Buying guide · Pressure care

Foam or alternating air mattress?

Name: Connect Mobility
Address: T27/9 Margaret Street, Picton, NSW, 2571, AU
Telephone: 1300 216 888
Price range: $$

Written by Nadim Assaf, registered pharmacist, Connect Mobility in Picton

Both protect skin that spends a lot of time in bed. Let's look at how each one works and when air is worth the extra cost.

Start with the skin

If the skin is healthy and you can still shift position, a good foam mattress is usually the place to start. The research backs this up.

Alternating air earns its price when someone can't move themselves, or already has a sore that won't settle. Your nurse or OT should make that call with you.

At risk, but no sore yetLifecomfort foamfrom $1,099

Your nurse says air, and you want to keep your mattressActive Air 5 Overlayfrom $2,699

High risk, can't turn aloneActive Air 8from $3,539

A deep sore that needs the most supportCuroCell A4 CX15from $6,499.95

You're not sure yetCall 1300 216 888talk it through

How each one works

A pressure sore starts when skin and the tissue under it get squashed for too long. Blood can't get through. Heels, hips, the tailbone and shoulder blades go first.

Foam spreads the body's weight over a bigger area. The deeper layers stop you sinking right through to the bed base. Nurses call that bottoming out.

An alternating air mattress is a row of air cells joined to a pump. Every second cell empties, then fills again. That takes pressure off each patch of skin for a few minutes at a time.

What the research found

The biggest trial so far is PRESSURE 2 from the UK. It put 2,029 high-risk hospital patients on either good foam or alternating air.

New sores were a little less common on air. But the gap was small enough that it could have been chance. There was an early benefit on air that faded over time.

A 2021 Cochrane review came to a similar place. Alternating air "may reduce" the risk compared with foam, with low certainty. The 2025 international guideline recommends high-spec foam for people at risk.

These trials were in hospital. We don't have the same research for people at home, and we won't pretend otherwise.

When air makes sense

NSW Health's Agency for Clinical Innovation gives a simple test. Can you lie in positions that keep weight off the sore? And do you stay clear of the bed base? Then foam or another static surface is enough.

If you can't keep off the sore, or you bottom out, move to air.

Whichever you choose, keep changing position. Victorian Health says repositioning is always needed. No mattress does that job for you.

In between

Two of our mattresses sit between foam and alternating air.

The CuroCell Area Zone has air cells over foam but no pump. It needs no power. Care of Sweden rates it up to stage 3. It starts at $3,999.95.

The SAM PRO CF16 has a pump, but the cells don't take turns. They hold a steady low pressure instead. It starts at $4,499.95.

Living with a pump

The most common complaint from carers is the pump at night. Newer pumps are quiet. Care of Sweden lists the CuroCell A4 pump at 17 dBA, which is quieter than a whisper.

Some people feel the cells moving, or find they get warm and sweaty. Try it for a few nights before deciding it isn't working.

Never cover the pump with bedding or clothes. It needs air around it to stay cool.

If the power goes out, the Active Air mattresses hold air for up to 24 hours in transport mode. CuroCell A4 mattresses hold air for at least 12 hours.

The Active Air and CuroCell A4 mattresses both have a CPR release that lets the air out fast. Find it on day one.

Bed rails and bed pads

An overlay goes on top of your mattress, so it lifts the person higher. The Active Air 5 adds 13 cm. That makes bed rails lower in effect.

UK safety guidance says the top of a rail should sit at least 22 cm above the mattress. Check your rails before the first night.

Keep what's under the skin thin. NSW guidance says not to add anything on top unless the mattress maker allows it. Ask us before you put a washable bed pad on an air mattress.

Our range

Care of Sweden rates its mattresses by the stage of sore they can help with. Aspire rates by risk level. The two aren't directly comparable, so ask us if you're unsure.

FoamAspire Lifecomfort Pressure Reducingfrom $1,099Four foam layers, 15 cm deep. Aspire rates it for medium risk. Up to 150 kg.View mattress

FoamCare of Sweden Optimal 5zonfrom $2,099.95Five zones for different parts of the body. Rated up to stage 3. Up to 180 kg.View mattress

Air overlayAspire Active Air 5 Overlayfrom $2,699Sits on your own mattress. 16 cells. Aspire rates it for medium risk. Up to 175 kg.View mattress

AirAspire Active Air 8from $3,539Goes straight on the bed base. Firms up when the bedhead is raised. High risk, up to 200 kg.View mattress

Air overlayCuroCell A4 CX10 Overlayfrom $5,499.95Sits on your mattress. Alternating, pulsating and low-pressure modes. Rated up to stage 4.View mattress

AirCuroCell A4 CX15from $6,499.95Full replacement, 15 cm deep. Rated up to stage 4. Up to 200 kg.View mattress

Cleaning the covers

From the makers' manuals

Both Aspire and Care of Sweden covers wash at up to 95°C. Don't use phenol-based cleaners on either.

Aspire says not to dry covers in direct sun. Care of Sweden says never to wring the foam core.

Check the cover often for tears or holes. A damaged cover lets fluid into the foam or cells.

Paying for it

On the NDIS, a mattress under $1,500 counts as low-cost assistive technology. Above that, you'll need written advice from an OT, nurse or other assistive technology advisor.

DVA needs a prescription from an OT, nurse or physio. On Support at Home, the AT-HM scheme covers these, and your provider arranges the assessment.

Send us the prescription and we'll quote the same day. We're NDIS registered (#4050144759).

Questions we get

Can I use an air mattress on an adjustable bed?

Yes. The Active Air 8 even adds pressure when the bedhead goes above 45 degrees, so you don't sink through. Read our adjustable beds guide for more.

What about a chair cushion?

Sitting puts even more pressure on the tailbone than lying down. If you sit for long stretches, see our pressure care cushion guide.

Do they come in king single?

Yes, all six do. The Lifecomfort foam also comes in double and queen.

How long do the warranties run?

Aspire gives 2 years on the Active Air pumps and mattresses, and 5 years on the Lifecomfort foam. Ask us for the Care of Sweden terms on a particular model.