We had a custom topper made of memory foam, and it's heaven. I can't say for sure whether the fold-down couch is worth it because once we've made up the bed, it generally stays that way for the duration of the trip. I suspect the only time we'd need it for regular use is if we had passengers. So far that hasn't happened except when we took it for a test drive at the dealers. We made him sit in the back, of course.
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