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I have the full-length version of this, and although it isn't as comfortable as a 2" thick sleeping pad, I have no problem getting a good night's sleep with it. The main issue with comfort that I have is that you can't really roll around all that well on it, since you need to line your pressure points up with the right spots on the pad. Once you get that down, it is fine. Definitely worth the pack size for me.
I don't use it the way the guy in the photos does. I put it under my sleeping bag, which, I think, allows the bag to fill in the gaps better. I've used it in the winter before, with no issues with warmth.