What each mechanism can and cannot do
A water pad conducts heat away from your body through direct contact. That is efficient, it works under a normal fitted sheet, and it is the only way to feel a surface that is colder than the air in the room. What it will not do is deal with moisture: if you sweat, the sweat stays on you and on the sheet.
An air system attacks the other half of the problem. It blows air through the space between you and your duvet, so it both carries heat away and evaporates moisture. The ceiling is room temperature — in an 80°F bedroom, 80°F air is the best it can offer — but for someone who wakes up damp, airflow often feels better than a cold pad does.
- Cold surface, cold feel, no moisture handling → water system.
- Damp sheets, hot flashes, sweat → air system.
- Cold sleeper who wants heat quickly → air system heats bedding fastest.
- Couple with opposite preferences → dual-zone water system, or two air units.