Should I replace my 20 year old mattress?

Yes, a 20 year old mattress should be replaced. Mattresses wear out long before that age, and a bed this old no longer supports your spine or relieves pressure the way it once did.

Over two decades, foam compresses, coils lose tension, and the surface develops body impressions that throw your spine out of alignment. A 20 year old mattress also holds years of dust, skin cells, and moisture. If you wake up stiff, sore, or sleep better on other beds, the mattress is the likely cause.

Guidance on how often to replace a mattress is one of the most-asked buyer questions, and 20 years is far beyond typical replacement timing.
Most side sleepers prefer soft to medium firmness, while most back and stomach sleepers prefer medium to firm.
A hybrid mattress pairs individually pocketed coils with at least 2 inches of foam comfort layers.
CertiPUR-US certification caps total VOC emissions at 0.5 ppm, which helps limit off-gassing from a new foam mattress.
A mattress from 20 years ago likely predates modern pocketed-coil hybrids and cooling comfort layers.