sleep Council in the UK has produced a free guide to the fundamentals that should cover the bed basics wherever in the world you are.

Most of you reading this probably sleep on a coiled-spring mattress – they’re the oldest (and, generally, the most affordable) type on the market, providing a range of firmness and styles. Foam mattresses are an alternative, with the newer (and more expensive) memory-foam beds claiming to curve round your body’s contours and offer a more supportive sleep. Even newer again (and even more expensive too) are gel mattresses. These claim to offer a whole new level of comfort and support, plus help with the overheating that some people find from foam mattresses.

Firm or soft?

Most mattresses come in a range of firmness, but just opting for the ‘orthopedic’ model may be something of a red herring. For many manufacturers this just means their most firm mattress, which might not be best for you. Finding the best mattress isn’t about just ‘going hard or going home.’ A test drive is your best bet – trying out different models and types to see which offers the best support for you.

Lie down on your back and slide your hand between the mattress and the small of your back. Big gap? It’s too hard. Hard to push your hand in? Too soft. Your ‘just right’ mattress will let you slide your hand behind you while still touching both bed and back. This advice is for the general population and does depend on how much mobility you have in your lower spine, but it serves as a good rule of thumb when comparing beds in the showroom.

For some independent advice on mattresses in the USA, Goodbed offers a choice tailored to your location, needs and budget. In the UK, the highly reputable Which? Website has also reviewed and rated 28 different mattresses (available for a small fee). If you’re prepared to really spend some cash, your mattress can have adjustable firmness, tilt up and down or have multiple zones of firmness. But what if you’re looking for something a little more economical?

Beds on a budget

For those of us who don’t have the spare change to go for a whole new bed, there are cheaper alternatives that could work too. If you feel your bed is failing the firmness test, try sliding a wooden board between bed base and mattress. Bed toppers are another economical way of jazzing up your current mattress. They are a thin foam or gel layer you can put on top of your current mattress that could offer the feel of a new mattress without the cost.

Pillow talk

Another even cheaper way to get a more bespoke night’s sleep could be investing in new pillows. The pillow options available could fill a whole new This AS Life article. The right choice for you is an even more personal one than that for mattresses – it might even vary from night to night for the same person, depending on that day’s symptoms and flare status.

On top of the traditional feather or polyester-filled versions, foam and gel pillows offer a more sculpted slumber in a similar way to mattresses. These could be useful additions to the night-time experiments you may already be conducting to find the winning pillow combination for a better night’s sleep.

Sleep isn’t an exact science (although the American Academy of Sleep Science might disagree). If an article dedicated to beds hasn’t already made you drift off, hopefully the content in it will help you get a better grade of sleep in the future. Sweet dreams.


This article was written by one of the resident experts at A social site helping the whole AS community to: Learn. Share. Inspire. Discuss.


1. Hakkou J et al. Rheumatol Int 2013; 33(2): 285–290.
2. Li Y et al. Arthritis Res Ther 2012; 14(5): R215.

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