Heart failure (HF) is a common and costly condition.1,2 It is responsible for the majority of acute hospital admissions in people aged > 65 years, of whom one in two are readmitted to the hospital for the same reason within the year. Paradoxically, due to improved management of most medical conditions, the incidence and prevalence of HF are increasing, such that > 10% of people aged 80 years have HF. Finally, despite advances in management, the mortality rate for patients with HF is approximately 50% at 5 years, which rivals that of patients with many malignancies. Thus, new and imaginative HF management strategies are required. One such strategy, namely positive airway pressure (PAP), has emerged over the past 30 years, particularly in three distinct HF patient categories.