Sleepless in Gaza: War-related trauma and the neurobiological toll on sleep

The Israeli war against Gaza has severely disrupted daily life, including sleep, a fundamental human need. Chronic war-related trauma has caused hyperarousal, nightmares, and insomnia, perpetuating psychological distress. Overcrowded shelters and limited mental health services exacerbate these challenges. This study examines how the Israeli war against the Gazans affected Gazans' sleep quality and patterns, focusing on sleep-related challenges faced by children and adults through firsthand accounts of war-induced trauma and stress. Forty semi-structured interviews with 20 children (ages 6-12) and 20 adults (14 mothers, 6 fathers) were analyzed using thematic analysis with a bottom-up, data-driven approach, refined through team discussions and cross-validation by independent judges. The five key themes identified are (1) chronic hypervigilance and sleep disruption, (2) trauma-driven sleep dysregulation in Gaza's children, (3) sleeplessness in shelters, (4) maternal vigilance and the ramifications of sleeplessness, and (5) the health toll of chronic sleep deprivation. The findings highlight the urgent need for culturally sensitive mental health interventions, improved living conditions, and family-centered support services to alleviate war-related insomnia in Gaza.