It took a week or so to get used to but I have really great sleep now. I wasn't doing too bad before but I got it mostly because of occasional problems with reflux and my neck is really stiff in the morning. It's not clear to me that it addressed my neck issues, which may be arthritis, but it definitely gives me more restful sleep.
So for the positives:
* High quality materials, excellent memory foam in the wedge.
* Long pillow is soft and super comfortable
* Once in position, it's very comfortable and relaxing
* Considering the cost of expensive pillows alone, this is overall an excellent value
Downside:
* It took a week or so to get comfortable
* It takes a little effort to get into position properly. You can't just plop down.
* Once in position, you are pretty locked in. Sometimes I flop onto my back without much difficulty. But switching sides requires a conscious effort of movement and repositioning
* On my usual (Ikea) mattress, my hip gets sore after a while and I have to switch. This is because a lot of weight centers on your hip because of the angle of the wedge. I have no problem when I sleep on a memory foam mattress (tempurpedic).