According to current trends in healthcare sensing technologies, we describe a textile-based pressure sensing matrix that can be integrated in the mattress of a smart bed to characterize sleeping posture/movement of a subject and to extract breathing activity. The pressure mapping layer is developed as a matrix of 195 piezoresistive sensors, it is entirely made of textile materials, and it is the basic component of a smart bed that can perform sleep analysis, can extract physiological parameters, and can detect environmental data related to subject’s health. In this paper, we show the principle of the pressure mapping layer and the architecture of the dedicated electronic system that we developed for signal acquisition. In addition, we describe the algorithms for posture/movement classification (dedicated artificial neural network) and for extraction of the breathing rate (frequency domain analysis). We also perform validation of the system to quantify the accuracy/precision of the posture classification and the statistical analysis to compare our breathing rate estimation with the gold standard.