Mattresses should be placed atop a firm base to prevent sagging. A new mattress should be rotated once a month for the first six months and once every 2–3 months after that. Double sided, or two sided, mattress should be alternately flipped and rotated. Manufacturers suggest that one rotate (spin) the box springs or foundation twice a year. Folding and bending of the mattress should be avoided if possible, as should heavy wear in one spot and excessive weight on the handles.
Once a mattress no longer feels supportive and instead seems to contribute to body pain or stiffness, it should be replaced. Some symptoms of a broken or worn out mattress include springs which can be felt poking through the upholstery layer, visible permanent sagging or deformity, lumpiness, and excessive squeaking.

Queen and larger size mattress sets should be supported by a 5- or 6-leg frame. A queen size mattress is 60 inches wide and requires more support than smaller sizes. If using a headboard/footboard style bed, one should use at least five wood slats with three positioned primarily in the center third of the bed.