Objective To explore the relationship between spontaneous activity in brain regions and executive function in depressive disorder patients with low sleep quality. Methods A total of 42 patients with depressive disorder in the Mental Health Center of the First Hospital of Hebei Medical University from September 2021 to April 2024 were selected as study group. During the same period， 14 matched age， gender， and education level were recruited from the Health Examination Center of the same hospital as healthy control group. Hamilton Depression Scale-17 item （HAMD-17）， Pittsburgh Sleep Quality Index （PSQI）， and Digital Span Test （DST） were used to assess the subjects' depressive mood， sleep quality， and cognition. 3.0T resting-state functional magnetic resonance imaging （rs-fMRI） scan was used to calculate the fraction amplitude of low frequency fluctuation （fALFF）. According to the PSQI score， patients in study group with a PSQI score ≤ 7 were defined as high sleep quality group （n=14）， and patients with a PSQI score ＞ 7 were defined as low sleep quality group （n=28）. After conducting a variance analysis of fALFF values for three groups of subjects， a backtesting was conducted， and Spearman correlation was used to analyze the correlation between different brain regions and digital span scores. Results There was no statistically significant difference in age， gender， education level， and forward digit span scores among the three groups of subjects （P＞ 0.05）. However， there was a statistically significant difference in the scores of backwards digit span （H=26.56， P=0.03）. Backtesting showed that low sleep quality group had a lower score for backwards digit span compared to healthy control group with a statistical difference （Z=-3.40， P ＜ 0.05）， but there was no statistically significant difference between high sleep quality group and low sleep quality group （Z=-1.34， P=0.18） or healthy control group （Z= -1.35， P=0.18）. There was a statistically significant difference in the fALFF values of the right superior occipital gyrus （MNI： x=0， y=-102， z=-31； k=37）， left middle occipital gyrus （MNI： x=21， y=-102， z=6； k=51）， and left anterior cingulate cortex （MNI： x=-9， y=-78， z=21； k=27） among the three groups （GRF correction， P＜ 0.05）. Compared with high sleep quality group， the fALFF value of the right superior occipital gyrus in low sleep quality group increased， and the difference was statistically significant （Z=-3.02， P＜ 0.05）. Compared with healthy control group， the fALFF value of the left anterior cingulate cortex increased in high sleep quality group （Z=-2.02， P=0.04）， while the fALFF values of the right superior occipital gyrus （Z=-3.47， P＜ 0.05）， left middle occipital gyrus （Z=-3.82， P ＜ 0.05）， and left anterior cingulate cortex （Z=-3.71， P ＜ 0.05） increased in low sleep quality group， and the differences were statistically significant. Correlation analysis showed that there was a negative correlation between the right superior occipital gyrus （r=-0.26， P＜ 0.05） and the left anterior cingulate cortex （r=-0.38， P＜ 0.05） and the score of backwards digit span， and the differences were statistically significant. Conclusions Depressive disorder patients with low sleep quality have increased spontaneous activity of the occipital lobe， and abnormal activity of the occipital lobe may be related to decreased executive function.