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To compare and measure the effects of sleep quality in women with and without postpartum depression.A case-control repeated measures matched pairs design.Home and obstetric office.Forty-six women who were 6 to 26 weeks postpartum. Two participants were dropped from the final analysis because they were outliers.Participants underwent wrist actigraphy at home for 7 consecutive days to measure sleep quality. The Postpartum Depression Screening Scale measured depression severity. Psychosocial variables were collected during a screening interview. A structured clinical interview was used to diagnose postpartum depression. Correlations, t tests, and hierarchical multiple regressions were run to analyze data.With the exception of wake episodes, sleep latency (B=1.80, SE=0.73, p<.05), wake after sleep onset (B=6.85, SE=2.85, p<.05), and thus sleep efficiency (B=−6.31, SE=3.13, p<.05) predicted postpartum depression symptom severity.Women with postpartum depression experienced poorer sleep quality than women without postpartum depression, and sleep quality worsened with increasing postpartum depression symptom severity. Clinicians need to address measures to improve sleep quality in depressed mothers to decrease symptom severity, and researchers need to develop interventions to facilitate better sleep quality in women with postpartum depression.