Aims : to discuss titration of chronic noninvasive ventilation (NIV) in patients with bulbar complaints, including how to adjust patients, additional therapies and techniques, when to decide that NIV goals have not been achieved, when to switch to invasive mechanical ventilation and when to decide to stop; to discuss titration of chronic NIV in patients with chronic obstructive pulmonary disease (COPD), including whether to aim for high-intensity NIV, how to adjust patients to high-intensity NIV, the back-up respiratory rate, inspiration and expiration times and new modes; to discuss the detection and clinical consequences of patient-ventilator asynchrony, including whether this should be treated in chronic care and how to reliably detect it; to discuss the value of alternative (autotitrating) modes, including whether AVAPS and EFL titration modes or other alternatives should be used.