Really not so bad. Provides a big dose of insulation under your knees, and some love to place it between their knees when they turn to their sides. The biggest down side for me is coming up with enough unused stuff to put in the stuff sack. A lot of times, between stuff sacks as pillows and layering in a PeaPod or putting extra clothes down below in a HH Super Shelter, I might not have enough left over for knee padding. But whether in a hammoc of any kind, in a bed, on an OR table, or in a recliner, having your knees slightly flexed can be a comfort booster.
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