ObjectiveThis study used a moderated mediation model to test the mediating effect of anxiety on the relationship between negative perfectionism and sleep quality and the moderating effect of COVID-19 epidemic risk perception during the COVID-19 pandemic in Chinese international students.Materials and methodsA sample of 239 Chinese international students from the south of China, was surveyed with the Negative and Positive Perfectionism Scale, the Pittsburgh Sleep Quality Index, the General Anxiety Disorder Scale, and the COVID-19 Epidemic Risk Perception Inventory. Version 23.0 (...) of SPSS and version 3.4 of PROCESS were used to perform the correlation analyses, mediation analysis, and moderated mediation analysis.Results Negative perfectionism was significantly correlated with anxiety and poor sleep quality. Anxiety was significantly correlated with poor sleep quality. The mediating effect test showed that anxiety had a mediating effect between negative perfectionism and poor sleep quality. Epidemic risk perception moderated the mediating effect of anxiety between negative perfectionism and poor sleep quality.ConclusionNegative perfectionism affected sleep quality indirectly through anxiety. In particular, COVID-19 epidemic risk perception moderated the relationship between anxiety and sleep quality, such that the association was stronger when the COVID-19 epidemic risk perception was high. These results provide a more comprehensive understanding of the negative link between negative perfectionism and poor sleep quality. (shrink)