I will give the other side. I have always used ramp and I assume that your machine has ramp setting the same as mine. Mine has a ramp start pressure that I found best set to 6, 4 was just not enough air for me. The machine then takes the set time to ramp from this starting pressure up to you minimum pressure. I started out at max time of 40 minutes and then decreased it to 20 minutes, with the 40 I never noticed when I got to full pressure because I was always asleep, now I can tell that the pressure is ramping and it is manageable but barely with the time set to 20.
This to me is an individual preference and is a comfort feature that the manufacturers put in the systems on purpose to help people tolerate CPAP. If it does nothing for yo then of course don't use it, if it helps then do use it. The bracketing I have always heard about was for APAP settings on the min and max for therapy and this has nothing to do with the ramp starting pressure.
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Ramp is a comfort feature so it's up to you if you want to use it or not.
Much success to you as you continue your CPAP therapy, hang in there for more responses to your post.
From my reading of your post, you are talking about two different things.
RAMP is when the pressure goes from 4 to the minimum pressure of the APAP or the treatment pressure of a CPAP. It does this over a set period of time. Some people like it, many people don't. I've gotten so used to my higher pressure that anything lower than that and I feel smothered. If you didn't use it before, you won't need it now. And if you are using the machine "wide open" at 4-20, then the ramp is not doing anything anyway.
Treatment pressure is the 4-20, 10-16 you are talking about. If your previous pressure was a CPAP setting of 12, then I agree with the suggestion of 10-16. Leave it there for a few weeks to see how it goes. It's a good spread with enough room for adjusting but not so much the machine can't keep up with you.
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EwanRGR.. Something is missing in my mind. IF you were good and comfortable at the CPAP setting of 12 for 6 years, why, are you using the total gauntlet of 4-20 in the APAP mode? Did Doc write a new prescription? If your apneas were controlled at 12 then I would start your machine (as OpalRose) suggested somewhere around 9-10 and a top of 14. No need to start at a ramp of 4 and struggle with the lower pressures.
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Thanks for all the advice on here. The reason I initially left the ramp at the default setting was that I wasn't sure if I could turn that off and still have the Auto functionality work. The last two nights I have had the ramp turned off, and the Auto range from 10-20, and seem to be doing much better. I have DL'd the Sleepyhead software, but have not yet pulled the SD card. The Philips phone app has shown my AHI came down from the first night (1.9) to .8 and then .6 after making the change.