Elderly patients are at high risk of postoperative sleep disorders (PSD), which are mainly characterized as reduced sleep time, reduced sleep quality, easy to wake up early and frequent nightmares. Furthermore, PSD affect multiple system dysfunction, lead to poor prognosis, and is detrimental to postoperative recovery. Therefore, it is of great significance to reduce the occurrence of PSD in elderly patients. This article introduces elderly patients’ sleep patterns and physiological risk factors in elderly patients, effects of general anesthesia on sleep, adverse outcomes and perioperative management, aiming to provide ideas for prevention and treatment of PSD in elderly patients.