Protective Bedding: Underpads vs Mattress Protectors vs Protective Sheets

Chad Birt

Written by Chad Birt on Tue Aug 17 2021.

Protective Bedding: Underpads vs Mattress Protectors vs Protective Sheets

Many people living with incontinence also experience nocturnal enuresis or bedwetting. Though common, without adequate protection, frequent accidents can damage your loved one’s mattress, blankets, and other bedding. To prevent stains and unpleasant odors, it’s important to invest in protective bedding, but what’s the difference between underpads vs. mattress protectors vs. protective sheets, and what’s best for your situation?

Everyone’s situation is different, but with a little bit of research and planning, it’s possible to make the right decision for you and your loved one. To assist in your efforts, we’ve created this comprehensive guide.  

What’s the difference between underpads vs. mattress protectors vs. protective sheets?

Before you purchase protective bedding, it’s important to understand the differences between the most common types:

Underpads. Underpads, or “chux,” are rectangular sheets of fabric with two layers of waterproof plastic. The plastic has absorbent polymers inside that provide a barrier against all types of moisture, including urine and fecal matter, foods, and beverages. 

Underpads offer a convenient, protective solution in almost any situation. You can put them on your loved one’s wheelchair, in the passenger seat of the car, or under the fitted sheet in your loved one’s bed. Some caregivers even use underpads as “puppy pads” for their furry companions. Experts suggest changing underpads at least every 12 hours—once in the morning and once at night.

Mattress protectors. Mattress protectors are waterproof coverings that look similar to a fitted sheet. Some envelop your entire mattress and have a zipper; others fit snugly over the corners of your mattress with elastic.

Mattress protectors have an absorbent, comfortable underlayer made of vinyl or polyurethane laminate. These materials repel liquid and reduce bacteria responsible for unpleasant odors and stains. Because of their unique qualities, mattress protectors don’t require changing right away. Your loved one can sleep through the night, even if they experience an accident.

Protective sheets. Protective sheets are an affordable alternative to mattress protectors. They look and feel like normal bedsheets, but have absorbent properties. This type of incontinence protection is particularly beneficial if your loved one spends several nights a week in a medical facility or care home. You might also want to invest in protective sheets if you frequently travel. Simply replace the hotel’s bedding with a protective sheet and then dispose of it in the morning.

What factors should I consider when selecting incontinence bedding?

There are so many underpads, mattress protectors, and protective sheets available, it can be difficult knowing what type will meet your loved one’s needs. To help streamline the process, we recommend focusing on three specific areas—comfort, ease of cleaning, and the frequency of changes.

Comfort. Comfort refers to an incontinence product’s ability to promote a good night’s sleep. Some incontinence bedding is made from absorbent, clothlike materials. Others feature vinyl or plastic. Vinyl and plastic are relatively cheap, but they trap heat and tend to make noise. Cloth and urethane products are more breathable and provide additional padding. They’re more absorbent and encourage airflow.

Frequency of changes. How often does your loved one experience accidents? If it’s a routine problem, you’re better off with disposable options like protective sheets or underpads. If they only have accidents on occasion, a longer-lasting solution, like a zip-up mattress protector might be your best bet. 

When thinking about the frequency of changes, consider the amount of work involved, too. Zip-up mattress protectors often require at least two people to change, while changing underpads or protective sheets is a one-person job.

Ease of cleaning. Disposable underpads and protective sheets don’t require cleaning. As soon as they’re used you throw them away. If you select a reusable option, like a zip-up mattress protector, take time to read the care instructions. Often, cloth and urethane mattress protectors go in the washing machine. Vinyl covers require hand washing with soap and warm water.

What type of incontinence protection is best for people who are bedridden?

If you care for someone with mobility issues, daily changing of their sheets or mattress cover probably isn’t an option. Underpads offer a convenient way to protect against urine or bowel voids. Most underpads hold up to 300 pounds without tearing, so you can gently change their position without inconveniencing your loved one.

Where can I buy underpads vs. mattress protectors vs. protective sheets?

At Carewell, we carry a variety of underpads, mattress protectors, and protective sheets. Below, we’ve highlighted some of our top sellers:

Beck’s Classic Reusable Underpads, Heavy

These sturdy, reusable vinyl underpads come in three sizes (34” x 36”; 36” x 52”; 36” x 72”). They have an ultrasoft cotton top sheet that mimics natural bedding while promoting airflow. A waterproof backing stops moisture from passing through, keeping your loved one (and furniture) dry and protected.

Key Benefits & Features:

  • Vinyl backing is sturdy and waterproof

  • The cotton top sheet is soft and gentle against the skin

  • Extra thread count ensures a long lifespan

  • Eco-friendly

McKesson® Underpads, Light

If your loved one only experiences incontinence on occasion, consider these light underpads from McKesson. Each underpad features a fluff/polymer core with a superior mat configuration. What’s more, the underpads’ heat-sealed, non-woven edges are gentle on even the most sensitive skin. 

Key Benefits & Features:

  • Polymer backing

  • Non-woven top sheet

  • Offers urine and fecal protection

  • Unisex

Protect-A-Bed Mattress Cover

The Protect-A-Bed Mattress Cover comes in four sizes – Twin, Full, Queen, and King. It features a miracle membrane barrier that protects against mites and other allergens. The waterproof layer on top blocks incontinence and perspiration, but is air permeable, ensuring your loved one remains comfortable and dry.

Key Benefits & Features:

  • Made of quick-drying, jersey knit polyester fabric

  • Safety tested and certified by the standard 100 by Oeko-Tex

  • Machine washable

  • Dryer safe

Graham-Field PVC Plastic Mattress Cover 

This PVC plastic mattress cover from Graham-Field is one of the newest additions to the Carewell store. It fits on any twin-size mattress and provides maximum protection against moisture, stains, and dust.

Key Benefits & Features:

  • Easy to clean

  • Completely envelops the mattress

  • Affordable

Tranquility® Peach Sheet Underpads, Maximum

These peach sheet underpads from Tranquility offer more than five square feet of protection and have four securing tapes, perfect for attaching them to a bed, wheelchair, or another piece of furniture. Each pad holds up to 34 fluid ounces (4.25 cups) and has a cloth-like top sheet that’s easy on even the most sensitive skin.

Key Benefits & Features:

  • Latex-free

  • Made in the USA

  • Disposable

  • Peach Mat Core keeps skin dry and reduces odors

Frequently Asked Questions (FAQ) – Underpads vs Mattress Protectors vs Protective Sheets

1) Which is Better – underpads, mattress protectors, or protective sheets?

There’s no right or wrong answer. The type of incontinence product that will benefit your loved one most, depends on their age, medical history, and the frequency at which they experience urine or bowel voids. 

If your loved one is relatively mobile and only has accidents occasionally, consider underpads. If they’re bedridden or wheelchair-bound and require frequent changes, a mattress protector or protective sheet is your best bet.

2) Are there different types of underpads?

There are two types of underpads—disposable and reusable. Disposable underpads are quick and convenient. Following a void, toss out the dirty pad and replace it with a fresh one. Reusable underpads are more economical. They’re machine washable and can be used dozens of times. 

3) What if I still have questions about underpads vs. mattress protectors vs. protective sheets?

If you have additional questions about underpads, mattress protectors, or protective sheets, contact our friendly Care Team at (800) 696-CARE or send an email to

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Chad Birt
Chad Birt

Chad Birt is a freelance medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.