Associations of healthy sleep patterns with non-suicidal self-injury, suicidal ideation, and suicide attempts among Chinese college students

Abstract

Background: Non-suicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SA) are major concerns among college students. Sleep may be a modifiable factor, but its associations with NSSI, SI, and SA remain unclear.

Methods: A cross-sectional survey of 10,498 college students using a self-report questionnaire. Sleep health indicators include insomnia symptoms, duration, chronotype, snoring, and daytime sleepiness. Multivariable logistic regression models and restricted cubic spline analyses were used to examine associations between sleep patterns and self-injurious behaviors.

Results: The prevalence of NSSI, SI, and SA was 4.8%, 29.7%, and 3.7%, respectively. Participants with higher healthy sleep scores exhibited significantly reduced risks of NSSI, SI, and SA, with dose-response relationships observed. Each one-point increase in the sleep score was associated with a 43% lower risk of NSSI (odds ratios (OR) = 0.57, 95% CI: 0.52-0.62), a 37% lower risk of SI (OR = 0.63, 95% CI: 0.61-0.66), and a 48% lower risk of SA (OR = 0.52, 95% CI: 0.48-0.58).

Conclusion: Healthy sleep patterns were significantly associated with reduced risks of NSSI, SI, and SA among Chinese college students. These findings underscore the importance of promoting comprehensive sleep health as a public health strategy to mitigate self-injurious behaviors in young populations.

Keywords

college students / dose-response relationships / non-suicidal self-injury / sleep patterns / suicidal ideation / suicide attempts

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