Bidirectional Association Between Sleep Quality and Mental Health: Correlation Analysis of DASS and MHC Indicators Among College Students

Objective: Based on the dual-continua model of mental health, this study aimed to explore the relationship between sleep quality and college students' mental health, while examining differences in association strength with negative psychological symptoms and positive mental health indicators. Methods: The study included 948 college students, with 832 valid samples after data cleaning. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), negative psychological symptoms were measured with the Depression-Anxiety-Stress Scale (DASS), and positive mental health was evaluated using the Mental Health Continuum–Short Form (MHC-SF). Spearman’s correlation analysis was employed to examine variable relationships. Results: PSQI total scores showed significant positive correlations with all DASS dimensions: DASS total score (rho = 0.50, p < 0.001), DASS stress (rho = 0.51, p < 0.001), DASS anxiety (rho = 0.49, p < 0.001), and DASS depression (rho = 0.47, p < 0.001), indicating that poorer sleep quality was associated with higher psychological distress. Conversely, PSQI scores exhibited significant negative correlations with MHC dimensions: MHC emotional well-being (rho = -0.398, p < 0.001), MHC total score (rho = -0.395, p < 0.001), MHC psychological well-being (rho = -0.392, p < 0.001), and MHC social well-being (rho = -0.31, p < 0.001), suggesting that worse sleep quality correlated with lower positive mental health levels. The study found that PSQI correlations with DASS dimensions were slightly stronger than those with MHC dimensions. Among DASS subscales, stress showed the strongest association with sleep quality, while in MHC, emotional well-being had the strongest link, and social well-being the weakest. Conclusion: The quality of sleep exhibited a bidirectional relationship with the mental health of college students, showing a positive correlation with negative psychological symptoms and a negative correlation with indicators of positive mental health, with varying degrees of strength across different dimensions. These results lend support to the dual-continua model of mental health, underscoring the significant role of sleep quality in the overall mental well-being of college students. This evidence provides a vital foundation for mental health education and intervention strategies on college campuses. In efforts to promote mental health, it is essential to focus on sleep-related issues, particularly their connection to stress and emotional well-being, as enhancing sleep quality may reciprocally improve the mental health of college students.