Sleep-disordered breathing (SDB) is a common comorbidity of heart failure (HF), which disrupts sleep. Indeed, patients with heart failure (HF) generally have quantitatively and qualitatively disturbed sleep. Central sleep apnea (CSA) is a unique feature of SDB in HF patients. CSA is likely a consequence, rather than a cause of HF, and results in further deterioration in cardiovascular function, consequently increasing morbidity and mortality. However, effects of treatment for CSA remain to be elucidated. This review article will highlight pathogenesis and pathophysiology of CSA and its management in patients with HF.