OBJECTIVE: The sleep of individuals who provide unpaid care for children with medical needs is likely to be significantly impacted by this role. Sleep may be affected by the practical tasks undertaken during the night (e.g., administering medication), in addition to the emotional impact (e.g., worry, rumination). The aim of this systematic review was to examine the available literature on the impact of caregiving for children with medical needs on caregivers' sleep. METHOD: Electronic databases, including PubMed, Medline, and Web of Science, were searched using predetermined criteria. Studies were included if they used validated subjective or objective measures of caregiver sleep, in contexts where caregivers were providing care for one or more children with medical needs. Data on study population, research design, and outcome measures were extracted, and study quality was reviewed by two authors. RESULTS: Search criteria produced 2,172 studies for screening. Based on inclusion criteria, 40 studies were included in the final review. Sleep of caregivers of children with medical needs was poorer than that for noncaregivers. Poor sleep included reduced sleep duration, impaired sleep efficiency, increased wake after sleep onset, and perceived poorer sleep quality. CONCLUSIONS: Providing unpaid care for children with medical needs is associated with sleep disturbances, including less total sleep, and poorer sleep quality. (PsycInfo Database Record (c) 2021 APA, all rights reserved).