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Purpose: The use of service dogs as a holistic intervention has grown significantly in the past 10 years. Studies report positive impacts of service dogs on primary and secondary symptoms associated with various disabilities. Dysfunctional sleep is a common symptom among individuals receiving service dog assistance. This study investigates the efficacy of service dogs in improving co-occurring sleep dysfunction in handlers with various conditions. Methods: A comprehensive search of Science Direct, ProQuest Psychology Journals, PubMed, MEDLINE, PsycINFO, and CINAHL was conducted in accordance with PRISMA guidelines, and 11 studies met inclusion criteria. Data extraction and quality assessment were conducted by multiple researchers. Data was then synthesized by theme. Results: Studies included subjects with PTSD, dementia, and chronic conditions. The review found positive trends in sleep quality and reduction of sleep disruptions among handlers. Nine studies demonstrated positive trends toward improved sleep quality and three in decreased sleep disturbance; however, only one study demonstrated statistical significance. Seven studies reported specific sleep-related tasks, which were linked to improved sleep. Sleep medication use decreased in two studies; however, this was not statistically significant. Discussion: This review demonstrates a consistent and positive trend between service dogs and improved sleep. Including sleep-related task training for service dogs may improve sleep outcomes. Conclusion: Evidence supports the use of service dogs to improve sleep dysfunction for individuals with PTSD, dementia, and chronic conditions. Higher-quality, long-term studies are needed to better validate the findings of included studies and to investigate the effects of service dogs on sleep for other diagnoses.