Objective: This investigation aimed first, to examine sleep quality in a sample of adolescent transplant recipients using a socioecological systems framework, and second, to evaluate sociocultural factors as markers of ecological risk. Method: Seventy-one adolescents (M = 16.49 years; SD = 1.62) with a solid organ transplant and their caregivers completed self- and proxy-report measures. Results: Adolescent transplant recipients have significantly more problems on certain domains of sleep quality compared to healthy peers. Better sleep quality was significantly associated with better psychosocial functioning, quality of life, fewer barriers to adherence, and greater medication adherence. Sleep quality was also a significant unique predictor of quality of life and barriers to adherence. Race significantly moderated the association between sleep and adolescent depressive symptoms. Sleep quality was not correlated with any of the micro- or macro-level factors examined. Discussion: Adolescent transplant recipients are at increased risk for experiencing poor sleep. Lower sleep quality in this population appears to be linked to various patient-level outcomes. Those from minority backgrounds are particularly vulnerable to the risks associated with disruptions in sleep. Sleep is an important modifiable factor that may contribute to adaptation and adjustment among adolescent transplant recipients.
