Titration Study Results Interpretation Help Please

[HereIamNow]

I have had hypoventilation for some time-now new hypoxemia. My new dr. did a titration and I'm shocked that it was inconclusive. How can a tech NOT be able to titrate to treat the problem? I had 1 liter of oxygen on the entire night, had hypoxia & CO2 changes. 
Anyone able to comment on the findings would be appreciated. Dr. recommendation it to sleep with head of bed up, try setting of 16-9 (currently at 15-10) & repeat overnight oximetry (previously showed low O2). 
I always sleep with head of bed up. Making that small change doesn't seem like it can treat low O2 & climbing CO2, unless I have something off here. 
Any experienced opinions are appreciated. This doesn't look good to me. Thanks

Sleep Architecture: Decreased sleep efficiency with increased arousal index. The total recording time of the polysomnogram was 424.8 minutes. The total sleep time was 287.5 minutes. Sleep latency was normal at 10.9 minutes without the use of a sleep aid. REM latency was 78.0 minutes. Arousal index was increased at 51.8 arousals per hour. Sleep efficiency was decreased at 67.7%. Wake after sleep onset was 126.0 minutes. The patient spent 26.1% of total sleep time in Stage N1, 52.2% in Stage N2, 10.6% in Stage N3, and 11.1% in REM. Time in REM supine was - minutes.
Respiration: Incomplete bi-level titration with residual obstructive hypopneas, and hypoventilation.
The patient was titrated at pressures ranging from BiLevel 10/5/0 cmH2O up to BiLevel 16/9/0 O2:1/2 cmH2O. 
The final pressure achieved was BiLevel 10/5/0  O2:1/2 cm H2O with a residual AHI of 53.3 events per hour. Time in REM supine on final pressure was - minutes. 
This titration was considered Unacceptable.
Snoring – was reported as mild/intermittent on treatment.
Respiratory rate and pattern – was notable for normal respiratory rate and pattern.
Sustained Sleep Associated Hypoventilation – Transcutaneous carbon dioxide monitoring was used, and significant hypoventilation present with a maximum change from 43 to 59.8 mmHg and 122.1 minutes at or greater than 55 mmHg.
Sleep Associated Hypoxemia – (Greater than 5 minutes O2 sat at or below 88%) was present. Baseline oxygen saturation was 90.9%. Lowest oxygen saturation was 80.0%. Time spent less than or equal to 88% was 73.4 minutes. Time spent less than or equal to 89% was 85.8 minutes.

[Jay51]

Welcome to apnea board.  Sustained Sleep Associated Hypoventilation – Transcutaneous carbon dioxide monitoring was used, and significant hypoventilation present with a maximum change from 43 to 59.8 mmHg and 122.1 minutes at or greater than 55 mmHg.  

I have had 4 of these tests.  Between 35 and 45 mmHg for most of the night is normal.  In my state, 25% of the time or greater above 45 qualified me for this Evo ventilator.  I think I just briefly went over 50 for a minute or less.  122.1 minutes greater than 55 is severe IMO.  This is like a COPD patient would present.  

I started with cpap, tried bipap, bipap with backup (ST, ST(A)), Astral ventilator and Evo ventilator.  I don't need supplemental oxygen at night or during the day though.  

Sleep Associated Hypoxemia – (Greater than 5 minutes O2 sat at or below 88%) was present. Baseline oxygen saturation was 90.9%. Lowest oxygen saturation was 80.0%. Time spent less than or equal to 88% was 73.4 minutes. Time spent less than or equal to 89% was 85.8 minutes.  As severe as both your hypoventilation is and your hypoxemia at night, I would think that you would qualify for a much more sophisticated machine that could treat you better during sleep.  

I guess the reason the titration was incomplete was because they couldn't get the bipap to treat you with it's algorithm.   More sophisticated machines have more advanced algorithms.  You can ask your PCP or Sleep Dr. about more advanced machines.