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Could you just use a full face mask?
I don't have time to read the many pages of text in this thread, so I hope my comment hasn't been covered elsewhere. Just because your OSA is being really well treated at 4 cmH2O doesn't mean that it's not real. There is little relation between AHI and the pressure required to treat it. Some people have horrendous OSA and are fixed the moment the CPAP is turned on at 4. Others have mild OSA are still not entirely stable at 20 cmH2O. People are different - they're annoying like that. If you had a proper in lab study that was scored by a human then a positive result is very reliable. Having a cold would not generate a false positive. If you really want to you could get a repeat study, but it's probably not worth it. As an alternative, you could ask your doc to show you the results of your study, and even a little of the raw data. It's not that hard to read the basics with a little guidance, and it might help you understand the situation better. Just be happy that your treatment was relatively easy, and at a pressure of 4 you should have few mask leak problems.
SenseAwake is designed to look for specific patterns in your breathing which it uses to tell when you are wake or asleep. The number 5 is the "SenseAwake pressure", or the pressure the machine will drop to if it senses that you are awake. Unlike a normal ramp it will return quite rapidly to full pressure once it has decided that your are asleep again. It can be very useful but it is also fallible. It can get confused and repeatedly drop the pressure at inappropriate times. Its use should be monitored to make sure that it is working correctly in each case.
Degree of oxygen desaturation is not necessarily an accurate measure of the severity of OSA, it is only one piece of the puzzle. It is very possible (I have seen it many times) for a person to have a very high AHI but their events only to cause small oxygen desaturations. Their oxygen saturation may never dip below 90%. However, it is the arousal process at the end of each event which causes most of the damage to your organs, more so than the drop in oxygen (although this is also not good). This is one of the main reasons why AHI is the standard measure of severity of OSA rather than a function of oxygen saturation. Both AHI and oxygen levels are part of the picture, but there are many things which can can contribute to the impact which OSA has on someone physically and mentally. Obviously it takes a bit of thought and effort to take all of this into account, which is why a good doctor is so valuable and why doctors who just want to churn patients through for the money can be so destructive.
ResMed make a variation of the Swift FX called the Bella, which straps that loop over the ears instead of going around the head. It might help. Click on this link to get some idea (if I got it right)
https://www.vitalitymedical.com/resmed-swift-fx-bella-face-mask-pink-gray.html
That's not always the case. Sometimes a leak can cause a suitable drop in pressure to lead to an increase in AHI.
The way you describe being unable to move sounds like sleep paralysis. Not a lot can be done about that. If you also have sleep apnoea (which is quite likely) then treating it may just help. It's certainly worth getting checked out anyway.
Waking up with a headache is a classic sign of hypercapnia - elevated CO2 levels. It would seem odd, though, if your CO2 went up when you started breathing better. Talk to your doctor.
The DreamWear comes in both intranasal (prongs that seal against your nostrils) and under-the-nose versions. The cushions are interchangeable.
As long as the patient is comfortable at 4 cmH2O then 4 is a fine minimum pressure. The minimum pressure is set for comfort. The only reason to lower the max pressure is to stop the machine getting confused for some reason and going too high. If this is not happening then there is no reason to lower the max pressure. If an auto CPAP is working properly then leaving it with a range of 4 - 20 should not cause any problems. Some patient require tweaking for some reason or another but for the vast majority it should be adequate to let the auto algorithm do its work.
Likewise I have found more people who find CPAP less comfortable with EPR than more comfortable. Whether it be min and max pressure settings or EPR, it's all about tailoring treatment to suit the individual.
Also, The DreamStation has auto ramp too.
