PURPOSE:To examine sleep disturbances in older adults in Macau and Guangzhou, China and their associated factors. DESIGN AND METHODS:Four-hundred and thirty seven subjects in Guangzhou and 244 subjects in Macau were interviewed. FINDINGS:In total, 681 older adults participated in the study, and 27.8% reported sleep disturbance, with 43.9% in Macau and 18.8% in Guangzhou. Physical quality of life was negatively associated with sleep disturbances. Severe depressive symptoms were positively related but living in Guangzhou was negatively related to sleep disturbances. Sleep disturbances are more common in Macau compared to Guangzhou. PRACTICE IMPLICATIONS:Appropriate screening and treatment strategies are needed to address sleep disturbance in this population.