Background/Objectives: Adults with heart failure (HF) have high prevalence of central sleep apnea (CSA). While this has been repeatedly investigated in adults, there is a deficiency of similar research in the pediatric population. The goal of this study was to compare prevalence of CSA in children with and without HF and correlate central apnea events with heart function. Methods: Retrospective analysis of data from children with and without HF was conducted. Eligible children were <18 years old with echocardiogram and polysomnogram within 6 months of each other. Children were separated into groups with and without HF and groups with and without elevated central apnea index (CAI) for comparative study. Results: 120 children (+HF:19, -HF:101) were included. The +HF group was younger, with higher prevalence of trisomy 21, muscular dystrophy, oromotor incoordination, and structural heart disease and lower Apnea Hypopnea Index and lower CAI. Prevalence of CSA was similar in both the groups. LogCAI was inversely correlated to age at time of sleep study. Children with elevated CAI were younger and had higher prevalence of prematurity. There was no difference in left ventricular ejection fraction (LVEF) between groups with and without elevated CAI. Conclusion: In contrast to adults, after adjusting for age, there is no difference in frequency of central apneic events in children with and without heart failure. Unlike in adults, LVEF does not correlate with CAI in children. Overall, it appears that CAI may be more a function of age rather than of heart function in the pediatric population.