Reported sleep quality was examined in relation to anxiety, depression, selected psycho-physiological sleep disturbing symptoms, daytime dysfunctions according to poor sleep, and quality of life 1 year after percutaneous transluminal coronary angioplasty (PTCA). Furthermore, females were compared with age-matched males to examine any differences in sleep quality, psycho-physiological symptoms and quality of life. A descriptive comparative study. Twenty-two females, mean age 62.7 (SD 5.7) and 70 men, mean age 60.4 (SD 6.7), were consecutively recruited. A mailed questionnaire was distributed, including the Uppsala Sleep Inventory, Spielberger State Anxiety scale, Zung's Self-rating Depression Scale and the Nottingham Health Profile instrument. Forty-six per cent of the patients had a history of myocardial infarction and 40.2% hypertension. Seventy-two per cent of the patients were anxious and 30.4% depressed. Difficulty in getting to sleep was related to intrusive thoughts with increased feelings of anxiety and sensitivity. Difficulty in maintaining sleep was the most common sleep complaint (42.4%) and physical tiredness/fatigue was the greatest consequence of disturbed sleep (51.1%). Those with pain, palpitations or respiratory nocturnal sleep-disturbing symptoms were characterised by shorter sleep duration, emotional distress, cognitive dysfunction, tiredness and reduced quality of life. Greater difficulties initiating sleep and worse health related quality of life were revealed in females compared with aged-matched males. Fragmented sleep is a problem partly because of psycho-physiological symptoms 1 year after PTCA, with reduced resilience to stress, increasing vulnerability or diminished coping ability and poorer quality of life.