Sleep quality and quality of life in patients with dermatological diseases during the war in Gaza

Skin diseases such as psoriasis and scabies can severely impact sleep quality and quality of life (QoL), especially under extreme stress conditions such as war. During the 2024 conflict in Gaza, displacement, limited access to healthcare, and widespread trauma created a unique context in which to study these interactions. This cross-sectional study included 498 participants from three healthcare centers across Gaza. Data on dermatological diagnoses, sleep quality (PSQI), quality of life (DLQI/CDLQI), pain levels, and displacement history were collected. Statistical analyses were performed to explore correlations and significant predictors of sleep and QoL outcomes. Poor sleep and reduced QoL were significantly associated with psoriasis, scabies, frequent displacement, high pain levels, and unemployment. Adults with psoriasis had the highest DLQI scores (mean = 15.82), whereas children with psoriasis and scabies had scores of 9.25 and 8.22, respectively, on the CDLQI. Sleep was worst among those with scabies (mean PSQI = 15.88). Displacement frequency was a key predictor; those displaced 10 or more times had notably higher impairment scores. Employment status, residency status (especially in Gaza City), and pain level were also significant. No substantial differences were found by sex, marital status, or education. Warm intensified the burden of skin diseases on both sleep quality and QoL. Displacement, pain, and socioeconomic hardship are key drivers of poor outcomes. Children and unemployed individuals are particularly vulnerable. These findings call for trauma-informed, integrated care approaches that combine dermatological treatment, mental health support, and social services, particularly for displaced and high-risk groups.