I switched from desktop Linux to Windows entirely because of Lennart Poettering. Audio was a complete disaster, as you mentioned. (This was only a few months ago.)
PulseAudio seems to get by far the most development and support. I tried ALSA and couldn't get any sound at all, and it didn't seem to be very well integrated into my shell. I did get ALSA to work on my laptop, but there were still lots of tradeoffs.
I experience about zero problems. Maybe it's because I don't run pulseaudio.