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

The image shows a Sleep Number Smart Bed mattress with adjustable firmness in a modern bedroom with grey walls and a grey rug
(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. 

A couple sharing a bed and sleeping soundly. The man is sleeping on his back, and the woman is on her side, both are tucked up in a duvet

(Image credit: Getty Images)

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? 

Woman holding her neck in pain while she sleeps on her side

(Image credit: Getty Images)

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. 

A woman sleeping on her back without a duvet in grey pyjamas. One arm is up and one leg is bent to the side

(Image credit: Getty Images)

2. Bed sharers 

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 

A man holding his shoulder in pain after waking up and sitting on the side of his bed

(Image credit: Getty Images)

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

1. Saatva Solaire mattress:Was from $3,295 from $2,801 at Saatva

1. Saatva Solaire mattress: Was from $3,295 from $2,801 at Saatva
Saatva’s Solaire is an adjustable  firmness mattress that has 50 firmness settings on each side, controlled via a remote rather than a companion app. It is chiropractor approved and has six layers, starting with a 3” pillow top with Lumbar Zone quilting to support your back. Underneath lies 1” of five-zone natural latex for pressure relief and lumbar support, followed by a 2” layer of CertiPUR-US certified gel-infused memory foam to dissipate body heat and bolster pressure relief. In short, it’s a great mattress for back pain. This Saatva sale means you can now get a queen size Saatva Solaire for $3,821 (was $4,495) with a 365-night trial, lifetime warranty, and free white glove delivery with mattress removal included. 

2. Sleep Number i8 Smart Bed:Was from $3,399 from $2,499 at Sleep Number

2. Sleep Number i8 Smart Bed: Was from $3,399 from $2,499 at Sleep Number 
Calling the Sleep Number’s i8 a smart bed is an understatement. Alongside responsive, adjustable firmness, this mattress has built-in sensors that will monitor different metrics as you sleep. It then collates all this data and provides sleepers with a SleepIQ score along with personalized recommendations on how to improve your sleep. It also has plush layers of CertiPUR-US certified foam that can help to sooth pressure points whilst providing additional support for back and stomach sleepers. The current sale price of a queen size is $3,199 (was $3,999) and that includes perks such as a 100-night sleep trial, 15-year limited warranty, free delivery and set up. 

3. Sleep Number c1 Smart Bed:From $599 at Sleep Number

3. Sleep Number c1 Smart Bed: From $599 at Sleep Number 
Offering personalized body contour, this air mattress prioritizes lumbar support. Our testers for the Sleep Number c1 Smart Bed review reviewer reports feeling relief in her achy lumbar when sleeping on this mattress. Although it is not currently discounted, the c1 is the most affordable bed in the Sleep Number range. It still features automatic firmness adjustments, dual firmness, and excellent pressure point relief, alongside the sleep tracking reports we expect from Sleep Number. You can get a queen size plus a 100-night sleep trial, 15-year limited warranty, free delivery and set up for $999, making this great value for what you get.

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. 

Eve Davies
Sleep Staff Writer

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.