i get that preset 5 comes with a bit more rng since you will have to get lucky with the number spawn, but wouldnt it be faster than preset 4 since 80% of the items needed for door escape are downstairs?

I think preset 5 works better for difficulties below extreme. For extreme and impossible mode, preset 4 proves as better

i assume when you say difficulties below extreme, that applies to practice mode too?

That is correct