I used this mat on top of a foam wedge pillow inside a cotton pillow case, basically it only came into contact through a cotton pillowcase layer plus through my night wear, so no direct skin contact. However the first night I noticed an unexpected difference… the Earthing mat has reduced the number of nocturnal bathroom visits by half! I still find it hard to believe, but it has continued and it makes a massive difference to the duration and quality my sleep, I’d even say my dreams are less stressful!