Objective To investigate the status of sleep quality and the family-related factors among elder-ly pregnant women who already have one child.Methods A total of 299 elderly pregnant women who already have one child were investigated using pittsburgh sleep quality index(PSQI),family APGAR index and a self-designed questionnaire. Results The total prevalence of poor sleep quality was 30.8% among elderly pregnant women who already have one child.PSQI score was average(6.31 ± 2.95). PSQI score were higher than the adult female norm and pregnant woman for the first time(u=16.396,5.497,P<0.05).Univariate analysis showed that the determi-nants of sleep quality included pregnancy,family support(parents),family support(husband),family support (child),family dysfunction,family right(χ2= 12.312,21.049,18.617,11.682,13.494,6.779,P < 0.05). Logistic regression analysis showed that pregnancy,family support(parents),family support(husband),family support(child)and family dysfunction were associated with sleep quality. Conclusion The poor sleep quality among elderly pregnant women who already have one child is related to low family support(parents,husband, child),obstacle of family dysfunction and late pregnancy.