Sleep patterns of nursing home residents are extremely fragmented. This is manifested not only as disrupted night-time sleep, but also by frequent daytime sleeping. Poor sleep represents more than a mild annoyance for nursing home residents. Nursing home residents often suffer from multiple medical and psychiatric co-morbidities and are often in poor physical health. Circadian rhythm changes contribute to sleep problems in nursing home residents. Real change will require administrators and other staff to recognize that sleep is important and encouraging better sleep would benefit both residents and staff over the long term. Sleep disturbance is associated with negative outcomes among nursing home residents. While data to support the use of pharmacotherapy for sleep in the nursing home are limited, there is some suggestion that disturbed sleep improves with non-pharmacological treatments; however, these treatments have not been adapted for implementation into routine care.