Pads and underquilts both work well.
Neither are plug and play. You need to fuss with them a bit.
Pads are way cheaper, tougher, waterproof, serve multiple purposes, and can be used above treeline.
Underquilts are slightly more comfortable and pack smaller.
Since I camp in the sierras often above 10K feet and in the desert, I need to be prepared for treeless camp/bivvy, so I use pads.
Make your own list of pros and cons. And sometimes you need both!
No reason to give pads a bad rap!
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