The aim of this study was to evaluate the influence of somatic health, mental health and age on sleep and the use of sleep medication in a group of elderly men and women. Questionnaires were distributed to 9417 persons, and the response rare was 69%. The mean ages (s.d.) of the male and female participants were 73.9 (6.3) and 74.5 (6.8) years, respectively. Sleep disturbances were more common in women than in men at all ages and increased with age in both sexes. A stepwise regression analysis showed that in men, more severely sleep disturbances were associated with poorer somatic health (R-2 = 0.089; P < 0.0001), poorer mental health (R-2 = 0.106; P < 0.0001) and increasing age (R-2 = 0.109; P < 0.0001) and in the women worse somatic health (R-2 = 0.087; P < 0.0001), worse mental health (R-2 = 0.104; P < 0.0001) but no further deterioration of sleep with age. Sleep medication was more common in women than in men at all ages and increased with age in both sexes. The use of sleep medication was more strongly related to somatic health than to mental health and age in both sexes. In conclusion, both sleep complaints and sleep medication showed a stronger relation to somatic health than to mental health and age in this group of elderly men and women. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.