SylviaT, all of this is new and was to us also. A bite at a time.
"your setup is for straight CPAP pressure with no exhale pressure relief"
straight CPAP means you machine is set for a steady pressure regardless of if you need that much pressure or not. some people need this, most don't. Some people do not react well to changes in pressure. Most people use these machines in APAP mode and this provides a range "Something like 7.0-10.0 " this way the machine provides a pressure of 7 unless it detects a reason for higher pressure and if so it increase the pressure as needed. Many find this more comfortable.
"no exhale pressure relief" What this treatment does is put pressure in our airways, this pressure holds the airways open. It's called splinting the airway open. They found that many people have a hard time exhaling into this pressure and that they can have the machine reduce the pressure during exhale and the airway still remains open. There is a setting on your machine EPR that is used to adjust just how far the pressure is reduced when you exhale-3, 2, or 1 cm of pressure reduction. Many find this reduction very helpful.
RERA-Respiratory Effort Related Arousals this just means that you are finding it difficult to breathe and this is waking you up, maybe not wide awake, but not sleeping soundly also. This is many times caused by finding it difficult to exhale into pressure. see my last paragraph.
"I also don't think ramp pressure of 4.0 does you any favors" many people, myself included, find that starting off at a pressure of 4 is not comfortable. I have found that I need at least 5.8 or I feel starved for air. Also if you get your mask working perfectly at the start, once it ramps up to therapy pressure you mask may leak a lot.
All of these things above are "comfort" settings and vary from person to person. Most medical staff just don't have the time to adjust all of these for every patient. It is trial and error, make little adjustments and try it out, keep doing this until you find your sweet spot. You will not sleep well if you are not comfortable. Pick one to adjust, keep a journal so you can remember what each setting was like, and then fine tune all of them once you get each setting close.
You can do this, one bite at a time, Please, Please do not expect the medical staff to make everything perfect for you. experience says they just don't have the time to do this. Experience also tells us that anyone, even you can do this.
Good explanations PoolQ. It is a lot of information, which is why we sometimes shorten our answers to acronyms and suggestions.
SylviaT, by all means ask questions, and if you are reluctant to make changes on your own, be assured that you can always put things back where you found them. Success at CPAP will involve some trial and error...what do you think a clinical titration is? Answer, it is one night of trial and error by a technician. Every night after the sleep study, you have to do it yourself.