The cut-out in the middle keeps my head fairly neutral throughout the night. I tend to curl a flat pillow around my arm and into my neck causing some major lateral flexion and rotation. This pillow doesn’t allow that. My regular contour was decent, but I still would wake up with some pain. This was less expensive than that pillow and helps more. A pillow is a very subjective item. But for $35 and able to return it if I didn’t like it, sign me up!