Objectives: The aim of this study was to evaluate the association between self-reported sleep quality, use of sleep medications and cognitive impairment among a representative sample of the Brazilian elderly population.

Methods: We conducted a secondary analysis using the baseline data of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), a representative sample of non-institutionalized older adults, aged 50 years or over, living across the five Brazilian regions. We divided our sample into groups according to self-rated sleep quality and the use of sleep medication, and descriptively reported sociodemographic and general health characteristics with their respective associations to each group. Subsequently, we analyzed the associations between these sleep measures and cognitive performance using linear regression.

Results: Data from 8,592 respondents were included, of which poor sleep perception was reported by 17.8% of participants, 16.2% were users of sleeping pills and 12.9% met criteria for cognitive impairment. Female sex, not having a partner, current smoking, having less education and more comorbidities were associated with poor sleep perception prevalence. Regarding the use of sleep aid, female sex, older age, not having a partner, having less education, more comorbidities and a problematic drinking behavior were associated to a current use. Any use of sleep medication (–0.06 (95% CI; –0.10 to –0.02)) and poor sleep perception (–0.06 (95% CI, –0.09 to –0.02)) were both associated with worse cognitive performance after adjustments in the multivariate analysis. Sensitivity analysis revealed that, when compared to individuals who reported “very good” sleep quality, the group who reported “poor” sleep quality was associated with worse cognitive scores (p = 0.015) When compared to not using sleeping medication, the group that used medication 3 or more times a week was associated with worse cognitive measures (p < 0.001).

Conclusions: We describe an association of sleep aid use and poor sleep perception with worse cognitive performance. We also report different frequencies of sleep quality perception and sleep aid use in accordance with a set of characteristics of this sample that can be considered potential risk factors for the development of sleep disorders and that can impact older adults’ quality of life.

Key words: Cognition, older adults, sleep quality, sleeping pills.