This last June my girlfriend and I took an entire trip across the country in roomette 19. We rode the CZ from EMY-CHI and the CL from CHI-WAS. I have done the trip a few times before in a "normal" sleeper car before and I have to say that I really enjoyed being in the transition sleeper. Your car attendant matters a lot. Here are a couple of wordy examples.
The consist on the Zephyr back in June had two coaches behind the transition sleeper, then the lounge, diner and two more sleepers on the back of the train. They added a 3rd sleeper on the back for Denver-Chicago. This meant that we had the coach attendant for the car behind us as our sleeper attendant. He was young and definitely had a lot of trouble with the workload. He forgot to turn down our room on the first night. The second day we talked to him about getting dinner in our room. We asked before arriving in Denver because we figured things would get busier then. He flat out declined us and said it wouldn't be possible. He was such a nice guy, but that kind of irked me, although I felt for how busy he was. After Denver he came back to us and said he could serve us on last call if we still wanted to eat in our rooms. We liked him and he seemed to like us (my girlfriend and I are in our 20s, so I think that helped us relate) but he really made us feel like we were asking a lot at times. I tipped him a few times throughout the trip, so maybe that helped.
On the Capital Limited we had a sleeping car behind us and shared that car attendant. He was AMAZING - he asked us what time we'd like the room turned down, offered to bring us dinner if we preferred, and never made us feel like we were asking a lot. It might have just been the contrast after our CZ experience, but it was no less than I have ever experienced, and he's probably the best sleeping car attendant I've had to date on Amtrak. That CL also got in on time to WAS, so maybe it was just a miracle train in general.
The bathrooms in the transition sleeper were almost never used, often clean, all three showers were available for us on both trains, and I think it was much quieter. The horn didn't seem overly loud and I didn't notice more foot traffic than in a normal sleeper. I think room 19 is far enough behind the staff rooms that you don't hear them much. There also seem to be less kids because they tend to be in the larger bedrooms with their parents and there aren't any larger bedrooms in the transition sleeper. All anecdotal, but that was our experience.
Wow this post ended up longer than I expected. Maybe I shouldn't have had a second cup of coffee today!