Did the recent changes in the management of heart failure change the prevalence and distribution of SDB? What is the most effective approach to diagnosis of this highly prevalent disorder in this very vulnerable patient population? A modern cost benefit analysis and comparison against the current slow inefficient and very expensive approach is needed. An approach that combines evaluation of risk factors and an abbreviated portable study may be adequate and certainly less expensive. Our program aims at providing every heart failure patient with clinically indicating and not otherwise available screening for SDB. Validated questionnaires and screening ambulatory sleep studies are provided to every patient. Additionally, this clinical operation has no risk to patients, rather a significant benefit. The sensitivity and specificity of this surveillance approach will need to be evaluated and validated. The validation operation will bring additional benefit to our future patients. The accumulation and analysis of the data will also enable us to determine the magnitude of the sleep co-morbidity in our heart failure patients and help educate clinicians who treat similar patients nationwide