Abstract Introduction Observational studies suggest poor sleep is related to lower bone mineral density (BMD) and increased osteoporosis risk. Yet, many studies focus on sleep duration and lack inclusion of other sleep characteristics. The sleep health construct simultaneously recognizes multiple dimensions of sleep and is operationalized as a composite score. Thus, we examined whether a composite measure of sleep health was related to BMD in a sample of older women. Methods The sample included 1968 older women (mean age: 83.6 ± 3.1 years) from the Study of Osteoporotic Fractures. Six sleep health domains (regularity, duration, satisfaction, timing, efficiency, sleepiness/alertness) were dichotomized into either “good” or “poor” categories. The number of “good” characteristics were summed into a score ranging from 0 (poor) to 6 (good). BMD (g/cm2) was measured at the femoral neck, total hip, and trochanter sites with dual energy x-ray absorptiometry. Multiple linear regression was used to explore the association between sleep health (composite score and the individual domains) with BMD (cross-sectional) and annualized percent change in BMD (longitudinal). All models were adjusted for age, body mass index, alcohol consumption, smoking, physical activity, education, diabetes, hyperthyroidism, fracture history, and cardiovascular disease. Results Average sleep health score was 3.8±1.2. Cross-sectionally, better sleep health was associated with higher BMD at the femoral neck (β=.04, p=.04) and trochanter (β=.05, p=.02). Sleep health was not cross-sectionally associated with BMD at the total hip (β=.03, p=.09) or with change in BMD at any region (Each p >.13). The individual domain of sleep regularity was cross-sectionally related to BMD at the total hip and trochanter, respectively (β=.04, P=.04; β=.05, P=.02). Conclusion A multi-dimensional measure of sleep health was related to greater BMD cross-sectionally at the femoral neck and trochanter regions in a sample of older women. Future studies should focus on associations between sleep health and osteoporotic-related fractures. Support The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, and R01 AG027576