Rotate the pillow-top mattress at the beginning of every season, or every three months, to keep sagging and wallows from happening. Lift the entire mattress and spin it 180 degrees so the portion from the head of the bed ends up at the foot of the bed.
Vacuum the pillow-top mattress each time you change the sheets to remove skin flakes, dust and dust mites. Vacuum the top and sides of the mattress and use a brush attachment, if available, to bring up particles from the fibers.
Spot check the mattress each time you vacuum to look for spills or stains on the pillow top. Spot clean any problem spots or stains with an upholstery cleaner and with a sponge rather than attempting to clean the entire mattress. Allow the area to dry thoroughly before putting sheets on the bed.
Beat the surface of the mattress pillow top with a broom handle or cane to fluff the material inside every one to two months. Work evenly across the entire top of the mattress with steady, light hits for 10 to 20 minutes.
Place a mattress pad over the pillow-top mattress to protect it if you expect spills or stains in the future, such as in homes with children or pets. Use a mattress pad that is machine washable for ease of cleaning.