Background. Fatigue, sleep disturbances, and cognitive impairment are prevalent and clinically important problems among head and neck cancer patients. Our study aim was to determine the most important correlates of these problems among patients with head and neck cancer. Methods. A cross-sectional, self-administered survey was completed by 58 (response rate 79%) patients with head and neck cancer in an academic oncology clinic. Results. Multiple linear-regression analyses demonstrated that fatigue was associated with younger age (β = -0.22), previous radiation therapy (β = 0.23), fewer months since cancer diagnosis (β = -0.25), and depression (β = 0.40). Sleep dysfunction was associated with younger age (β = -0.31) and higher symptom index (β = 0.39). Cognitive dysfunction was associated with higher symptom index only (β = -0.49). Conclusions. Younger age, previous radiation, more recent cancer diagnosis, depression, and more severe symptoms may be associated with fatigue, sleep, and/or cognitive dysfunction. These results suggest at-risk subgroups warranting more aggressive screening and potentially supportive care interventions. © 2008 Wiley Periodicals, Inc.