Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) occurs when periods of hyperventilation with waxing/waning tidal volume altated with periods of central hypopnea/apnea. It is present in approximately 40 percent of patients with severe congestive heart failure (CHF). CSR-CSA may contribute to the progression of heart failure by causing repetitive arterial oxygen desaturation, sleep fragmentation, increased left ventricular afterload, activation of sympathetic nervous system, and oscillations in heart rate and blood pressure. There are evidences indicating that CSR-CSA is associated with a remarkable increase in mortality and is also an independent risk factor for cardiac transplantation; furthermore, treatment of CSR-CSA in combination with optimal medical therapy may influence the course of chronic heart failure, improve quality of life and the survival of patients.1 The paper by Zhang et al2 highlights the importance of recognizing this pathological breathing patt as a potential therapeutic target.