When you hear the term “alternating pressure air mattress”, it sounds like a cutting-edge solution; something you’d expect in every hospital room to prevent pressure injuries.
But here’s the truth: there’s no clear evidence that air mattresses perform better than high-specification foam (HSF).
Even after a large, two-year clinical trial with over 2,000 high-risk patients, researchers found no statistically significant difference between the two surfaces (Nixon et al., 2019).
So, while a tiny difference was detected (a 2% difference in pressure injury rates), it was so small that it may simply be random noise, not a real benefit of air mattresses.
The Study That Burst the Bubble
This wasn’t just any study. The PRESSURE 2 trial was a follow-up to years of research showing that high-specification foam (HSF) consistently outperforms standard hospital foam mattresses and is recommended as the minimum prevention standard in national and international guidelines (Nixon et al., 2019).
Before this trial, a Cochrane review of 10 Randomised Controlled Trials (RCTs) had already found no clear evidence that Alternating Pressure Mattresses (APMs) were better than HSF (relative risk: 0.85; 95% CI: 0.64 to 1.13) (Nixon et al., 2019).
Despite this, APMs are still widely used, often without demonstrated patient benefit.
The PRESSURE 2 Trial: What They Found
Over two years, more than 2,000 high-risk patients in UK hospitals were randomly assigned to:
- Alternating Pressure Mattresses (APMs)
- High Specification Foam (HSF)
Here’s what happened:
- 6.9% of patients on APMs developed a new grade 2 or worse pressure injury.
- 8.9% of those on HSF did.
So yes, APMs had a slightly lower injury rate. But the researchers stressed:
- The difference was not statistically significant.
- It may not be clinically meaningful.
- You’d need to treat 50 patients on an APM to prevent one injury
In other words, even if the small benefit were real, it would only make a difference for 1 in 50 patients.
More Technology ≠ More Comfort
Let’s not forget the patient experience. The PRESSURE 2 study also captured how patients felt using each mattress:
- Many patients on APMs felt unsafe, disturbed by the noise, or frustrated with the constant motion (Nixon et al., 2019).
- Sleep quality, a key part of recovery, was rated lower on air mattresses.
- A higher proportion of patients on APMs requested mattress changes due to discomfort, with 40.5% citing issues like noise and movement disturbances.
- In contrast, only 12.7% of patients on HSF mattresses requested changes for similar reasons (Nixon et al., 2019).
So even for the 1 in 50 patients who may benefit, 49 out of 50 sacrifice their comfort, sleep, and sense of safety.
What About the Cost?
Alternating Pressure Mattresses are not cheap.
In fact, they can cost upwards of $10,000 per unit.
High-specification foam? A fraction of that cost.
Interestingly, the PRESSURE 2 study found that APMs were marginally more cost-effective, but this was mostly in ICU settings, where many patients cannot be repositioned and where APMs might provide the greatest benefit (Nixon et al., 2019).But if you take ICUs out of the equation? The story changes. For most patients in general hospital wards and aged care, the benefits don’t justify the cost.
Enter LenexaCARE®: Smart, Personalised, and Always On
LenexaCARE® is not a mattress replacement, it’s a smart sheet that works with any foam, air, or hybrid surface to deliver real-time pressure monitoring and precision-guided prevention. Because while air mattresses have long been seen as high-tech, all the evidence points to the dangers of simply relying on air to prevent pressure injuries. Only LenexaCARE® sees risk building up in real time and alerts staff before harm begins.
At Lenexa Medical, we refuse to accept that nearly half of already vulnerable patients on air mattresses should have to sacrifice their comfort, peace, or sleep quality, especially when there’s a better way.
LenexaCARE® is not a mattress replacement, it’s a smart fabric sensor that works with any surface to deliver real-time pressure monitoring and precision-guided prevention.
LenexaCARE® objectively tracks pressure injury risk as it develops, saving staff time, supporting compliance, and ultimately empowering teams to prevent injuries before they occur.
We think the sensor works best with high-specification foam mattresses. While air mattresses have long been seen as high-tech, all the evidence points to the dangers of simply relying on air to prevent pressure injuries.
Facilities using LenexaCARE®, including those previously experiencing over 5 to 10 pressure injuries per month, have successfully eliminated them entirely.
So what makes LenexaCARE® different?
It doesn’t cycle pressure like APMs, it uses real-time, intelligent pressure monitoring to detect when and where intervention is needed.
Here’s how we change the game…
🔹 True prevention, not just redistribution
LenexaCARE® identifies prolonged pressure early and prompts staff to act, before damage occurs.
🔹 Continuous, personalised monitoring
Every patient’s pressure pattern is tracked in real-time, tailored to their individual needs.
🔹 Data-driven decisions that drive accountability
Accurate, visual pressure data ensures effective repositioning, staff accountability, and compliance, no guesswork.
🔹 Tracks risk before Stage 1s appear
LenexaCARE® can detect high-risk accumulation of pressure before visible signs emerge, giving carers time to intervene.
🔹 Silent, seamless care
No noisy pumps. No bulky equipment. Just a discreet, medical-grade cover that works 24/7 to protect patients with dignity and comfort.
Time to Move Beyond Air
For decades, air mattresses have dominated pressure injury prevention strategies, but the evidence doesn’t stack up.
The difference in patient outcomes is so small that it may not even be real.
With LenexaCARE®, you’re introducing a smarter, more accountable, more patient-centred solution. On a comfortable surface.
LenexaCARE® makes you smarter and residents happier. Regardless of the surface, our intelligent sensor tracks pressure risk in real time, ensuring that repositioning decisions are evidence-based and effective.
It’s time to invest in prevention that’s personal, not inflatable.
🔗 Want to see how LenexaCARE® works?
We’d love to show you. Contact us to book a demo or clinical case study.
References
National Institute for Health and Care Excellence (NICE). (2015). Pressure ulcers: prevention and management (Clinical guideline [CG179]). https://www.nice.org.uk/guidance/cg179
National Pressure Injury Advisory Panel (NPIAP), European Pressure Ulcer Advisory Panel (EPUAP), & Pan Pacific Pressure Injury Alliance (PPPIA). (2019). Prevention and treatment of pressure ulcers/injuries: Clinical practice guideline. https://www.internationalguideline.com/
Nixon, J., Moore, Z., Cullum, N., Barnard, A., Nelson, E. A., Iglesias, C., … & Brown, S. (2019). Pressure relieving support surfaces for prevention of pressure ulcers: Clinical effectiveness and cost-effectiveness analysis. Health Technology Assessment, 23(52), 1–176. https://doi.org/10.3310/hta23520
