Relationship between non-suicidal self-injury and sleep among college students: a multifactorial analysis

To investigate the relationship between non-suicidal self-injury (NSSI) and sleep quality, and associated psychosocial factors among college students.

A cross-sectional study was conducted using cluster sampling at a university in Tianjin, China, in August 2022. Validated questionnaires, including the Adolescents Self-Harm Scale (ASHS), Pittsburgh Sleep Quality Index (PSQI), and Center for Epidemiological Studies Depression Scale (CES-D), were administered to 454 freshmen. Generalized linear models were employed to analyze associations between NSSI and independent variables.

After excluding the questionnaires with insincere responses based on the test time and trap questions, a total of 454 valid questionnaires were collected. The use of hypnotic medications was significantly associated with higher NSSI scores. (β=2.342,P<0.001). Sleep duration was positively associated with NSSI scores (β=0.765,P=0.017). CES-D score positively affected NSSI score (β=0.117,P<0.001). Non-heterosexual students scored 2.379 points higher on the NSSI scale than heterosexual students (P<0.001). Relationship with parents significantly positively affects NSSI. The score of NSSI was significantly increased by 2.951 (P=0.002) in those who had a poor father-child relationship compared to those with harmonious parental relationships. Childhood trauma had a significant positive effect on NSSI, that is, students who had experienced childhood trauma had 3.815 higher NSSI scores than students who had not experienced trauma (P<0.001).

Non-suicidal self-injury (NSSI) among college students is associated with sleep disturbances, particularly reduced sleep duration and the use of hypnotic medications. Moreover, psychosocial risk factors, including depression, non-heterosexual identity, familial discord, and childhood trauma, are also linked to the occurrence of NSSI. Intervention measures that improve sleep quality and provide psychosocial support may effectively reduce the risk of non-suicidal self-injury behavior.