Our objective was to better define sleep in patients with Chiari-I malformations (CIM). Sixteen female CIM patients and 34 healthy female controls underwent sagittal-axial T1 and T2 brain magnetic resonance imaging. Subjects completed the Epworth Sleepiness Scale, Insomnia Severity Index, Berlin Questionnaire, modified Johns Hopkins telephone restless legs syndrome (RLS) diagnostic interview, and individual questions on sleep latency and duration. Compared to controls, CIM patients were sleepier, had more insomnia and longer sleep latencies, shorter total sleep times, more RLS, and had greater risk of sleep-disordered breathing (all itP < 0.05). These findings support an association between CIM neuropathology and impaired sleep respiration, regulation, and increased RLS.