Heart Failure (HF) is a syndrome in which a structural or functional abnormality of the heart results in an inadequate cardiac output, frequently caused by ischemia. There is growing evidence that non-invasive ventilation (NIV) and positive airway pressure (PAP) therapy could play a role in the treatment of ischemic chronic heart failure (ICHF) by treating comorbidities and improving cardiac and respiratory performance. Although its role is better established in patients with acute decompensation, it appears to improve outcomes and be generally safe. Providing bilevel positive pressure in the airway improves gas exchange and reduces the work of breathing, which optimizes cardiac function and coronary blood vessel oxygen delivery. In turn, PAP therapy is the main treatment in concomitant Sleep Breathing Disorders (SBD), both in Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA). These pathologies may increase the severity of heart failure and cardiac dysfunction, and treatment with PAP has demonstrated improved cardiac function, a decrease in sympathetic markers and blood pressure, and reduced mortality.