Quite the track length! Opening up with some piano was a nice move and helps really set the mood. The second section with the PWM sounding saw is cool but I feel like there may have been a better patch to lead with. The supporting instrumentation there is wonderfully moody and ambient, doubly so when the piano really comes back in with some large chords and movement.
The gradual building of the bass is pretty well done - once it really starts clicking around the 3 minute mark and the cut-off opens up just enough to let some more tonality into it, even more effective with the use of the offset delay. Taking a moment here to appreciate the string work throughout; soft articulations, waving back and forth and sometimes almost disappearing entirely in the mix. I like how they don't feel omnipresent but instead lull back and forth.
There is some neat sound design throughout the movement, and in particular I really enjoyed the noise bursts that felt like someone breathing. Reminded me of something that Akira Yamaoka would do in Silent Hill, especially the second game. Great for building atmosphere and creating tension.
All in all, solid work. I can hear some of the Larkin affinity in it, but it felt very much your own. The piano playing toward the end displayed some great use of articulation and dynamics to push the mounting tension. Best of luck!