Falls are a serious problem among older adults because they are common, disabling, and sometimes fatal. This chapter provides an overview of the effects of aging on balance and falls, to explore potential mechanisms by which sleep disorders might affect balance and falls. The sleep disturbances of aging have the potential to be frequent but unrecognized contributors to balance disorders and falls. One of the most obvious mechanisms by which sleep disorders might contribute to falls is by reducing alertness and attention. Recent cross-sectional and prospective observational studies have confirmed an association between general sleep problems among older adults and falls. State-of-the art methods of research in sleep and in balance can be applied to future observational, physiological, and intervention studies. Multiple potential mechanisms are possible; transient and chronic effects of poor sleep on attention and alertness are the most likely direct consequences related to balance.