Central sleep apnoea with a Cheyne-Stokes pattern of respiration is a disorder commonly observed in patients with established symptomatic congestive heart failure (CHF). It is associated with hyperventilation and hypocapnia which are likely to result from either increased pulmonary vagal afferent nerve stimulation due to pulmonary oedema or from upregulation of chemoreceptors induced by increased sympathoneural activity. Treatment should be aimed at improving underlying cardiac function which may include angiotensin-converting enzyme inhibitors, nasal continuous positive airway pressure (CPAP) or possibly supplemental oxygen.