This disclosure describes systems and methods for providing optimized adjustment of a ventilator based on an estimated net value of patient effort. The disclosure describes a novel breath type that delivers a target airway pressure calculated based on an estimated patient muscle effort. A net value of patient muscle effort is estimated using a parameter estimate vector update equation to solve for a recursive least squares gain value representing the estimated net value of patient effort. The estimated net value of patient muscle effort is used to determine a target airway pressure, which is then used to determine a target inspiratory pressure to be delivered to a patient. The target inspiratory pressure is used to determine an onset and/or end of a ventilation cycle and therefore improves the synchronization between the ventilator and the patient.
