Sleep apnea is a common condition in patients with cardiovascular disease (CVD), contributing to various cardiovascular complications. It involves intermittent hypoxia, oxidative stress, sympathetic activation, and endothelial dysfunction, which are critical in CVD pathogenesis. Sleep apnea is associated with hypertension, coronary heart disease, arrhythmia, heart failure, and stroke. Recent research has identified mechanisms linking sleep apnea to CVD and shown that treatment can improve outcomes. The review discusses the types of sleep apnea (obstructive and central), their pathogenesis, and the effects of treatment. It also highlights the importance of personalized treatment approaches, especially for patients with heart disease. Obstructive sleep apnea (OSA) is linked to systemic hypertension and increased risk of stroke, heart failure, and coronary heart disease. Central sleep apnea (CSA) is rare in the general population but common in patients with heart failure, stroke, and atrial fibrillation. Recent studies suggest CSA is also a risk factor for atrial fibrillation and heart failure. The review emphasizes the need for collaboration between cardiologists and sleep physicians to conduct research on sleep apnea treatment in high-risk patients. OSA is caused by anatomical and physiological factors, including obesity, which is a major risk factor. Non-anatomical factors, such as upper airway dilator muscle dysfunction, heightened chemosensitivity, and low arousal threshold, also contribute to OSA. Treatment options include continuous positive airway pressure (CPAP), which is effective in reducing blood pressure and improving outcomes in patients with OSA and hypertension. CPAP also improves pulmonary hypertension, stroke, and arrhythmias. CPAP therapy has been shown to reduce blood pressure in patients with OSA and resistant hypertension. It also improves pulmonary hypertension and reduces the risk of stroke and arrhythmias. However, its effectiveness depends on adherence to treatment. CPAP is also beneficial in patients with central sleep apnea, though it is only partially effective in some cases. Other treatments, such as nasal oxygen and phrenic nerve stimulation, are also used. Sleep apnea is prevalent in patients with asymptomatic left ventricular dysfunction, and its treatment may prevent progression to symptomatic heart failure. In patients with heart failure with reduced ejection fraction (HFrEF), CPAP improves cardiac function, reduces hospital readmissions, and improves survival. However, the effectiveness of CPAP in central sleep apnea is limited, and newer therapies, such as adaptive servo-ventilation, are being explored. The review concludes that sleep apnea is a significant contributor to CVD and that effective treatment is crucial. Future research should focus on personalized treatment approaches, improving adherence to CPAP, and exploring new therapies for central sleep apnea. The role of sleep apnea in CVD remains a critical area of study, with ongoing research aimed at improving outcomes for patients with sleep apnea and cardiovascular disease.Sleep apnea is a common condition in patients with cardiovascular disease (CVD), contributing to various cardiovascular complications. It involves intermittent hypoxia, oxidative stress, sympathetic activation, and endothelial dysfunction, which are critical in CVD pathogenesis. Sleep apnea is associated with hypertension, coronary heart disease, arrhythmia, heart failure, and stroke. Recent research has identified mechanisms linking sleep apnea to CVD and shown that treatment can improve outcomes. The review discusses the types of sleep apnea (obstructive and central), their pathogenesis, and the effects of treatment. It also highlights the importance of personalized treatment approaches, especially for patients with heart disease. Obstructive sleep apnea (OSA) is linked to systemic hypertension and increased risk of stroke, heart failure, and coronary heart disease. Central sleep apnea (CSA) is rare in the general population but common in patients with heart failure, stroke, and atrial fibrillation. Recent studies suggest CSA is also a risk factor for atrial fibrillation and heart failure. The review emphasizes the need for collaboration between cardiologists and sleep physicians to conduct research on sleep apnea treatment in high-risk patients. OSA is caused by anatomical and physiological factors, including obesity, which is a major risk factor. Non-anatomical factors, such as upper airway dilator muscle dysfunction, heightened chemosensitivity, and low arousal threshold, also contribute to OSA. Treatment options include continuous positive airway pressure (CPAP), which is effective in reducing blood pressure and improving outcomes in patients with OSA and hypertension. CPAP also improves pulmonary hypertension, stroke, and arrhythmias. CPAP therapy has been shown to reduce blood pressure in patients with OSA and resistant hypertension. It also improves pulmonary hypertension and reduces the risk of stroke and arrhythmias. However, its effectiveness depends on adherence to treatment. CPAP is also beneficial in patients with central sleep apnea, though it is only partially effective in some cases. Other treatments, such as nasal oxygen and phrenic nerve stimulation, are also used. Sleep apnea is prevalent in patients with asymptomatic left ventricular dysfunction, and its treatment may prevent progression to symptomatic heart failure. In patients with heart failure with reduced ejection fraction (HFrEF), CPAP improves cardiac function, reduces hospital readmissions, and improves survival. However, the effectiveness of CPAP in central sleep apnea is limited, and newer therapies, such as adaptive servo-ventilation, are being explored. The review concludes that sleep apnea is a significant contributor to CVD and that effective treatment is crucial. Future research should focus on personalized treatment approaches, improving adherence to CPAP, and exploring new therapies for central sleep apnea. The role of sleep apnea in CVD remains a critical area of study, with ongoing research aimed at improving outcomes for patients with sleep apnea and cardiovascular disease.