Patients with heart failure frequently have associated sleep-disordered breathing, which has a significant negative impact on cardiac function. Echocardiography is a versatile modality for the management of heart failure. Recent developments in speckle tracking analysis have demonstrated that two-dimensional strain has potential for the quantification of subclinical abnormalities in ventricular function. This article outlines the utility of speckle tracking echocardiography in patients with heart failure and sleep-disordered breathing.