How to Choose the Best Pressure Relief Mattress [Updated for 2020]

Pressure relief mattresses are a necessary tool when caring for people who are confined to bed for extended periods of time. By helping prevent the formation of pressure ulcers and bedsores, pressure relief mattresses help distribute body weight evenly while promoting proper circulation.  

Who are pressure relief mattresses for?  

Anyone who needs to remain in bed for an extended period of time for any reason should be using some sort of pressure-relieving sleep system to prevent the formation of pressure ulcers. The need is even greater when the user or patient is not independently mobile, and cannot adjust their position in bed on their own. 

Becoming bedridden could be the result of a chronic physical or medical disability. Or, it could be that you or a loved one have sustained a temporary injury or illness which will resolve itself in time.    

Recently, the emergence of COVID-19 has created a growing need for pressure relieving mattresses and cushions. Hospital workers are often short-staffed and overworked. To prevent bedsores and skin irritation, healthcare professionals are tasked with giving skin assessments multiple times a day, turning the patient in bed, moving them to a chair, or applying bandages to areas that commonly get pressure ulcers. 

With the number of patients in hospitals increasing, it has become very difficult for nurses to take all the necessary measures to prevent these injuries that can quickly turn fatal. Pressure relief mattresses have become vital to prevent and treat these skin conditions. In any case, without adequate care to prevent pressure sores, there is a risk of compounding the medical concerns already being faced. 

What are bedsores?  

Also known as pressure ulcers, decubitus ulcers, and pressure sores, bedsores are injuries to the skin and underlying tissue, resulting from prolonged pressure on the skin in that area. Developed primarily from pressure and shear, bedsores are often quite progressive in nature and are most commonly found on bonier parts of the body, such as the tailbone, hips, ankles, and heels. 

When people are confined to a bed or sitting position for extended periods of time, they are at a higher risk of developing pressure sores. Largely preventable, especially with the use of a pressure relief mattress, bedsores can be hard to treat once formed. They break down the skin and underlying tissue which results in tissue ischemia, stop the supply of nutrients and oxygen to the tissues, and can eventually result in tissue necrosis if not addressed.

Things to consider when choosing a pressure relief mattress: 

Mobility of the patient?  

For an individual who is completely immobile without assistance, a high-tech, adjustable mattress which changes their position periodically will likely do the best job at preventing ulcers. These mattresses can be inflated and deflated at set times according to the positioning and comfort needs of the patient.

Most of these pressure relief mattresses can be set to adjust automatically, at fixed intervals, guaranteeing no area of the body remains under pressure for too long. Additionally, many high-tech mattresses are zoned, allowing separate adjustments for different areas of the body simultaneously. 

Mattress design: adjustable mattress or low-tech mattress? 

Adjustable mattresses are pressure-adjustable mattresses which can be inflated and deflated according to a patient’s preference or physical needs. 

Low-tech mattresses, along with their overlays and supports, are filled with either air, fiber, foam, or gel. Most often, their pressure is not adjustable. 

Beyond hi-tech (adjustable) or low-tech, you should consider these various factors when deciding on a mattress type:

Mattress filler: water, air, fiber, foam, or gel?

Water has a unique ability to conform to a user’s body and distribute pressure evenly. For this reason, many individuals prefer a water mattress over other low-tech options - for optimized pressure relief, as well as for comfort. 

Air-filled mattresses, or ROHO mattresses, offer the opportunity to inflate and deflate the mattress at different times and in different locations, to increase or decrease pressure based on the patient’s comfort and skincare needs. 

Foam mattresses have their own unique advantages. One advantage is how they can be cross-cut, meaning the cells of the mattress are able to shift along with the patient’s body, making shearing less likely. Shearing occurs when the outer layer of skin pulls as the patient shifts, leading to skin tears and eventually, infection. 

Many people find gel mattresses to be quite cushioned and comfortable. Like memory foam, gel conforms to the user’s body, and many people enjoy the sensation of sinking deeply into the surface of their mattress. Gel mattresses provide a much cooler sleeping surface than foam as they retain a lot less body heat. They also facilitate a more responsive feel when they’re not combined with foam.

Lateral Rotation Mattresses:

One type of patient not mentioned so far is someone who is at risk for pulmonary or gastrointestinal complications. For these people, there are lateral rotation mattresses that rotate the patient side-to-side to improve circulation and provide pressure relief.

Lateral rotation, or turning mattresses, can also be used by patients who are completely immobile, making it easier for the caregiver to turn them as needed. Bear in mind, however, that caution must be taken so the patient does not fall off of the mattress during turning! Bed rails will help prevent rolling out of bed and accidental falls. 

Have pressure ulcers already developed? 

When pressure sores have already developed on the patient’s body, the best choice of mattress will depend on how far the sores have advanced. The more serious they are, the more care will need to be taken to avoid further injury to those spots. In these cases, a hi-tech mattress is usually the best option. 

For moderate to severe pressure sores, a bubble-style mattress or pad that has multiple touch-points often distributes weight and relieves pressure most effectively. 

An alternating pressure mattress, which maximizes blood flow to the affected areas by inflating and deflating throughout the day, is also recommended. 

How much pain is the patient already experiencing? 

Advanced pressure sores can be very painful. If your patient is already living with developed ulcers (or is in recovery), you’ll need a mattress that provides enough weight distribution, padding, and the right construction to minimize pressure on these painful areas. Many patients with advanced ulcers prefer water-filled or gel-filled mattresses for comfort.


How to prevent bedsores? 

  • Keep skin clean and dry
  • Protect the skin from shearing by applying talcum powder at points of friction. Likewise, applying lotion to dry skin will prevent the dragging that produces shearing injuries.
  • Watch for tiny items that may inadvertently make their way into bed and irritate the skin. Simple things, such as buttons on clothing, can cause injury to already delicate skin. 
  • Keep bedding as wrinkle-free as possible.      

How long does it take to get a bedsore?  

When the blood supply to the skin is cut off for more than 2 to 3 hours, a bedsore can develop. As the skin dies, the pressure sore first presents as a painful red area which eventually becomes purple in color. If it's left untreated, the skin can break open and become infected. 

With their ability to deeply embed into the tissues, pressure ulcers can extend into muscle and bone. Often very slow to heal, bedsores can take days, months, or even years to heal, with some requiring surgery to remove. 

Can you die from bedsores?  

About 60,000 people die each year from bedsore-related complications. If they are left untreated, they can lead to severe infection and sepsis. Bedsores are categorized into four stages, from the least severe to the most severe:

  • Stage 1 - Affected area appears red and feels warm to the touch. In darker skin, the area may have a blue or purple tint. It may hurt, itch, or burn at this stage.
  • Stage 2 - Affected area appears more damaged, with an open scrape, blister, or sore. The skin around the wound may be discolored, and the patient may experience significant pain.
  • Stage 3 - The affected area has a crater-like appearance that comes from the damage below the skin’s surface.
  • Stage 4 - The affected area has severe damage and a large wound is present. Bones, muscles, joints, and tendons can be involved, and infection is a significant risk in this 4th stage.

A wound isn’t assigned a stage when there is full-thickness tissue loss and slough or eschar (dead tissue/scabbing) is present in the wound bed. The eschar may be tan, brown, or black, while the slough is usually tan, gray, brown, green, or yellow. 

Does Medicare typically pay for a pressure relief mattress?

According to, Medicare Part B covers “air-fluidized beds and other support surfaces” as Durable Medical Equipment, provided your doctor has prescribed the equipment for use in your home. We recommend you check with your primary care physician prior to purchasing a pressure relief mattress, either for yourself or for a loved one. 

Will private insurance cover a pressure relief mattress? 

Individual insurance companies and policies vary. However, generally speaking, your doctor will need to prescribe the mattress as “medically necessary” for it to be considered for insurance coverage. 

Beyond that, it’s best to speak with someone from your insurance company to determine the specifics of your coverage and what is covered! 

Final thoughts 

If you or a loved one are dealing with pressure sores, you should have a skin evaluation done by a doctor, who can then advise you on the best pressure relief mattress to fit your needs. 

Prevention is key to bedsore management, by employing proper nutrition, hygiene, and using a pressure relief mattress. If pressure sores have already developed, it is crucial to get treatment as soon as possible to avoid the sore advancing to the next stages. Effective therapies often include adding a pressure relief mattress to help the bedsore get better, unlike regular mattresses which can make it worse.

It’s important to understand that all mattresses, once purchased, are generally non-returnable and non-refundable. For this reason, it’s even more imperative to get the help of a healthcare professional before making a final decision.


For a complete look at the wide range of pressure relief mattresses available, visit RehabMart's pressure relief mattress category page, and read The 5 Best Pressure Relief Mattresses!

Want to learn even more? Find dozens of videos featuring products and caregiver tips like these at Rehabmart’s YouTube channel!



Megan has been a part of Rehabmart since its inception nearly 20 years ago. For the past several years she has been enjoying her role as HR Director while maintaining her Physical Therapy license. When she isn't working on her next in-service or working to find a new team member, she enjoys her five children, helping those who have PT type ailments, baking, practicing yoga, and working out.

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