Since the time of my cardiology fellowship I have had an interest in the interaction between sleep apnea and cardiovascular disease. I believe that all cardiologists need to have a better awareness of the impact of unrecognized sleep apnea on the patients they see because sleep apnea is endemic in all areas of cardiovascular medicine. Although a clear consensus regarding the best way to integrate the diagnosis and treatment of sleep apnea into cardiovascular practice is lacking, I believe that current data support routine screening for sleep apnea in patients with cardiovascular disease and provide the basis for practical treatment and management recommendations. I am optimistic that future well-designed prospective trials of sleep apnea management and diagnosis in cardiovascular disease are just around the corner and should provide a stronger evidence-base to base treatment recommendations on. My presentation covers my approach to the diagnosis and management of sleep apnea in patients with different cardiovascular conditions.