In Short: Great comfortable cooling side sleeper pillow, would recommend. Only gripe is not as lofty as I would like. See full review below... After using this pillow for about a month, I am torn on whether I like it more than my regular pillows. A little background...I am a side sleeper/stomach sleeper. However, I tend to favor side sleep, only rolling my hips onto my stomach, so my head alignment always tends to be in ""side sleep"" configuration. I chose this pillow because it literally looks like how my pillows turn out after months of use...the center middle of the pillow is always crushed (due to my shoulders digging into pillow). So if anything, this seemed like a great fit. So I gave it a try. The first week: So the first week I started using it took some adjustment. I was always used to super lofty pillows, generally stacking them higher than I need. So to switch solely to this pillow was rough, as its not super high, and sinks with the weight of my head more than any of my firmer pillows. I really wanted to give this new pillow a try on its own, but I have to admit the first day or two I shoved a small pillow underneath to give me some extra loft. After those first couple days I took the dive using only the ceramo pillow. That first week was an adjustment...my shoulder hurt from digging into my mattress since my head was not lifted higher. But as far as neck pain....non-existent. After adjustment period of a week: My body has adapted to the pillow and without shoulder pain. The hole for my shoulder is perfect, I always make sure to slide up against it, and my head loves the cooling soft touch as its ready to go into slumber. So, now that I have given it a true chance, I actually love it! I mean, Folks at Blu Sleep, maybe you should make a second pillow that is thicker for some of us broader shoulder folks. I know just a little more loft would have done wonders and reduced any adjustment period. I know I sleep with my hand under my pillow under my cheek just to keep it slightly higher now. But no pins and needles in my hands, so at least the pressure isn't high. Quality Pillow: Yea, this is definitely a quality pillow. The soft soft cloudlike memory foam is amazing. I hate memory foam...I think its hard and uncomfortable and I don't like how much I need to sit still in order to finally find comfort. But this is a different memory foam.... reminds me more of a pillow top, without the heat as it is cooling. So kudos to that. While I am aware that the foam can be cleaned in a washing machine, I did not get the opportunity to try washing it. I also am oddly in love with the packaging smell (or foam smell), don't know why, but I fear washing it will cause me to lose that smell that I've come to love. I'm sure I will wash it at some point though. The pillowcase is soft, smooth and cooling. I'd love to just use that pillowcase, but I don't want to ruin it so I put my own pillowcase on top of the one it came with. Cooling Sensation: I've tried a few cooling pillows in the past...This is on some other level. Most of the time a cooling pillow will be cool just at the beginning when I first lay my head down. This literally feels like its cooling even as I'm heating up. It's a strange sensation that I have come to love. I run hot, like to the point that my partner calls me a furnace in bed. While I don't sweat all the time, my temp is definitely higher as I sleep and I crave frigid a/c temps at night. So its normal for me to feel warm in bed. So I lay my head on the pillow and I get that initial cool feel. Great. Maybe 5-7 minutes later when my cheek has now warmed the pillow, I start to feel it. its almost like its coming through the pillow, a cool sensation. And then I concentrate on it....and its almost like when you put your face on cool tile or cold metal...like its emanating from inside. Strange, but super super satisfying. It's almost like its reacting to my body heat. My body heats up, it kicks on and cools. If anything, this is my absolute favorite feature. So overall, Love the quality of the pillow: smell, construction, cooling. Only gripe is I wish it was loftier. or had maybe a thicker memory foam in the center so that it won't collapse as much... But again, this may be me being picky. I've slept great since using the pillow and that should be the main focus. Although I received this product for a review, I actually am considering buying another one. I think I want to try a second one to see if it gives me the loft I want, plus my partner has been itching to use mine. Although expensive for a pillow, it seems like its quality and will last. Read Less