Air mattresses primarily intended for hospitals, long-term care facilities and in-home use are described. The mattress includes multiple foam layers and an air sector having multiple resilient foam filled air cylinders. The air cylinders at different locations are filled with foam having different density (firmness); some are filled with multiple layers of foam. Each air cylinder has an air inlet connected to the atmosphere by an inlet valve and an air outlet. The air outlets are either connected to one or more restricted internal check outlet valves in a non-powered air mattress, or connected to a pump via hose connectors in a powered air mattress. The restricted outflow of air from the cylinders in a non-powered air mattress allows the patient to slowly settle into the supportive foam layers for optimal interface pressure distribution. The air cylinders re-inflate when the patient adjusts position or is vacated from the surface.