Engineering the perfect mattress: The influence of substrate mechanics on deep tissue stresses in supine

Abstract

BackgroundWith increasing global interest in sleep hygiene, sleep ergonomics is an area that has been largely understudied. During sleep individuals turn over during the night to restore blood flow in occluded blood vessels, indicating that control of local tissue pressure may play a role in improving sleep comfort. This study investigates the influence of mattress stiffness on tissue compressive stresses during supine lying. MethodsA subject-specific 3D finite element (FE) model of the pelvis area has been developed to simulate supine lying on substrates of varying firmness. Constitutive parameters for the adipose-skin tissue and muscle-organ tissue were calibrated using a novel application of the inverse finite element method. FindingsThe compressive stress was consistently greatest in the muscle interfacing the sacrum at 18.5 kPa on the soft foam, and 30.9 kPa on the firm foam. From soft to firm, the compressive stress increased by 67% at the sacrum, 20% at the ischium, 42% at the lesser trochanter, and 50% at the skin. InterpretationThe non-linearity of the foam substrate had a pressure distributing effect, relieving the peak compressive stresses at the sacrum, indicating that it may be possible to design arrays of foam substrates that can provide most efficient pressure relief.