Discusses the evaluation and management of sleep disorders, including insomnia, sleep-related breathing disorders, periodic leg movements, and restless legs syndrome, in the elderly. Because of the medical illnesses often encountered, elderly patients are extremely difficult to treat. The methods of evaluation are essentially the same as for younger patients, however, the management is more complex because of numerous medical and psychosocial factors. It is asserted that psychiatric or psychophysiologic problems compound the difficulty in evaluation of this patient group, therefore, effective treatment must employ both psychological/psychiatric and medical approaches.