*Purpose: Sleep disturbance is a severe problem in liver transplant recipients; few studies have confirmed the psychosocial factors associated with sleep quality in patients after liver transplantation. This study aimed to identify the psychosocial factors related to sleep quality among liver transplant patients during outpatient follow-up.

*Methods: A retrospective cross-sectional study was performed in 124 liver transplant patients during outpatient follow-up. All participants completed a general demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Generalized Anxiety Disorder-7 scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the perceived social support scale (PSSS).

*Results: The global PSQI score was 6.57 (SD, 4.28), which was significantly higher than the score for people with normal sleep quality; 50 (40.3%) recipients were classified as having poor sleep quality (PSQI> 7). Among the self-reported sleep problems, 62 (50.0%) participants reported that they had to go to the bathroom at night, 58 (43.5%) woke up in the middle of the night or early morning, 84 (67.7%) reported depression symptoms, and 116 (93.5%) had low-level social support. The global PSQI score was positively correlated with anxiety and depression scores. The global PSSS score was negatively correlated with anxiety and depression scores (p < 0.01). Multiple linear regression analysis showed that the length of the postliver transplant period, the type of residence, BMI, depressive symptoms and anxious symptoms were important factors affecting sleep quality among liver transplant patients (p<0.05).

*Conclusions: Our findings showed high prevalences and incidences of poor sleep quality in liver transplant recipients in outpatient follow-up, with significant correlation between anxiety, depression and social support, and affected by multiple factors. This indicates a need for further research on the follow-up results of sleep and the benefits of comprehensive interventions involving psychosocial factors in liver transplant recipients in China.

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