This wedge is great. It is definitely firm, yet comfortable with or without a pillow. It doesn't let you sink way down into it, so it maintains it's shape quite well--and we're not small people! It doesn't fit the whole width of our king-sized bed, which is probably it's only drawback. It's great for watching TV or reading in bed or if you need to sleep with your head and shoulders elevated. You would definitely need something under your knees for sleeping, because that position can be hard on your back without something to ease the pressure. Plus if you're a smaller person, you might slide down. The cover is soft and comfortable. Haven't had to wash it yet since we've only had it about two weeks--so don't know how it will hold up to washing or if it will shrink when dried.