•There was a considerable need for treatment of sleeping difficulties in the Swedish population.•The factor most strongly associated with this need was difficulty initiating sleep.•Other important factors were nonrestorative sleep, mental health disorders, and fatigue.•Nearly one-third of those who felt that they needed treatment did not consult healthcare providers.•More than one third with insomnia disorder reported no need for treatment. This study aims to investigate factors associated with the self-reported need for treatment of sleeping difficulties in the general population. This study consisted of a cross-sectional telephone survey of 1550 people randomly selected from the total population of Sweden. The survey, conducted by the Swedish national statistics agency, Statistics Sweden, was completed by 1115 people aged 18–85 years. Participants were asked about sleep patterns, daytime symptoms, physical and mental health disorders, use of prescribed hypnotics, help-seeking behaviors, and sociodemographic characteristics. They were also asked whether they thought they needed treatment for sleeping difficulties. A total of 12.5% of the participants reported a need for treatment because of sleeping difficulties. Significantly more women than men reported such a need (OR 1.46, 95% CI 1.02–2.10). Additionally, in univariate analyses, older age (age 60–69), sick leave, retirement, and unemployment were associated with a self-reported need for treatment, as were several sleep complaints, daytime symptoms, and physical and mental health disorders. A logistic regression model showed that difficulty initiating sleep (OR 6.29, 95% CI 3.67–10.78) was the factor most strongly associated with a self-reported need for treatment for sleeping difficulties. Other important factors were nonrestorative sleep (OR 3.70, 95% CI 2.05–6.69), mental health disorders (OR 3.01, 95% CI 1.59–5.67), and fatigue (OR 2.95, 95% CI 1.53–5.68). There was considerable self-reported need for treatment for sleeping difficulties in the population. Difficulty initiating sleep was the factor most strongly associated with this need, followed by nonrestorative sleep, mental health disorders, and fatigue.