Juno Perth Clinical Trial

Inclusion Criteria * Subject has ability to provide written informed consent * Subject aged ≥18 years old * Subject has a diagnosis of COPD, OHS or NMD with sleep hypoventilation (historical PtCO2 increase overnight ≥ 10mmHg) and/or daytime hypercapnia (\>45 mmHg) * Subject is currently using non-invasive ventilation for ≥ 3 months * Subject with an AHI ≥ 5 hr. (as documented in diagnostic or pressure determination sleep study report) Exclusion Criteria * Subjects not compliant on NIV (ie. \< 4 hr/night) * Subjects with severe asthma * Subjects who are pregnant * Subjects on oxygen therapy (ie. \>4 L/min) * Subjects with a tracheostomy * Subjects who are acutely ill, medically complicated or who are medically unstable * Subjects in whom PAP therapy is otherwise medically contraindicated * Subjects who have had surgery of the upper airway, nose, sinus, or middle ear within the previous 90 days * Subjects with untreated, non-OSA sleep disorders, including but not limited to; insomnia, periodic limb movement syndrome, or restless legs syndrome. * Subjects who require ventilatory support during wakefulness * Subjects with the following pre-existing conditions: severe bullous lung disease, recurrent pneumothorax or pneumomediastinum, low blood pressure, cerebrospinal fluid leak, recent cranial surgery or trauma. * Subjects with severe developmental delay and who will not be able to follow tasks as instructed in the protocol. * Subjects who the investigator believes are unsuitable for inclusion because either: * they do not comprehend English * they are unable or unwilling to provide written informed consent * they are physically unable to comply with the protocol * they are unsuitable to participate in the trial for any other reason in the opinion of the investigator