Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 6, 2025
Date Accepted: Sep 4, 2025
The Associations of Pre-sleep and Post-wake Mobile Phone Use with Nonsuicidal Self-injury among Chinese University Students: A Cross-Sectional Study
ABSTRACT
Background:
Nonsuicidal self-injury (NSSI) is regarded as the gateway behavior of suicide. This situation has been identified as a critical public health concern that requires immediate attention.
Objective:
This study aimed to explore the associations of mobile phone use before bedtime and before getting up with NSSI among Chinese college students.
Methods:
A multistage random cluster sampling survey were conducted from six universities in Shaanxi province, found in Northwest China, during October and November 2022, a total of 18,585 students included for the final analyses. Four different logistic models were used to analyze the links between mobile phone usage behaviors and NSSI during the past month, and restricted cubic splines regression were used to estimate the dose-response relationship between pre-sleep and after-sleep and the odds of NSSI.
Results:
The proportions of participants exhibiting NSSI were 3.8% in past month. Prolonged use of mobile phone before bedtime for more than two hours was associated with an increased risk of past month NSSI (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.38-2.20). While after-sleep mobile phone use does not significantly affect the risk of NSSI. No significant gender differences in these associations of pre-sleep and after-sleep mobile phone use with NSSI were observed. Restricted Cubic Spline (RCS) model results shows that P for non-linear association for pre-sleep and after-sleep mobile phone use time and NSSI were ＞0.05.
Conclusions:
Prolonged mobile phone usage before sleep is associated with an increased risk of NSSI. Early intervention strategies aimed at regulating mobile phone use during night should be implemented to mitigate NSSI behaviors among college students.
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