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The elderly population in the United States is growing rapidly, presenting increasing challenges in health care provision. One of the most salient and complex issues facing the elderly is cognitive impairment. This condition often leads to dementia and has a significant quality of life and financial impact. One of the most common and preventable causes of cognitive decline is heart disease, specifically atherosclerotic vascular disease (AVD). This condition is related to myriad health risk factors and conditions, including sleep disorders. The current study examined 51 adults between the ages of 55 and 88 with a diagnosis of AVD. Participants were divided into sleep disordered (N = 20) and non sleep disordered (N =31) groups and compared in terms of fatigue, performance on neuropsychological testing, and a marker of inflammatory pathology. Participants with sleep disorders and AVD reported significantly greater levels of daytime fatigue and performed significantly more poorly on objective cognitive testing than those with AVD alone. Implications for the relationship of disordered sleep, AVD, and cognition as well as future research directions are discussed.