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DIY mattress help for pressure sore prevention for a wheelchair user 04 Dec 2021 14:18 #1

Hi TMU! I came over from Reddit's mattress sub, hoping to get a bit more feedback on two separate DIY builds I was looking at: one for myself (a wheelchair user where pressure sores are a real concern), and one for a family member.

Mattress 1
The family member build is probably easier, so let me start with that one:: she's a 5'5", 132lb back sleeper who prefers firmer mattresses. Having tried a few different builds at a local Nest Bedding, she liked (but didn't love) their all latex Finch medium best (and experienced dizziness/vertigo when trying their other currently-unnamed all organic latex mattresses). I know that the Finch is an unknown ILD quilted foam cover > 27 ILD 3" Dunlop comfort layer > 36 ILD 6" Dunlop support layer.

Would a good starting point for a similar build here be something like:
  • Unquilted stretch knit cover
  • 20 ILD 3" Dunlop topper? I'm not sure if this would mimic the quilted foam + support layer of the Finch, or if this would be too soft. I imagine an immediate 27 ILD layer would be too firm, unless I opt for one of the medium 25-29 ILD Talalay toppers for a slightly softer feel? I know Arizona also carries 20-24 ILD Talalay layers
  • 34-38 ILD 6" Dunlop base (or two 3" toppers since there are more options there)

Mattress 2
As for myself, I'm a 5'10" 125lb side sleeper who occasionally shares the bed with my 5'4" 135lb combo back/side sleeper girlfriend (who can mostly sleep on anything). The recommendation among healthcare providers for those at high risk for pressure sores seems to be air mattresses, but I'm probably not at high risk yet, though I've definitely had flare ups in the past when traveling and sleeping on firmer hotel beds. My own bed of the past 15 years, a spring base + Tempurpedic topper, has worked fairly well, but has caused concern from time to time as well, and has started sagging, hence the search for a replacement.

I also tried a variety of builds at Nest and found we liked their medium Owl latex hybrid the most (1.5" unknown ILD quilted foam > 27 ILD latex comfort > unknown ILD transitional foam > 6" 15 gauge spring support), rating it a 7 or 8 out of 10 in comfort, but wanted something DIY to allow for more customization as needed to deal with pressure relief, and to try to get closer to a 10 in comfort. Reddit folks actually recommended against a DIY hybrid build due to their added complexity and instability of springs, suggesting all latex, which supposedly would offer superior pressure relief as well.

For added context (or to complicate things lol), Nest's plush Sparrow foam hybrid rated next best at a 6 or 7 (felt close to the medium Owl), while their medium was a 5 or 6 (better support than an Owl but pinched my shoulders), their medium "all" latex Finch rated at a 4 (not sure why I wasn't a fan of this, might have just been too firm, but they didn't have any true all latex non-foam cover layers to try), and plush Owl rated 3 (poor support, and led to lumbar and shoulder pain).

My takeaway from this is that I probably need something softer for comfort, but still need strong support. Would something like this make sense?
  • Unquilted stretch knit cover
  • 19 ILD 3" Talalay topper? Or, alternatively, a medium 25-30 ILD 2" Talalay topped by a softer 19 ILD 2" Talalay?
  • 34-38 ILD 6" Dunlop base? Or even a 38-40 ILD base with one of the two options above for support?

Thanks in advance for the help!

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Last edit: by jmuca.

DIY mattress help for pressure sore prevention for a wheelchair user 07 Dec 2021 00:02 #2

Bump!

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DIY mattress help for pressure sore prevention for a wheelchair user 07 Dec 2021 22:58 #3

Hi jmuca.

Welcome to our Mattress Forum… All the way from the Reddit’s mattress sub :)

Thanks for the details you provided and the little “bump”, helps us keep on our tiptoes. ;)
Pressure relief due to pressure sores is an important criterion for someone that is using a wheelchair for an extended time period.

Having tried a few different builds at a local Nest Bedding, she liked (but didn't love) their all latex Finch medium best (and experienced dizziness/vertigo when trying their other currently-unnamed all organic latex mattresses). I know that the Finch is an unknown ILD quilted foam cover > 27 ILD 3" Dunlop comfort layer > 36 ILD 6" Dunlop support layer….


As it stands, Mattress 1 construction (3” @ 20 ILD Dunlop + 6” @ 34-38 ILD Dunlop core) would be more of a medium plush vs Finch’s medium with the added note that every individual layer and component in a mattress (including the cover, FR barrier, any quilting material, and of course all foam layers) will affect the feel and response of every other layer and component both above and below it and the mattress "as a whole" which means that it only in very general terms you can make an educated guess. To add to this the Finch is using Continuous poured Dunlop which has a different feel and performance than the usual Dunlop even in the same ILD which is relative to the manufacturer (there is not standardized ILD rating across manufacturers)

When you say “she liked (but didn't love)” the Finch what aspect of it was less than your family member would have loved? Was it a bit too firm for her needs?

Moving to Mattress 2 for you and your girlfriend. First off, I would not say that you are a “big guy” as you state in your topic title but rather a tall or lanky body type with a fairly low BMI (which is what it counts when it comes to pressure points). Sorry about the pressure sore “flare-ups”. When foams start degrading would tend to result in pressure point discomfort as the person would go through the broken-down and sagging foams much more and feel the firmer layers below. This is why I’d make sure to find the mattress specifications you need to know so you can compare the quality of the materials and components to the mattress durability guidelines here and know for how long the foam will maintain its integrity. – In this respect latex is both durable and it’s known for its unusual abilities to be both soft and supportive at the same time and to shape itself to the profile of the body having similar pressure relieving qualities to memory foam especially in the lower ILDs. The unquilted stretch-knit cover would certainly allow for the latex to better conform to your body and take advantage of these abilities.

found we liked their medium Owl latex hybrid the most (1.5" unknown ILD quilted foam > 27 ILD latex comfort > unknown ILD transitional foam > 6" 15 gauge spring support), rating it a 7 or 8 out of 10 in comfort, but wanted something DIY to allow for more customization as needed to deal with pressure relief, and to try to get closer to a 10 in comfort.


As you probably know building your own DIY mattress out of separate components that are purchased from one or several different sources I’d make sure the first place I would start is by reading post #15 here and the posts it links to (and option #1 and #2 as well) so that you have realistic expectations and that you are comfortable with the learning curve, uncertainty, trial, and error, or in some cases the higher costs that may be involved in the DIY process. While it can certainly be a rewarding project and can bring you closer to the comfort you need, it's generally characterized by a "spirit of adventure" especially as it is almost impossible to replicate the feel and performance of a mattress unless all materials and construction and manufacturing process are exactly the same. On the other side, a DIY allows for more customization, choice of material, and fine-tuning for a closer match.

For added context (or to complicate things lol), Nest's plush Sparrow foam hybrid rated next best at a 6 or 7 (felt close to the medium Owl), while their medium was a 5 or 6 (better support than an Owl but pinched my shoulders), their medium "all" latex Finch rated at a 4 (not sure why I wasn't a fan of this, might have just been too firm, but they didn't have any true all latex non-foam cover layers to try), and plush Owl rated 3 (poor support, and led to lumbar and shoulder pain).

A mattress works as a whole and in combination with the individuals sleeping on it. I’d say a firmness rating scale is unreliable at worst and at best only possible as an internal way to compare mattresses made by the same company or/and … tested by the same individuals. There are many variables involved in assigning a “confront level” to a mattress. I am not clear what criteria Nest Bedding uses on their internal firmness rating scale to assess this. Suffice to say that no two people are similar and that they would have different comfort experiences on the same mattress. As you have a little more unusual body profile, you’ll have a different comfort perception than other people. It all depends on your BMI, if you have a more bony or curvy profile, sleeping positions, personal preferences, health limitations or conditions, and much more. When a mattress is rated for comfort within a company it is based on an average body type, sleeping position, and individuals who tested it.

My takeaway from this is that I probably need something softer for comfort, but still need strong support. Would something like this make sense?

Yes and no .. as usual, it depends on many variables. As a side sleeper if you have a bony profile you may find that you go through a soft 3” Talalay topper and bottom out onto the firmer layer below thus feeling pressure points along the bony parts. The Alternatives you mention for Mattress 2 is closer to Nest Bedding’s (12.5") Owl Natural Latex Hybrid Mattress

I’d keep in mind that as a side sleeper with a fairly light BMI you won’t need much thickness (3” comfort + 2” topper on top of 6” support) as this may affect the support needed to keep your spine in neutral alignment. This is to say that that only you can say for sure which of the configurations you listed will work best for you.

Hope the information gives you a bit more insight and helps with DIY endeavors.
Phoenix
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Last edit: by phoenix.

DIY mattress help for pressure sore prevention for a wheelchair user 08 Dec 2021 23:09 #4

Thanks for getting back to me, phoenix!

When you say “she liked (but didn't love)” the Finch what aspect of it was less than your family member would have loved? Was it a bit too firm for her needs?


I'll have to double check, but I think the firmness was about right, but that it could have been a little more firm, while the vertigo caused by the other all latex mattresses was harder to diagnose. My only guess is that those might have been too firm, causing her to be positioned/angled in such a way that blood would pool to her head? The other concern was the pricing, with DIY builds coming in at almost half the price of what Nest was quoting, and that's with the Black Friday sales! Conversely, I know you end up spending much more time and energy with DIY builds, so choosing an online retailer as you linked to in post #15 is certainly another option that seemed pretty similarly priced when I initially looked.

Mattress 1 construction (3” @ 20 ILD Dunlop + 6” @ 34-38 ILD Dunlop core) would be more of a medium plush vs Finch’s medium with the added note that every individual layer and component in a mattress (including the cover, FR barrier, any quilting material, and of course all foam layers) will affect the feel and response of every other layer and component both above and below it and the mattress "as a whole" which means that it only in very general terms you can make an educated guess. To add to this the Finch is using Continuous poured Dunlop which has a different feel and performance than the usual Dunlop even in the same ILD which is relative to the manufacturer (there is not standardized ILD rating across manufacturers)


I actually found a few merchants to also do continuous pour, so that helps nix that variation a bit, but I get what you mean about the different materials used in a build. I know it's hard to say, but given that the Finch has that top quilted foam layer (which I imagine is more a plush), I was wondering if the medium plush of a 20 ILD comfort layer would be a good approximation to start with. I believe I've read that having a 27 ILD layer would actually be quite firm and more suited (generally speaking) for stomach sleepers. Would love your thoughts on this!

As a side sleeper if you have a bony profile you may find that you go through a soft 3” Talalay topper and bottom out onto the firmer layer below thus feeling pressure points along the bony parts.


Ah I should have given a little more context there on my body type. It's definitely a bit more unusual because of my disability, but I'd say my upper body is quite fit, and where the majority of my weight lies, while my lower body is quite bony, ankles, knees, and hips included, with the latter being one of the major areas of concern for pressure sores. So in a way, I'm more top-heavy, with most of the pressure likely falling around my hips due to it being the midway. The boniness resulting in bottoming out makes sense though!

The Alternatives you mention for Mattress 2 is closer to Nest Bedding’s (12.5") Owl Natural Latex Hybrid Mattress.


To make a bit more sense of this, do you mean that a build like the 2" 19 ILD talalay > 2" 25-30 talalay > 6" 38-40 ILD dunlop would be a closer equivalent to the Owl?

I’d keep in mind that as a side sleeper with a fairly light BMI you won’t need much thickness (3” comfort + 2” topper on top of 6” support) as this may affect the support needed to keep your spine in neutral alignment.


Likewise, for a bit of clarity here, do you mean that a 2" > 3" > 6" would (possibly) be too thick for support given my BMI, or are you saying that a 2" + 3" would be a maximum I'd likely want to consider? Or, did you mean that I'll possibly need to figure out how to balance support + pressure relief because my bony hips might go through a 3" comfort, while a 2" + 3" comfort (or even a 2" + 2") might be too thick for support due to my lower BMI?

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DIY mattress help for pressure sore prevention for a wheelchair user 11 Dec 2021 00:46 #5

Hi jmuca.

I'll have to double check, but I think the firmness was about right, but that it could have been a little more firm, while the vertigo caused by the other all latex mattresses was harder to diagnose

Let us know what find from your family member. I do understand why she would favor a DIY for price considerations and as long as she is aware of the possible downfalls this approach is as good as others.

I actually found a few merchants to also do continuous pour, so that helps nix that variation a bit, but I get what you mean about the different materials used in a build. I know it's hard to say, but given that the Finch has that top quilted foam layer (which I imagine is more a plush), I was wondering if the medium plush of a 20 ILD comfort layer would be a good approximation to start with. I believe I've read that having a 27 ILD layer would actually be quite firm and more suited (generally speaking) for stomach sleepers. Would love your thoughts on this!

Glad to hear that you found continuous pour Dunlop but there are a few kinks in the road. I’ll detail it below. You are correct the (10”) Finch Natural Latex ~ All foam comes has a plush quilted layer. For ease of discussion here is the general built for both comfort options.
• 1.5" Quilted zippered Cover ~ Polyfoam Quilted to Organic Stretch Knit Cotton & Joma Wool with (Eco Flex) / plush feel (only for this layer)
• 3” 100% Natural Dunlop Latex (Continuous Pour) ….27 ILD (M) or 36 ILD (F) target points
• 6” 100% Natural Dunlop Latex Support Layer 36 ILD (F) target point (Continuous Pour)
Comfort Options: Medium & Firm (On NB internal scale) // Other Features: Split dual comfort available, Made to Order

Based on the ILDs that were given the Continuous Pour is sourced from Latexco. You’d need to confirm the source though. Mountain Top is another producer of Continuous pour which has different specs (ILD, density support factor, and durability) this will translate in a different feel for the same thickness and comfort option.

Your last question about “a good approximation to start with” in trying to use the Finch as a baseline is very difficult if not impossible to answer as it depends on so many other personal variables. Your family member selected the medium comfort option for the Finch as detailed above and a “20 ILD 3" Dunlop comfort layer” in combination with 6” 36 ILD NR Dunlop will be softer and won’t mimic the comfort or feel of the Finch.(1.5” plush quilt in combination with 3” of 27 ILD Dunlop on top of the same core. I am still not very clear what your family member is trying to achieve with this…firmer in the comfort more supportive for the alignment. The feel will also be very different.

. Ah I should have given a little more context there on my body type. It's definitely a bit more unusual because of my disability, but I'd say my upper body is quite fit, and where the majority of my weight lies, while my lower body is quite bony, ankles, knees, and hips included, with the latter being one of the major areas of concern for pressure sores. So in a way, I'm more top-heavy, with most of the pressure likely falling around my hips due to it being the midway. The boniness resulting in bottoming out makes sense though!

For this, I would definitely ask your care provider’s help and recommendations. From where I stand (as a nonprofessional in the field) It looks like you could benefit from e softer zoning for the lighter lower part of your body but not so soft as to sink in too much and throw your fitter and heavier upper part out of alignment. Have you considered a zoned comfort layer? Something like the Mountain Top 7 zoning might be helpful. It looks like zones 7 & 6 are denser than zones 1 & 2 shown in the product pdf but I might be wrong. (I’ll ask next week if that’s the case) You may also need to position yourself a little higher or lower from the horizontal center so that the recessed parts of your body have adequate support. I’d definitely run this scenario by a musculoskeletal specialist.

To make a bit more sense of this, do you mean that a build like the 2" 19 ILD talalay > 2" 25-30 talalay > 6" 38-40 ILD dunlop would be a closer equivalent to the Owl?

For reference (12.5") Owl Natural Latex Hybrid Mattress has the following built
• 1" Organic Stretch Knit Cotton and Joma Wool
• 1.5" 1.5lb Eco-Flex Quilting Foam
• 3" Oeko-tex Cert. Continuous Pour Dunlop Latex (Medium 27 ILD/ Firm 36 ILD)
• 1" 1.5LB Eco-Friendly Comfort Foam
• 6" Reinforced Edge Coil Support Pocketed Coils
• Comfort Options - Plush, Medium or Firm.

In very general terms you could say that the build you mention is heading more towards the Owl, but neither is a “closer equivalent” to it. The mattress heights are different and with a 12.5" mattress ... the firmness would need to go up (than what you would have for a 10” mattress) on average because thicker mattresses will "act" softer for most people. If you make changes to one of the specs (such as the layer thickness of the top layer(s)) ... then you may also need to make other changes to the other layers to compensate. The materials are different and will perform differently.

Likewise, for a bit of clarity here, do you mean that a 2" > 3" > 6" would (possibly) be too thick for support given my BMI, or are you saying that a 2" + 3" would be a maximum I'd likely want to consider? Or, did you mean that I'll possibly need to figure out how to balance support + pressure relief because my bony hips might go through a 3" comfort, while a 2" + 3" comfort (or even a 2" + 2") might be too thick for support due to my lower BMI?

The weight differential between your upper body and lower body is also an important factor… for all intents and purposes, you may need to get a mid-horizontal split construction for the desired 10 comfort level. You are quite right …part of the challenge you may have is to balance primary support with pressure relief for the different parts of your body (see post #4 for primary support, secondary support, and pressure relief and how they are related[/url])

In your DIY quest, it looks like you have a bit more homework to do and I’d start by diving in a few more readings about the effect of thickness in post #14 here . Zoning is suitable for people that have more difficulty finding a mattress with the right "balance" between comfort/pressure relief and support/alignment or who have more challenging circumstances or sensitivities, body types that are more difficult to "match" to a mattress, more complex medical issues, or who have a history of having more difficulty in finding a mattress that works well for them. There is more about zoning in
this article
and in post #11 here and the additional posts it links to but the only way to know whether any specific mattress (zoned or otherwise) will be a good match for you in terms of comfort, firmness, and PPP will be based on careful testing or your own personal experience. You may wish to reach out to TMU zoning expert Flowbeds for guidance on their own dedicated forum. FloBeds offers a zoned option in varying firmness levels

Regardless of how thick/thin zoned/nonzoned a mattress may be, the most important part is how suitable the mattress is "as a whole" for your particular body type, medical condition, sleeping positions, and preferences in terms of PPP (Posture and alignment, Pressure relief, and Personal preferences).

Phoenix
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