Saatva RX vs Helix Midnight Luxe: Which luxury mattress for back pain should you buy?

As someone who deals with episodes of lower back pain, one of the things I look for when testing mattresses is lumbar support. Two of my favorite mattresses that I've tested are the Saatva RX and Helix Midnight Luxe. Both deliver targeted lumbar support along with superb pressure relief and a luxurious finish, but which one should you buy if you have back pain?

The Saatva RX is a mattress made for people with joint and back conditions such as scoliosis, arthritis, and sciatica. We named it our best mattress for back pain overall for its exceptional pressure relief and supportive build. I noticed a reduction in my lower back pain after sleeping on it.

The Helix Midnight Luxe makes our best mattresses of 2025 guide as our top choice for side sleepers who want a balanced bed with a plush pillow top they can comfortably fall into. I slept on the version with an ErgoAlign upgrade, and I woke up refreshed and pain-free each morning.

Below, I'll be comparing the Saatva RX and Helix Midnight Luxe in areas of price, design, comfort and support, and temperature regulation — all based on the testing conducted by me and my fellow reviewers.

Saatva RX vs Helix Midnight Luxe: Price & trial

• The Saatva RX retails for around $1,000 more than the Helix Midnight Luxe
• White Glove Delivery is free from Saatva but costs extra from Helix
• Both Saatva and Helix offer a lifetime mattress warranty

The Saatva RX is among the brand's most expensive beds, with a queen-size retailing for $3,399. You'll rarely have to pay this price as Saatva mattress sales happen year-round.

However, I recommend waiting for one of Saatva's percentage-off sales to purchase a Saatva RX at the best possible price. Discounts typically range from 12% to 15%, saving you about $500 on a queen-size. In contrast, Saatva's general dollar-off discounts reduce prices by $300 to $400.

Meanwhile, the Helix Midnight Luxe is a comparatively more affordable option, but it's still a premium-priced mattress, even with regular Helix mattress sales.

A queen-size Helix Midnight Luxe retails for $2,373, but it typically sells for 20% to 27% less, dropping the price as low as $1,733. You can add cooling and support upgrades, including an ErgoAlign layer for extra lumbar relief, but these can increase the final price by hundreds of dollars.

Unlike the Helix Midnight Luxe — a mattress-in-a-box delivered for free to your doorstep — the Saatva RX arrives flat via free White Glove Delivery, which includes the removal of your old bed and foundation. Helix offers an à la carte White Glove service in select ZIP codes from $119.

Both Saatva and Helix offer a lifetime warranty, but Saatva offers a much longer trial period of one full year. (Helix provides a 100-night trial.)

Saatva RX: was from $1,999 now from $1,799 at Saatva
This luxury mattress for sleepers with chronic and serious back and joint pain is Saatva's most expensive mattress behind the Solaire, Saatva HD and larger sizes of the Zenhaven. All sizes are $200 to $400 off, bringing the price of a queen down to $3,049 after $350 off (was $3,399). It comes with a 365-night trial, a lifetime warranty, and free White Glove Delivery straight to your bedroom, including old mattress removal.

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Helix Midnight Luxe: was from $1,373.80 now from $1,048 with code TOMS27+ freebies at Helix Sleep
The Luxe Collection represents the mid-point of Helix's lineup. Use our exclusive code TOMS27 for 27% off, bagging you more money off than the brand's ongoing 25% off sale. With our coupon, a queen-size Midnight Luxe falls to $1,733 (was $2,373). It also comes with free sheets and a mattress protector, along with a 100-night trial, a lifetime warranty, and free shipping.

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Saatva RX vs Helix Midnight Luxe: Materials & design

• The Saatva RX is a 15" hybrid of springs, foam and microcoils
• The 13.5" Midnight Luxe has a pillow top, coils and multiple foams
• Midnight Luxe upgrades add more lumbar support and cooling

At 15", the Saatva RX is one of the tallest mattresses on the market. Atop a bed of triple-tempered recycled steel coils sits a layer of waved foam with five zones to target pressure points along the hips, shoulders, and lower back. Firmer caliper spring coils line the bed lengthwise for stronger edges at the sides.

The comfort layers consist of 1" micro-coils sandwiched between two pieces of 3/4" high-density foam, topped by a half-inch strip of gel-infused foam across the middle for lumbar support. The organic cotton cover features special quilting in the center to complement the lumbar crown.

The 13.5" Helix Midnight Luxe features a quilted pillow top, a dense layer of responsive foam, a layer of copper gel-infused memory foam and a transitional foam layer.

Below this is to up to 1,000 individually-wrapped springs, which are reinforced across the middle and along the perimeter for extra lumbar and edge support, respectively.

You can level up the standard Tencel cover to a specialist GlacioTex cooling material to boost temperature regulation. For maximum relief from night sweats, you can also add a series of graphite-infused ribbons on top of the gel-infused foam comfort layer to help draw heat away from the surface.

Opting for the ErgoAlign upgrade adds a three-zoned foam layer directly above the coils. It's denser in the middle to support the lower back.

Saatva RX vs Helix Midnight Luxe: Support & comfort

• We rate the Saatva RX a 7.5-8/10 firmness (firmer than advertised)
• We rate the Midnight Luxe a 6/10 firmness (close to Helix's rating)
• Our testers experienced reduced in back and hip pain on both

The Saatva RX is rated 'Supportive Plush,' which Saatva describes as between 3-4 out of its 10-point firmness scale. However, my fellow testers and I considered it medium-firm to firm, between a 7.5 and an 8, in our Saatva RX Mattress review.

Despite that perceived firmness, the Saatva RX delivered on pressure relief. In our objective tests using a 50lb weight, we measured a 3.5" sink in the middle and a 2.5" sink toward the foot of the bed.

We enjoyed the Saatva RX most for back sleeping — one of our testers likened it to relaxing on a pool float. The combination of foams, springs, and microcoils evenly distributed our weight and contoured our bodies for full-body relief without sacrificing support. The stomach sleepers in our group gave it their seal of approval, as well, as their hips didn't dip.

As for side sleeping, the reactions were mixed. While I managed just as well on the Saatva as an average-sized sleeper with lower back pain, one of our smaller side sleepers with chronic pain from RSD and herniated discs couldn't get comfortable due to pressure buildup in her hips.

Helix rates the Midnight Luxe a 6 out of 10 on its firmness scale. In our Helix Midnight Luxe Mattress review, our testing panel agreed with that assessment, although I personally felt it was closer to a 7/10 with the addition of the ErgoAlign layer.

Our lead tester for the Midnight Luxe (sans upgrades) benefited greatly from the plush premium pillow top, ultra-responsive foam comfort layers and reinforced midsection. She didn't experience the 'dead hip' she's prone to developing when resting on her side for too long.

With the ErgoAlign layer, I was surprised to find myself involuntarily flipping onto my back, which is likely a good thing, given my history of back pain. The increased support in the middle helped with alignment, and the pillow top fit the nook of my lower spine nicely.

As versatile as the Helix Midnight Luxe is, we wouldn't call it a sound mattress for stomach sleepers, as it's not quite firm enough for that. (I was able to rest on my front with the ErgoAlign upgrade, but not long-term.)

Saatva RX vs Helix Midnight Luxe: Temperature control

• Both mattresses scored a 4.5/5 in our temperature regulation tests
• The Saatva RX has a breathable cotton cover and PCM-infused foam
• The Midnight Luxe's features multiple cooling upgrades

The waved foam layer inside the Saatva RX is infused with graphite and phase change materials (PCM) to help keep the mattress at a reasonably cool temperature. That's in addition to the breathable organic cotton cover and layers of coils and microcoils through which air can travel freely.

I slept on the Saatva RX through a transitional season. No matter the temperature, I was perfectly cozy — not once did I wake up sweaty. For most people, the Saatva RX will maintain a comfortable microclimate for sleep.

Our lead tester awarded the Helix Midnight Luxe's temperature regulation a passing grade, with the caveat that she's not particularly a hot sleeper. However, the mattress now boasts 4lbs of titanium and graphite-infused memory foam for greater cooling prowess than the model we tested.

The Tencel cover will be breathable enough for most people, but if you deal with chronic overheating, consider turning it into a proper cooling mattress by adding a GlacioTex cover with a soothing sensation and graphite ribbons beneath the cover to draw heat from the surface.

Saatva RX vs Helix Midnight Luxe: Which one should you buy?

Buy the Saatva RX if...

✅ You want a luxurious orthopedic mattress: Saatva has created a supportive, comfortable mattress for sleepers with serious chronic back and joint conditions that's more fitting for a hotel suite than a hospital room.

✅ You don't want a mattress-in-a-box: Saatva doesn't roll-pack its mattresses like Helix does, so they're delivered flat. That means your mattress will be ready to sleep on almost immediately — and you shouldn't have to worry about off-gassing, either.

✅ You want the best perks in the industry: White Glove Delivery is free, and it includes haul-away of your previous mattress and foundation, too. You also get a full year to test it at home, allowing you to try it across all seasons and circumstances.

Buy the Helix Midnight Luxe if...

✅ You're a dedicated side sleeper: The Helix Midnight Luxe is the best mattress for side sleepers we've ever slept on. The plush pillow top, contouring foams, and reinforced middle deliver the ideal combination of lower back support and joint relief for the hips and shoulders.

✅ You want to make your mattress your own: While the Helix Midnight Luxe only comes in one firmness level, you can modify it to suit your preferences by boosting the lumbar support and/or cooling features.

✅ You have a (relatively) smaller budget: Of course, this is very much a splurge, but even with upgrades, you'll still wind up spending less for the Helix Midnight Luxe than you would for the Saatva RX.