Several adverse effects have been associated with exposure to traffic noise. Studies supporting a noise-stress-health model have suggested links between noise level and increased noradrenalin concentrations in urine, hypertension and myocardial infarction. Among the more commonly documented effects, sleep disturbances have been regarded as being the most serious. Both noise annoyance and sleep disturbance have been proposed as important mediators of the impact of noise on health. The present paper investigates the relationships among long-term noise exposure, annoyance, sleeping problems and subjective health complaints by the use of a structural equation model. Further, it aims at giving insight into how noise sensitivity is related to sleep disturbances from road traffic noise. Finally, it examines whether any effect of noise exposure or response to noise can be detected on prevalence of cardiovascular problems, when information on sleep disturbances is included in a model. Data from a questionnaire survey conducted among a population sample in Oslo (N=2786) are combined with nighttime noise levels calculated from outside each respondents dwelling, at the bedroom façade. The results of the analysis showed significant relationships between noise annoyance at night and sleeping problems. The model also showed strong links among pseudoneurological complaints, annoyance and sleeping problems, thus pointing to the importance of including information on psychosomatic disorders and mild psychological problems in future studies looking at potential health effects of noise. The analysis showed no relationship between neither noise exposure nor response to noise and cardiovascular problems. Copyright 2010 Elsevier B.V. All rights reserved.