I like adjustable foam pillows but I've always been disappointed by the fact that I can feel the foam chunks when I lay on them. When I saw this pillow I thought this has to be what I need. The outer pillow is thick enough that I can't feel the foam chunks at all. It does need some fluffing/shaking every night before bed but don't most foam or fluff filled pillows? I don't notice it being crinkly (the tag is very noisy so if that bothers you I say cut it off.) I would say the only thing about this that annoyed me was that there was way too much foam filling. After I cut it out of the vacuum sealed bag it puffed up in no time and a lot. I probably have enough filling that I took out to make another pillow. They give you a very small ziplock bag to put the excess filling in but I needed a much bigger container. It takes a few days or more to get it where you like it but once you do I think it's worth the hassle.
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