I've been a C-Pap user for over nine years now. I spent the first six years looking for a good pillow. And the last three using what I had determined was the best. I bought this several days ago, and now have a new favorite.
My off the top of my head appraisal is that it's like an infinitely variable, infinitely adjustable foam pillow that you can make into any shape you like. Want more neck support? Rearrange the beads with your hand. Want some cutouts on the ends? Hit the end with your hand, and the cutout is there. The big difference between this and the foam pillow I've been using, is that this doesn't compress like foam and lose its support. Nor does it get warm like the foam.
Top quality materials and a warrantee unequaled in the pillow industry. Glad I bought it.