Safety Beds: What Are They and Who Needs One?

Getting good quality sleep every night is vital for good health. While it’s important for all of us, it’s especially crucial for children. If your child is prone to wandering at night or has a hard time settling down to sleep, you may want to try what other parents have called the answer to their prayers - a safety bed. This guide will help you decide what safety bed is best for your family’s needs and recommend the best products. 

What is a Safety Bed?

Specially designed to prevent children from leaving their bed at night without supervision, a safety bed helps to prevent injuries, falls, and wandering. Safety beds are sometimes also referred to as institutional beds, adaptive beds, enclosed canopy beds, special needs beds, and child-safe beds. They’re frequently used by youngsters living with special needs, such as cerebral palsy, Down syndrome, developmental disabilities, Angelman syndrome, and autism spectrum disorder; as well as kids who are medically fragile or recovering from an illness, injury, or surgery. Safety beds are also utilized by children who have a more challenging time winding down to sleep and rest, such as those living with ADHD and other hyperactive behaviors. 

Things to Consider

Although there are quite a few design features to consider in order to choose the best safety bed for your child, understanding these benefits will help you determine what kinds of special features you require to meet the unique requirements your child presents.

Entrapment

Although there is usually a risk of entrapment associated with beds that have rails, safety beds are specially designed to reduce this risk. Children can get their head, neck, chest, or other body parts caught within the rails or in tight spaces around the rail if it is not designed correctly, or if the bed and rail system are used improperly. The FDA (US Food and Drug Administration) and the HBSW (Hospital Bed Safety Workgroup) have established the 7 Zones of Bed Entrapment to help prevent the serious entangling injuries that can sometimes happen when using bed rails: 

• Within the bed rail: The open space between the perimeters of the rail should be less than 4 ¾ inches to avoid head entrapment.
• Under the rail, between the rail supports, or next to a single rail: The gap under the rail between the rail and the mattress should be less than 4 ¾ inches to prevent head entrapment.
• Between the rail and the mattress: The area of space between the inside surface of the bed rail and the mattress should be less than 4 ¾ inches to reduce the risk of head entrapment.
• Under the ends of the bed rail: The gap between the lowest portion of the end of the rail and the mattress should be less than 2 inches to prevent neck entrapment.
• Between separate foot and head rail sections on the same side, or between split bed rails: The space between split or partial-length side rails presents a risk of both chest and neck entrapment. No FDA guidelines have been established for the safe configuration of this space.
• Between the side edge of the headboard or footboard and the end of the rail: The gap between the headboard or footboard’s side edge and the end of the bed rail presents a risk of body entrapment. No FDA guidelines have been established for the safe configuration of this space.
• Between the headboard or footboard and the end of the mattress: If the space is too large between the inside surface of the headboard or footboard and the end of the mattress, this increases the risk of head entrapment. No FDA guidelines have been established for the safe configuration of this space. 

Transfer Height

If your child uses a wheelchair or needs supervised assistance to get in and out of bed, it’s important to choose a safety bed that will safely accommodate those needs. Hi-lo styles are generally best for frequent wheelchair transfers as they can be raised or lowered into exacting positions as needed with a manual crank or via electric power. Fixed foundations can also be ordered at specific heights to facilitate easier transfers as well. Generally, 17 to 23 inches is considered a good transfer height for a bed, but this will depend on the wheelchair model.

Mattress

Safety beds that come with their own mattress are most often available in twin or full sizes, with some manufacturers also offering a queen size. Other safety beds use your own existing mattress or one that you purchase separately. It’s important to remember that the taller the mattress is, the taller the rail protection needs to be. It’s crucial that the mattress fits snugly within the frame and rails and that no gaps are created for possible entrapment.

Bed Opening

Safety beds differ in the ways that they open for parent and caregiver accessibility. Some styles will have openings on both sides, while others just have one side that opens. Determining your needs for access is important to ensure you choose the best safety bed to accommodate those specific requirements.

Assembly

Safety beds are made in a variety of formats, with some that are easier to assemble than others. Although the portable styles that fit on top of existing mattresses or bed frames can be quite easy to attach and set up, the larger styles with rail protection tend to require more involved installation. Because they need to be properly assembled to optimize safety and to work as intended, it’s important to consider professional assembly and installation. Rehabmart offers this helpful assembly service with some of the safety beds we carry in our catalog. 

Autism

While different children living on the autism spectrum present diverse needs, a common behavior among kids with ASD is overstimulation. They often appreciate a chill-out, personal space to relax and sleep, that helps shut out any unwanted distractions. This is why an enclosed bed is usually the best choice for youngsters living with ASD, helping them to unwind in their own safe space. Kids on the autism spectrum often like to jump when they’re excited, so it’s important to choose a safety bed that is tall enough to accommodate standing and jumping, and one that’s padded on the inside as well. 

Padding

Several safety beds come with their own padding or offer the add-on option, while others allow you to add your own. If your child is highly active and likes to bounce off the walls, padding can help prevent injuries. It also optimizes comfort, creating a soft, cushy space to relax and sleep. If padding is installed when you order the bed, the safety bed should never be used without it, as the space it leaves could create dangerous entrapment gaps. 

Locking Casters

Several safety bed formats come with smooth-rolling casters to enable mobility, allowing you to place the bed wherever you may need it. At least two of the casters should be lockable, ensuring the bed stays in place when it’s occupied, or whenever stationary placement is needed.

Ceiling Height

Tall and tall-with-extension safety beds can be quite high, as can enclosed safety beds. Be sure to measure the floor-to-ceiling height in the room you intend to use the safety bed, ensuring it will fit within this space. 

Bed Windows

Windows provides a way for children to still connect and not feel isolated in a safety bed, allowing them to view parents, caregivers, and other family members, and reduce claustrophobia. In safety beds with rails, the windows are usually constructed as clear, while fabric or enclosed safety beds are usually covered in a close-knit mesh that kids can see through. 

Wood Finish

For safety beds that are designed in a wooden frame, there are several different natural wood veneers to choose from to complement your decor. As a rustic birch with a straight grain and random knots, the Alder finish is moderately light, resulting in a clear, natural veneer. Maple shows very little wood grain and is the lightest wood color. A little darker than maple, the Oak finish shows more natural wood grain and is relatively light in color. A bit darker than maple or oak, but still quite light in color, the Cherry finished wood will gradually darken naturally over the years. The Mahogany finish is similar to the cherry in that it darkens over time, but varies significantly in tone and is naturally lighter than the typical dark mahogany. Safety beds made with fabric and/or mesh also offer a range of colors to match your room.

Accessories

A number of different safety beds offer add-on options such as access ports for medical tubing, IV poles, mounting brackets, additional openings or windows, and much more. Some also offer a wide range of choices when it comes to mattresses, casters, Trendelenburg options, low bed conversion, length extensions, and other customizable design features, ensuring the safety bed meets your child’s specific needs. 

What is a Safety Bed?

A safety bed is designed to keep children and adults safely in bed throughout the night, preventing wandering and falling injuries. Often used to stop children from climbing out of bed, safety beds come in a wide variety of designs to optimize sleep, comfort, and safety for the occupant.

How do you keep a special needs child in bed?

The sleep hygiene strategies you employ with special needs children aren’t all that different from what works for other children - many children of any ability tend toward hyperactivity at bedtime! Or they may wander around at night, not getting the rest they need. Here are some of the best suggestions you can employ to prepare your child for a successful night of good sleep:

• Ensure your child is getting plenty of physical activity during the day, which will help them expend energy and fall asleep easier at night. Be sure to limit this rigorous activity to an hour or two before bedtime. 
• Limit sugar and caffeine intake, especially in the afternoon and evening hours.
• Keep regularly scheduled, predictable bedtime routines, such as a bath, brushing teeth, and a bedtime story. Stick to a consistent bedtime and wake-up time as much as possible, as this will help your child stay in rhythm with a solid sleep-wake cycle.
• Avoid electronic screens like computers, smartphones, and the TV at least one hour before bedtime, and dim the lights to cue your child’s body that it’s time to sleep.
• Choose quiet music, a white noise machine, or a fan if your child requires some level of background noise to fall asleep - avoid the TV.
• If your child prefers to sleep with a nightlight, consider choosing one that can automatically turn off after a specific time. The best sleep environment is dark, quiet, and cool, and even a low light can interrupt good quality sleep. Turn down the thermostat to around 65 degrees to prevent your child from waking up overheating.
• Weighted blankets can help children on the autism spectrum and those with sensory processing disorders to better settle and feel comfort, resulting in deeper relaxation and sleep.
• An enclosed safety bed provides children with their own private, safe space that’s free from outside distractions, enabling improved relaxation and better sleep.

What is the best bed for autism?

An enclosed safety bed is usually the best bed for children on the autism spectrum. This format reduces the distractions that can greatly irritate kids living with ASD, creating a calming, chill-out space they can use for relaxing and sleeping. Enclosed safety beds are available in different designs to accommodate a wide range of autistic behaviors. Our favorites include the popular Sensory Bed by zPod - Special Needs Bed for Autism and the innovative Safety Sleeper TWIN-SIZED Bed Enclosure by Abrams Bed. 

What is bed entrapment?

Bed entrapment is when a child or adult can become stuck in or around the rails of a bed, which can lead to strangulation and other serious injuries. Although safety beds are specially designed to prevent the 7 zones of entrapment set forth by the FDA and the HBSW, it’s important to be aware of the various ways that people can become trapped or injured by bed rails for the most effective prevention of these dangers.

What is the safest bed for a child with special needs?

While enclosed safety beds are a good choice for many children living with special needs, other safety bed designs may be a better fit for your child’s unique needs. We highlight exactly what to look for in this article to help you choose the best safety bed to meet your child’s requirements. 

What is a Hannah bed?

A Hannah bed is a safety bed made by KayserBetten, one of the foremost industry leaders in safety bed design. The best-selling Hannah 135 Safety Bed by KayserBetten has been a favorite for many families through the years, delivering multiple benefits and design features to keep children of all ages safe and comfortable. It also has a wide range of add-on elements, enabling parents to completely customize its design to accommodate the special needs of their children. Like many of the other exceptional safety beds offered by KayserBetten, the Hannah bed can be chosen in a solid platform, hinged platform, semi-electric platform, or full electric platform. 

How Do I Choose the Best Safety Bed?

Although there are multiple factors to consider when you’re choosing the best safety bed for your child, the two most important aspects to determine include safety rail height and adjustment functionality. Read on to learn more about what these specific design formats are all about.

First Consideration: Rail Height 

The height of the rail protection varies widely among safety beds and should be chosen based on your child’s activity level. Great for younger, smaller kids, a basic or low safety rail can accommodate children with lower activity levels, who are not as mobile. But children who can sit up or pull to kneel or stand, along with those with higher activity levels and kids prone to wandering will be better served with a taller rail height or an enclosed style. 

Another important consideration in choosing the correct rail height is factoring in the height of your child’s mattress along with any additional padding that may be used. While some safety beds come with their own mattress and/or padding, if you plan on using an existing mattress, you’ll need to subtract its height from the overall height of the rails to ensure adequate rail or side height protection ABOVE the mattress.

Second Consideration: Adjustment Function

Mostly involving the type of foundation used in a safety bed to support the mattress, the adjustment function you choose is important for safer transfers to and from the bed, along with optimizing ergonomics for parents and caregivers. Customizing comfort to meet every child’s unique needs, adjustment functions come in four basic configurations that include fixed, manual, articulating, and hi-lo. 

Transfer height is also important to consider to determine the best adjustment function style for your child, ensuring if they require the bed to be lowered for a transfer to and from a wheelchair that it meets that height range. For children who require adjustable positioning, an articulating safety bed serves those needs with separate foot and head sections that are angle-adjustable.

Rail Height Options 

There are six rail height options: basic, low, medium, tall, tall with extension, and fully enclosed. Below we give you the breakdown of each height, along with our top recommended products. 

Basic Rail Height

Ida Bed - Electric Adjustable Safety Bed by Kayserbetten View Product

Although they’re generally the most economical option, basic safety beds may still offer quite a few customizable features to suit your child’s unique requirements. Their rail height typically ranges from 16 ½ to 22 inches above the mattress, depending on the configuration. Their transfer height of 21 ¼ inches tends to work well for most wheelchair transfers as well as for fully ambulating children to enter and exit the bed. 

Pros

• The best economical option
• Rail height above the bed usually ranges from 16 ½ to 22 inches
• Lower height for safer wheelchair transfers and entry/exit
• Good choice for less active or mobile children

Cons

• Not as customizable as other safety bed options
• Does not provide high enough rail protection for highly active or mobile children

Best Basic Rail Height Safety Bed: Ida Safety Bed with Fully Electric Height and Positional Adjustment by KayserBetten

Low Rail Height

SleepSafe Low Bed View Product

Ideal for children who are medically fragile or recovering from illness or injury, low-safety beds often come with a range of options to optimize your child’s safety and comfort. Depending on the format, they usually offer a rail height range of 0 to 17 ¼ inches, making this style better suited for youngsters with a lower level of activity and mobility. Its 22 ¼-inch transfer height conveniently accommodates most wheelchair transfers. 

Pros

• Ideal for medically fragile children
• Rail height above the bed usually ranges from 0 to 17 ¼ inches
• Low height for safer wheelchair transfers
• Suitable support for kids who aren’t very active or mobile

Cons

• Doesn’t provide enough rail height for more active or mobile children
• May be too low for ergonomic caregiving (If it’s chosen in a fixed foundation style)

Best Low Rail Height Safety Bed: SleepSafe Fixed Low Safety Bed

Medium Rail Height

SleepSafe II Medium Bed View Product

As one of the most popular sizes, medium safety beds offer significantly higher rail protection than basic or low versions, making them a better choice for children who are moderately active or mobile. Determined by the configuration, medium rail height can range from 4 ¼ to 27 inches above the mattress, with a typical transfer height of 32 inches. Choosing this rail height in a hi-lo adjustment function can greatly improve caregiver ergonomics and make wheelchair transfers easier and safer to perform.

Pros

• Provides higher rail protection than basic or low safety beds
• Rail height above the bed usually ranges from 4 ¼ to 27 inches
• Most popular choice for kids with moderate mobility and activity levels
• Can be selected in a hi-lo format to ensure safer transfers and comfortable caregiving

Cons

• A tall or enclosed safety bed would be a better choice for children with higher activity
• May be too high for wheelchair transfers and ergonomic caregiving (if it’s chosen in a fixed foundation)

Best Medium Rail Height Safety Bed: SleepSafe II Medium Bed

Tall Rail Height

SleepSafer Professional Tall Safety Beds View Product

Perfect for more active children, the tall rail-height safety beds provide higher protection to guard against wandering and falls. Offering a height range of 18 ¾ to 36 ¼ inches above the mattress, this taller rail height helps to prevent more mobile youngsters from climbing out of bed at night. While its 26-inch transfer height is a little bit high for standard wheelchair transfers to and from the bed, tall rail height safety beds are usually offered in a variety of foundations to adjust this height to meet your specifications, such as hi-lo and articulating styles. 

Pros

• The taller rail height guards against wandering and falls
• Rail height above the bed usually ranges from 18 ¾ to 36 ¼ inches
• Ideal for children with a higher level of activity and mobility
• Can be selected in an articulating or hi-lo format for lower transfers

Cons

• Might not provide enough security for kids who are super active or “escape artists”
• Transfer height may be too high unless chosen in an articulating or hi-lo foundation

Best Tall Rail Height Safety Bed: SleepSafer Professional Tall Safety Beds

Tall with Extension Rail Height

KayserBetten Hannah Safety Bed 170 View Product

Safety beds that are configured with a tall extension rail height provide maximum protection for exceptionally active and mobile children and teens. As the next best thing to an enclosed safety bed, the tall with extension beds add another section to expand their rail height, offering a range of 35 ¾ to 53 inches above the mattress. These safety beds can also be selected in various foundations for lower, safer transfers and for higher ergonomic caregiving. They typically offer a standard transfer height of 24 ½ inches without the rail in place or 26 inches with the rail in place.

Pros

• Optimizes protection for exceptionally active children and teens
• Rail height above the bed usually ranges from 35 ¾ to 53 inches
• Offers maximum rail height to prevent the occupant from climbing out
• Selectable in a variety of foundations to match user needs

Cons

• Might be too confining for smaller children or those who don’t require as much protection
• Higher height may not fit well in low-ceiling rooms

Best Tall with Extension Rail Height Safety Bed: Hannah 170 Safety Bed by KayserBetten

Fully Enclosed

Safety Sleeper Bed by Abrams Bed TWIN-SIZED View Product

Enclosed safety beds deliver optimal safety for kids who are able to escape their bed at night, providing all-encompassing security that completely surrounds the entire bed. Available in a range of styles and sizes, some enclosed safety beds use an existing mattress, while others come with their own. They’re usually constructed with a combination of soft fabrics and other durable materials to keep the child comfortable and safe within the structure, using specially designed zippers and other closures that cannot be opened from the inside. They’re frequently configured to be lightweight and easy to collapse, making them the best portable choice for travel. Because enclosed safety beds offer the perfect chill-out space and effectively eliminate distractions, they’re often used for children on the autism spectrum and those with sensory overload issues.

Pros 

• Provides the most effective protection against wandering and bed escapes
• Soft fabrics inside the structure optimize user comfort
• Range of sizes and styles to suit each child’s unique needs
• Creates a calming, chill-out space for autistic children 
• Lightweight and collapsible for easy portability

Cons

• Some children may find it too restrictive or claustrophobic
• May be too high for low-ceiling rooms

Best Enclosed Safety Bed: Safety Sleeper TWIN-SIZED Bed Enclosure by Abrams Bed

Adjustment Function Options

After you have chosen the rail height, the next biggest consideration you must make is the adjustment function. You have 4 functions to choose from: fixed, manual, articulating, and hi-lo. Below we take a deeper dive into each function and we recommend the best products.

Fixed Adjustment Function

Slumber Series Fixed Height Non-Adjustable Safety Bed View Product

A fixed foundation does not come with any articulation or hi-lo adjustment functionality. As one of the most economical choices, fixed foundation safety beds come with either a box spring or bunkie board. The mattress lies flat on top. You can choose the height to be fixed in a lower or higher position when you place your order. Lower positions increase the rail height protection above the mattress. Bunkie boards also add 5 inches of rail protection over box springs. Fixed adjustment function options are best for children who are medically fragile, along with those with very low mobility, who are not very active. 

Pros

• The most economical option
• Choice of box spring or bunkie board
• Can be ordered in a fixed height position of your choice
• Great protection for children who are not very active or mobile

Cons

• Not enough positioning options for children who need specialized support
• Because the bed can’t be raised, it may cause over-extension injuries for parents and caregivers as they’re attending to the child

Best Fixed Foundation Safety Bed: Slumber Series Fixed Height Non-Adjustable Safety Bed

Manual Adjustment Function

Dream Series Manually Adjustable Safety Bed View Product

Utilizing a hydraulic system and hand cranks, manual adjustment function safety beds offer multiple options so you can customize their use to meet your child’s unique requirements. The manual hi-lo combined with articulation will raise and lower the mattress height, head section, and knee section of the bed with the use of a hand crank, while the electric articulating foundation combined with manual hi-lo raises and lowers the head and knee sections with a remote, and the mattress can be adjusted with the manual crank. The manual articulating foundation without the hi-lo capability will raise and lower the head and knee section, and the manual hi-lo foundation without articulation will raise and lower the bed, keeping the mattress flat. 

Pros

• Multiple positioning and height options to suit a wide range of user needs
• Versatile adjustment functionality is well-suited for medically fragile children
• Hand cranks are easy to operate, requiring very little exertion from parent or caregiver
• Customizable support can include hi-lo and articulating head and knee sections

Cons

• Some parents and caregivers require fully electric operation so they can keep their hands free to attend to the child
• More challenging to operate than full-electric models when parents/caregivers have injuries or illness

Best Manual Foundation Safety Bed: Dream Series Manually Adjustable Safety Bed

Articulating Adjustment Function

Ida II Electric Height Adjustable Safety Bed with Articulating Mattress by KayserBetten View Product

An articulating safety bed offers the adjustment functionality for knee and head elevation in an electric frame with a fixed height choice. With the touch of a button on the remote control, these sections can be raised or lowered according to the child’s comfort and positioning needs. The head section can be adjusted from zero to 70 degrees in angle, while the knee section adjusts from zero to 40 degrees in angle. Like the Fixed foundation, an articulating safety bed offers several height positions to choose from when you place your order. Selecting a lower position will increase the height of the rail protection above the mattress, as will choosing a bunkie board instead of a box spring foundation for the mattress. 

Pros

• Adjustable positioning to optimize comfort and support
• Head and knee sections can be raised or lowered with a remote control
• Fixed height can be customized in a high or low position
• Great option for children who require maximum support

Cons

• It is not adjustable in height like a hi-lo safety bed
• This style may not be as ergonomic for parents and caregivers as a hi-lo safety bed

Best Articulating Foundation Safety Bed:  Ida II Electric Height Adjustable Safety Bed with Articulating Mattress by KayserBetten

Hi-Lo Adjustment Function

SleepSafe II Medium Bed View Product

The hi-lo adjustment function safety bed is fully electric, powering through every needed adjustment with a wired remote control. It raises and lowers the mattress surface so you can place your child exactly where you need to for more ergonomic caregiving. This hi-lo capability also makes wheelchair transfers easier, along with the supervised entry and exit of your child to and from the bed. Also offering articulation, both the head and knee sections can conveniently be raised or lowered to optimize comfort and positioning for special needs. The rail height protection is highest when the bed is in the lowest position, and decreases as the bed is raised into the highest position. The hi-lo format is ideal for children who require multiple positional changes, along with those who need to be attended to more often. It’s also a great choice for wheelchair transfers.

Pros

• Fully electric with a wired remote control
• Offers the easiest adjustment functionality
• Raises and lowers the height of the mattress
• Raises and lowers the angle of the foot and knee sections

Cons

• Higher price point
• Dependent on electric power and may not be as functional in power outages

Best Hi-Lo Safety Bed: SleepSafe II Medium Bed

Final Thoughts

Getting a good night’s sleep is crucial to good health and proper development. Sleeping in a safe and comfortable environment benefits children and adults physically, emotionally, and mentally. But sometimes, kids can have a much harder time staying in bed and falling asleep due to their higher energy levels and youthful exuberance. Special needs children are often that much more challenged with winding down and going to sleep, often needing added support to optimize their safety and comfort and prevent them from wandering during the night.

Safety beds fulfill this need by ensuring kids stay in bed and cannot exit unsupervised. Available in a wide array of designs to suit a plethora of unique requirements, safety beds help children to relax, fall asleep, and stay in bed. Their multiple design elements maximize comfort and reduce entrapment risks, while they also prevent the child from climbing out of bed during the night. Often employed in children's hospitals and care facilities, safety beds are most commonly utilized at home. Some models are even portable so you can take them along wherever you travel with your child.

Learn more about the superior quality safety beds we carry and check out our comprehensive hospital and home care beds catalog, too. As always, you can find more valuable information from our expert healthcare team at Caregiver University, an educational resource to help you take better care of your loved ones.