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BACKGROUND Impaired gait function after stroke contributes strongly to overall patient disability. Recently, sleep disturbance was reported to negatively affect functional recovery after stroke. OBJECTIVE The aim of this study was to identify the impact of sleep disturbance on balance and gait function in stroke patients. METHODS We retrospectively reviewed 140 patients with first-ever stroke. The patients were divided into two groups according to the presence of sleep disturbances, and differences in characteristics, such as demographic information, lesion factors, initial balance, and gait function. Lesion volume was measured on magnetic resonance images. Linear regression analyses were performed to examine predictors of balance and gait function after a 1-month rehabilitation program. RESULTS Of the 140 patients, 35 had sleep disturbance (25%). The patients with sleep disturbance were older than those without. Patients who had sleep disturbance had worse balance and gait function. BBS and FAC were also predicted by the initial BBS and sleep disturbance. The 10-m velocity was strongly associated with initial BBS, onset duration, and the presence of sleep disturbance. CONCLUSIONS Our study showed that sleep disturbances negatively affected functional outcomes, especially balance and gait function. Therefore, sleep problems should be controlled to improve outcomes in stroke patients.