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Background Sleep-disordered breathing (SDB) is common in heart failure, and is associated with increased morbidity and mortality. The aim of the study is to determine the prevalence and patterns of sleep apnea in Asian Indian patients with heart failure. Methods This was a prospective, observational study of consecutive 60 cases of heart failure. All these patients were clinically assessed and evaluated for sleep apnea with sleep study. Apnea-hypopnea index (AHI) was used to determine the severity of sleep apnea. Results In this study of 60 patients, the mean age was 62 ± 8 years, with a higher prevalence of sleep apnea observed in older age groups. There was a male predominance, but it was not statistically significant. Approximately 51.7% of patients had a co-morbidity, with diabetes and hypertension significantly associated with sleep apnea. 43 (71.7%) were found to have sleep apnea, with varying degrees of severity. Central sleep apnea was present in 60.5% of sleep apnea patients, while obstructive sleep apnea was present in 39.5% of patients. Higher NYHA class, atrial fibrillation, higher dyspnea class, and elevated heart rate were significantly associated with sleep apnea. Conclusion Our study identified significant rates of undiagnosed sleep apnea in patients with chronic heart failure, with a higher prevalence of central sleep apnea. Patients with more heart failure symptoms were more susceptible to developing sleep apnea. Routine screening for sleep apnea using polysomnography is crucial in chronic heart failure patients. This comprehensive approach holds promise due to the bidirectional relationship between sleep apnea and heart failure. [ABSTRACT FROM AUTHOR]