We had a fantastic welcome upon arrival, the gentleman on reception gave us lots of advice for itinerary based on our length of stay and directed us to good locations for eating and where to go for nightlife all without us asking... not sure if the attempt at speaking Italian helped here though as we met other guests who didn't get the same advice
Our room was on the 4th floor with an annex roof. We had a double room although it was 2 singles pushed together, I personally don't see the problem with this though. The room was cosy, I wouldn't expect anything much bigger in a central position, it was big enough for the amount of time we actually spent in the room. There was a mini bar in the room but we didn't use this. We couldn't figure out the air con to adjust the temperature but this wasn't an issue with the cooler nights in October.
The bathroom was small but clean, no bath just shower - if you walk as much as we did you may want a bath to soak the muscles! We never had a problem with no hot water but did have to play around with the taps a bit to get the right temperature for a shower.
Breakfast was good, not on the roof terrace as I expected though, not sure whether this is just summer thing. There was plenty of choice, cereals, fruit and fruit salad, pastries, toast, yogurts, meats and cheeses; the American bit consisted of scrambled eggs prosciutto ham cooked like bacon and hot dog style sausages.
The location is great, we walked everywhere and the furthest was the Vatican which took us about 30 minutes, the pantheon about 5-10 minutes, the forum and Colosseum about 5-10 minutes, Trevi about 15 minutes and Trastevere for eating about 5-10 minutes (the best restaurant we ate in was Ponentino in Piazza del Drago - highly recommended!) For a central hotel we had no problem with street noise.
A word of advice on taxis – From the airport they often drop you off saying your hotel is just on the side street – we had a 10 minute walk from where we got dropped off!! The driver was being lazy and didn’t want to go around the 1 way system!!
To the airport if you ask your hotel for a taxi you will not get an official white cab with the fixed fee, it is usual that you will get a merc that charges about €50 (if you challenge this you should get it cheaper)