There is clear evidence that sleep disturbances are associated with health deterioration, and growing evidence that exposure to noise pollution, around-the-clock, negatively affects health, too. It has also been proven that nocturnal noise pollution significantly impairs sleep, objectively and subjectively. Whether these noise-induced sleep disturbances represent the link between environmental noise exposure and negative health outcomes still remains uncertain. However, the emerging data suggest that indeed nocturnal environmental noise may be the most worrying form of noise pollution in terms of its health consequences, possibly because of its synergistic direct and indirect (through sleep disturbances) influence on biological systems. Duration and quality of sleep should thus be regarded as risk factors or markers significantly influenced by the environment and possibly amenable to modification through both education and counseling as well as through measures of public health. One of the means that should be proposed is avoidance at all costs of sleep disruptions caused by environmental noise. Furthermore, more large scale prospective studies are needed. These studies should involve representative samples of the population including vulnerable groups like children, elderly and mentally ill subjects, have a sufficient follow-up period, assess health outcomes according to daytime versus nighttime exposure, assess hormonal and polysomnographic measures, and take into consideration potential confounders. Subgroup sleep analyses should also be performed. This would help to better understand to what extent sleep disturbances indeed mediate between exposure to environmental noise and negative health consequences.