Do they increase small bump sensitivity?

I get full travel on big hits ,so my pressures are ok.

Do you reduce your pressure if using them?

Yes they increase the ramp rate, so you can run lower pressures without bottoming out

They are a compromise.

The ramp up can be quite limiting on getting into the last travel, so compensating with lower pressures tends to mean there isn’t as much support around sag.

Currently I prefer to run with maximum volume, relatively high pressure (as low as 14% sag on a 170mm fork), fast rebound and a fair bit of LSC to get some energy out of the system.

Useful tool, but more for controlling full travel end. I’m a bit chunky, so don’t like too big a spacer. If I use too big I can’t get full travel without lowering pressures and falling through the midstroke. Prefer a small spacer and higher pressures. This way I get the correct sag and supportive midstroke while still achieving full travel.

TBH, it sounds like you’ve got your set up pretty well sorted.

Are you talking about fork and shock? Also, what make?