Leptin is best known as a regulator of energy homeostasis, but it also interacts with sleep and breathing. Leptin secretion increases at night and decreases during the day. The circadian secretory profile of leptin is determined both by the hypothalamic circadian pacemaker and sleep-wake cycle. Leptin is also a powerful respiratory stimulant. Serum leptin levels are higher in obstructive sleep apnoea syndrome but lower during extended sleep deprivation in healthy subjects or in narcolepsy. Abnormalities in serum leptin concentrations have recently been linked with deleterious effects on weight control, cardiovascular health and glucose regulation. Since sleep curtailment and sleep-disordered breathing are epidemics of the modern society, better understanding of leptin pathophysiology could open new perspectives to pathophysiology of major public diseases, including obesity and metabolic syndrome.