OBJECTIVE: This study describes and compares sleep disturbances in chronic pain patients while assessing the role of age, race, gender, and psychological health on sleep. METHODS: Self-report data fitted from chronic pain patients (N=4269) presenting for initial assessment were fitted to regression models predicting difficulty falling asleep, difficulty staying asleep, and overall sleep quality. RESULTS: We found high prevalence of difficulty falling (71.1%) and staying asleep (78.3%), and relatively poor sleep quality (9.76+/-2.86; 3=best; 18=worse). Blacks, men, and younger people with chronic pain were at higher risk for poor sleep quality and difficulty falling asleep. Significant interactions between race, age, gender, and sleep were identified. Sleep improved with age, but the gender gap in difficulty falling asleep and poor sleep quality was greatest at younger age, with young men at greatest risk. Young black men had more difficulty staying asleep, with a significant improvement with age. Individuals with chronic pain most at risk for sleep disturbances differed from those identified in general populations. DISCUSSION: The ability of health professionals to identify individuals at risk for sleep disturbance and to understand the dynamics of sleep, pain, and psychological health could improve healthcare quality.