Sleep-disordered breathing occurs in approximately 70% of people with congestive heart failure and might have deleterious consequences.1 Treating obstructive sleep apnoea (OSA) in people with congestive heart failure has been associated with improved surrogate markers, such as cardiac function,2 but randomised controlled trials that are focused on clinical endpoints have not been reported.3 Treating central sleep apnoea (CSA) or Cheyne–Stokes breathing in people with congestive heart failure has also been associated with improved clinical outcomes in observational studies, although randomised controlled trials have not reported these effects—both the CANPAP and SERVE-HF studies showed potentially deleterious effects of treating CSA in people with congestive heart failure,4,5 although the underlying mechanisms are unclear.

Back in the 1970s, when Amir Shaviv was in his mid-20s, there was no such thing as sleep apnoea. Of course, there was, but sleep apnoea was rarely talked about in medical circles, never mind the general public. Growing up in Israel in the northern city of Haifa, young Amir had a career as a TV news reporter, until he moved to the USA at the age of 37 years and changed careers. “I cannot say I had ever noticed problems with my sleeping, but my partner at the time, she told me that not only was I snoring a lot, there were periods where my breathing would stop altogether—she would then spend a number of seconds anxiously waiting for the breathing to restart, which thankfully, every time it did!”