You wash your sheets every week. And your mattress itself? You never really see it get clean, because what's in it sits deeper than a sheet can catch.
On average, a body loses sweat and skin flakes every night, which build up, night after night, in the fibres of your mattress. Over a year, you're talking about roughly one and a half kilos of sweat that has soaked in. Not visible. Usually not something you can smell. But it's there, every time you put your face on the pillow and breathe for eight hours above what's underneath you.
Washing a mattress cover, vacuuming, airing it out now and then: it feels like maintenance. And it is, on the surface. But sweat soaks into the fibres. Skin flakes are exactly what dust mites live on. Neither disappears by running a vacuum cleaner over it, however thoroughly.