This question can apply to basically every rhythm game. Personally, I find it lame. I would call it cheating depending on the context, though it realistically is not and is just an option. That's just how distasteful I tend to find it.
If it's a tough and arduous map that takes up much, if not all, of your stamina and you pause, that's when I have problems with it. Did you run out of stamina in the middle of the song? Yes. Do I believe that should be the reason you failed the song or gotten a worst score? Also yes.
Did you pause to recollect yourself and calm your nerves? That is so incredibly lame, though that mainly comes from my RoBeats experience where pausing is not an option.
I just don't like the idea of stopping a song while it is in the middle of playing, or a chart mid-play to gain an advantage. Yes, it's an advantage everyone has access to, but I feel like it destroys the whole difficulty of maps if you memorize a spot where you can pause then can go "give me 5 seconds to readjust, rest my fingers, and figure out this pattern and the next few sections in my head" when you have like a 400ms reaction window or less or more, then have that be a top play even locally.
I'm fine with it if you feel pain mid-song and can't ignore it, though I would hope you quit out instead of endure it. As well, I am fine if it's some marathon and there are either very obvious break sections or you have sat there for like 15 minutes and want to get up or readjust yourself before your legs detach from your hips or your back caves in. Basically, reasonable IRL interference, though that is very subjective.