To be clear, I am not "beating up" anyone -- but it is fair to challenge the ideas of others. The subject of this thread implies that people don't use ramp because doing so isn't macho. He(?) then posits an argument to, "Consider using ramp not just as a comfort feature, but to eliminate false events while still awake. The opinion that no experienced user needs the ramp feature is just bogus."
I think someone should use ramp whenever they think it improves their actual therapy and/or sleep quality. There is no other criteria that makes sense to me -- and there is no one-size-fits-all answer for all users about using ramp (and with what settings). I don't really like "You should really consider using (or not using) ramp..." unless it is followed by an if. "You should really consider trying ramp (or trying without ramp) if you are having trouble with..."
Here is why I stopped using ramp long ago:
a) I want to check for any mask leaks at full pressure -- so they can be addressed before I go to sleep. Same with pillow positioning.
b) There is less risk that I will be woken up because of the ramp (either ramp letting a few OAs happen and/or the pressure change upon it detecting sleep). I also felt like my breathing was fighting against some of the auto ramp algorithms.
c) The ramp does not improve my comfort nor does it make it easier (for me) to fall asleep.
For someone else, ramp will be thing that allows them to go to sleep, avoid uncomfortable sensations, etc. They absolutely should use ramp.
Now, on to the of measuring AHIs. If one is only evaluating their therapy by one measure -- AHI as reported by MyAir as an example -- I agree the OP has a point. So if your machine does not record more data or if an employer (or MD doing your DOT physical) looks only at the AHI reported by the machine, that might be a consideration. Otherwise, we (and providers) have more granular data to review to sort through false positives (as well as subjective measures around quality of rest).