I am a side sleeper and in the past used an old therma rest on top on half length closed cell pad and always inside a tent. I have hundreds of nights on that setup. Now, I use a Neo Air in large but only about 20 night on it, so, I cannot say if it is reliable although much more comfy than my older and heavier two pad deal. I carry Park stick on tube patches just in case but so far, not had to use them.