Why sleep and comfort are the first line of defence against poor health

better sleep better health

Mammoth’s Human Performance Specialist, Dr Jonathan Bloomfield, investigates how sleep and comfort can have a profound effect on health and wellbeing.

Before we can consider how best to improve sleep among the general public, we must first understand the scale and the nature of the problem. Let me put a few statistics in front of you.

sleep problems in the UK

Of the three pillars of health – nutrition, exercise and sleep – it would be fair to say that sleep is the least understood. But as we can see here, the implications of sleep quantity and quality can be profound. In fact, the effects can be extremely serious indeed:

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Sleep problems and poor sleep patterns can largely be attributed to the modern lifestyle, which is characterised by:

  • Sleep deprivation
  • Long working hours
  • Poor diet
  • Stress
  • Screen binging
  • Pain and discomfort

In particular, this pain and discomfort is something that many of us can relate to:

better sleep medical grade foam

Sleep impacts on our health and wellbeing, but equally our attention to health and wellbeing impacts on our sleep. Studies show that 50% – 88% of patients with chronic pain complain of significant sleep disturbance. While clinical trials have documented that a greater amount of sleep actually reduces sensitivity to pain.

These statistics alone demonstrate the scale of the problem we face in the UK – and indeed most industrialised have comparable data. Sleep problems are epidemic, back pain is epidemic and the two are wholly inter-related.

Through my day-to-day work with elite sports, I regularly come into contact with strength and conditioning coaches and, of course, physiotherapists who are keen to learn more about how they can better care for their athletes. And while I wish to share some of these findings with you, it is also important for me to say that these principles of sleep and comfort are as relevant to your elderly patients with mobility issues and chronic restlessness at night as it is to those performance athletes you may treat. The fundamentals of sleep and recovery are just as applicable to the people from all walks of life.

Let’s start with a few basics that have come from research into sleep science. We know that prolactin, testosterone and growth hormone are released during sleep. This directly affects muscle growth, tissue repair, protein synthesis and immune system function – all of which are essential to prehabilitation, rehabilitation and recovery for patients.

There are a number of studies showing how this has resulted in improvements.

In baseball, for example, a study of 80 Major League players assessed 3 years apart returned the following results:

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A further study of collegiate swimmers in the US, which involved spending an extended time in bed (10hrs) over several weeks recorded a number of benefits

better sleep physical performance

And there are a number of other studies supporting this. In contrast, research has shown us that fatigue results in:

 

  • slower reactions and reduced coordination
  • absentmindedness
  • decreased awareness
  • lack of attention
  • underestimation of risk

The fact is that if quality, restorative sleep was prescribed as readily as many other medications and forms of treatment, A&E departments across the country could find themselves significantly less stretched.

The correlation between sleep and obesity are also critical in this discussion. Sleep deprivation has been found to affect the metabolism significantly. 73% of people who sleep for fewer than four hours a night are likely to gain excess weight as the body craves an extra 900 calories a day, on average.

For health professionals, the implications of this can, of course, be wide reaching. Not only for doctors concerned with issues such as cardiovascular disease and diabetes, but for physiotherapists handling musculoskeletal problems caused and exacerbated by weight problems.

 

Righting the sleep environment

A number of factors contribute towards sleep quality, including behavioural, environmental, physical and medical conditions. Whilst addressing behavioural, physical and medical factors such as stress, depression and osteoarthritis can be a significant challenge, optimising the sleep environment may result in immediate and dramatic improvements to the sleep cycle.

Improving the sleep environment can begin with righting some of the simple wrongs of the modern lifestyle – such as reducing screen time, blocking out light pollution from the street, eating and exercising at the right times and avoiding stress.

But above all it is the sleep system that dictates the quality of sleep and the comfort experienced in bed. It is also directly related to the management and maintenance of the musculoskeletal system.

Yet the sleep system – comprised of bed base, mattress, sheets and pillows – remains an under-covered issue in the study of recovery rehabilitation and general health. And outside of hospitals and other healthcare institutions it really does not receive a great deal of attention.

Of course, the typical scenario is that people test a few mattresses in a showroom under the guidance of a sales rep and they opt for a product that feels comfortable at the time of testing and perhaps is part of an attractive display or comes ‘highly recommended’ by the sales staff. But does this really result in a restorative night’s sleep long term. Surely, with such a profound impact on health and wellbeing we should all be sleeping on medically prescribed beds.

Yet historically, there have been no genuine pressure-relieving seats or mattresses widely available for the consumer within the retail market, and none that a clinician can credibly recommend as being backed by a strong evidence base in relation to the management and prevention of long and short-term musculoskeletal conditions and illnesses.

And this leads me on to Mammoth’s unique approach. Mammoth is the only brand to produce beds that are registered medical devices, backed by clinical proof as to their benefits both in terms of sleep quality and direct physiological benefits – in terms of pressure relief and temperature regulation.

 

better sleep with medical grade foam

In clinical trials performed at Northumbria University’s Centre for Sleep Research under the guidance of sleep scientist Professor Jason Ellis, Mammoth’s Medical Grade Foam mattresses significantly outperformed traditional sprung surfaces and memory foam mattresses.

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Mammoth’s unique High Specification Medical Grade Foam is recognised by both the Medicines and Healthcare Products Regulatory Agency and the National Institute for Health and Care Excellence for pressure relief and temperature regulation, and they recently won an NHS Innovations award for their work on pressure relief.

To put this into some form of context, Mammoth commissioned independent tests at SATRA, which showed that against standard 50kg memory foam, Mammoth’s Medical Grade Foam mattresses cooled the body 69% faster and offered 46% greater pressure relief – a significant improvement.

 

So, what’s different about Mammoth’s approach to sleep and comfort?

Traditional mattresses with springs create counter pressure – the opposite of what is required when providing pressure relief. While memory foam does relieve pressure it has not been designed for application in beds. Memory foam requires heat and time to mould to the shape of the body, and as a result this can cause discomfort and dehydration through overheating.

The heat and moisture caused by sweating at night is a significant problem when we consider tissue viability. Of course, a raised skin temperature increases the rate of tissue breakdown and therefore the likelihood of developing pressure sores, while excessively most conditions at the skin/mattress interface macerate the skin, exacerbating the risk of mechanical damage to the skin.

Mammoth represents the very best retail sleep surface for tissue viability based on:

  • Higher heat transfer rates (indicating a cooler skin microclimate)
  • Higher water vapour transfer rates (indicating drier skin microclimate)

 

Unlike traditional memory foam, Medical Grade Foam does not require heat to shape to the contours of the body. This means instant support, instant pressure relief, no seasonal variation and no overheating. Such pressure relief and support enables a Mammoth to:

  • Dissipate pressure at the shoulder and pelvis
  • Support the neck and back
  • Maintain neutral spinal alignment

 

Interface pressures also have a direct impact on transcutaneous oxygen tensions, indicating the second greatest likelihood of tissue breakdown after altered blood flow. These benefits not only come as a result of the quality of the high density, pliable foam but also from the PostureCells cut into the surface of the mattress. These castellations feature cooling air channels, which are great for dispersing heat, moisture and allergens, but they also move independently – shaping to the contours of the body more effectively and encouraging more even support across the body.

The mattress plays a key role in achieving normal sacroiliac joint motion and pain-relieving positions for lower back pain sufferers. Reducing the load on the sacroiliac joints during the sleep cycle may be used to combat a problem that affects 10–25% of lower back pain sufferers. Sleep surfaces such as memory foam are dangerous in that they “lock in” sleepers and do not allow the natural movements of the body required during the night. Mammoth’s mattresses enable the body to continue to move throughout the night, without compromising the pressure relief and support.

Incidentally, this also helps to reduce disturbance at night from a restless partner – something that is a common cause of sleep issues.

How does this stand up to the scrutiny of one of your peers? We invited experienced physio, Tracey Atkinson to give her professional appraisal of our products and, in particular, the Medical Grade Foam, which lies at the heart of all our products. She said:

“On physically testing a variety of mattresses and pillows made up of Mammoth’s High Specification Medical Grade Foam, they provided the correct alignment and support for the spine. By testing the gap within the lumbar spine, the spine did not sink into the mattress so there was no lumbar curve present, neither was there too much of a gap, which would have suggested there was no support at all.”

 

Sitting: the 21st century epidemic

Lying in bed may take up a third of our lives on average, but prolonged periods of time spent seated is a significant challenge in modern society. In fact, the sedentary lifestyle of long hours spent at a desk or sat in front of a screen at home has profound effects on the body – and in the last 2 years this has been a key focus for the evolution of Mammoth’s technologies.

Professor Steve Bevan, director of the Centre for Workforce Effectiveness at the Work Foundation has described “Sitting as the new smoking”.

If we go back to one of my earlier slides, you will no doubt tell me that prolonged sitting is every bit as culpable for the back pain epidemic we face.

pressure relief seating

Just as Mammoth has developed comfort technologies to improve the sleep surface, so that pressure relieving, heat dispersing and supportive Medical Grade Foam material can be utilised in seating to achieve many of the same benefits.

In 2016, Mammoth launched its first seating range, including rise and recline chairs and two- and three-seater sofas, while Mammoth’s integrated pressure-relieving cushion is also featured in a range of La-z-Boy chairs and sofas, which have been refined and improved in consultation with the CSP itself.

The primary focus in these seating options has been:

 

Ensuring hips sit equal to or slightly higher than the knee joint

Using medium-firm Medical Grade Foam, we have helped to avoid the reduced mobility, unnatural hip joint flex, hunched back and stiffness caused when the hips sit lower than the knees.

 

Shortened seat depth to keep feet flat on the floor

On average, 19% of bodyweight is supported by the feet during sitting when feet are kept flat on the floor. This reduces pressure on the posterior, lower back and spine.

 

Standardised chair and arm height for support and mobility

Based on anthropological data gathered by physiotherapists, our chair height and arm height were set at levels appropriate for 90% of the population.

 

Waterfall back ensuring pressure relief when reclining

The waterfall back on Mammoth’s recliner range features more material and a deeper layer of fibre than a traditional recliner. This helps to support more bodyweight through the back of the chair, thus reducing the pressure forced through the lower back and posterior.

 

Ensuring hips sit equal to or slightly higher than the knee joint

  • Improved mobility
  • Correct hip joint flex
  • Natural back position
  • Avoid stiffness

 

Shortened seat depth to keep feet flat on the floor

  • Keeps 19% of bodyweight supported by feet
  • Reduced pressure on posterior, lower back and spine

 

Standardised chair and arm height for support and mobility

– Height set to accommodate 90% of the population

 

Waterfall back ensuring pressure relief when reclining

  • Increased bodyweight through the back of the chair
  • Reduced weight through the lower back and posterior
  • Pressure relief

 

Mammoth has identified that as people age and spend an increasing amount of time seated in their favourite chair at home, they need a seating solution that supports improved mobility. It is also apparent that existing pressure-relieving cushions that are placed on seating serve to impair the ergonomics and increase the chances of slips and trips among the elderly and infirm.

What Mammoth has produced is an integrated pressure-relieving cushion that tackles all of these issues and also meets another requirement of elderly individuals – to gain all the benefits of a medical chair or cushion without the stigma and perceived loss of dignity.

While the range has benefits to offer customers of all ages and physical abilities, it is worth mentioning that this seating range has a particular role to play among those with mobility issues. External medical cushions can cause embarrassment to some elderly or infirm individuals. Indeed, the idea of a traditional “medical chair” in general can be seen by many as a sign of giving up – and something that is to be avoided for as long as possible. Mammoth’s integrated Medical Grade Foam cushion offers the benefits of a medical chair or cushion without the stigma and perceived loss of dignity.

By addressing both seating and sleeping conditions, Mammoth is working towards the goal of 24/7 comfort, offering proven health technologies within stylish and affordable retail products. Through close work with the CSP and its membership we hope to bring the many benefits of our ranges to those who need a credible clinical recommendation the most.

 

Dr Jonathan Bloomfield was speaking at the Liverpool Physiotherapy Show in November 2016 on behalf of Mammoth.

 

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