Not really. Regarding "usual" sound, I haven't had a problem for years now, and just a while ago I actually set up a fairly complex system with JACK for a music performance I was preparing (midi controllers each connected to a specific synth software, some of that straight to output, some of it to looper software first, along with the mic input, etc.) and I was surprised at how smooth it all went.
I really think Linux left that behind in 2008 :)