The backrest and pillows are very compacted on arrival, so it takes some massaging to get them to expand fully. The one drawback for my wife (the primary user) was she developed a cough, likely from cloth dust after leaving this on her bed overnight. Washing the cover fixed that.My wife likes the support, it has really lessened her back pain from reading in bed. The additional pillows allow her to get the right amount of neck support so she can concentrate on whatever textbook she is studying that night.Overall, very happy with this purchase, but run the cover through the laundry first.