1160 Sleep Health Among Palestinian Civilians Amid Armed Conflict

Abstract Introduction Sleep is highly vulnerable to the cumulative stressors of displacement, bombardment, and economic collapse, yet there is little data describing civilian sleep health during protracted armed conflict. We quantified sleep quality and psychological well-being among Palestinian civilians living in Gaza and the West Bank during the February 2025 “ceasefire” phase. Methods We analyzed data from an online cross-sectional survey conducted 5–16 February 2025 among Palestinian civilians residing in the five Gaza governorates and major urban and peri-urban centers of the West Bank. The questionnaire included sociodemographic items, the Pittsburgh Sleep Quality Index (PSQI), WHO-5 Well-Being Index, Patient Health Questionnaire-9 (PHQ-9), and Post-Traumatic Growth Inventory–Short Form, alongside conflict-specific exposures (night-time noise from drones, gunfire, airstrikes; household crowding). Descriptive statistics summarized symptom burden. Mann–Whitney U and χ²/Fisher’s exact tests compared Gaza and West Bank respondents. Spearman correlations examined associations between environmental exposures and sleep/mental health scores. Results Among 284 respondents (mean age 25.3 years; 83% women), households in Gaza were more crowded than in the West Bank (mean 9.1 vs 5.1 persons). In Gaza, 99–100% reported nocturnal disturbance from gunfire, drones, and airstrikes; 54% had ≥1 family member and 87% ≥1 friend killed, compared with 86%, 5%, and 26%, respectively, in the West Bank (all p< 0.001). Across the combined sample, 84% had PSQI>5, 88% had WHO-5< 50, and 83% had PHQ-9>9, indicating pervasive poor sleep, low well-being, and at least moderate depressive symptoms. Mean PSQI and PHQ-9 scores were higher, and WHO-5 scores lower, among Gaza than West Bank respondents (all p< 0.05). PTGI scores indicated only modest post-traumatic growth (mean ≈25/40) without regional differences. Conclusion During the February 2025 “ceasefire,” Palestinian civilians, particularly those in Gaza, experienced profoundly disturbed sleep and high depressive symptom burden amid near-universal exposure to bombardment-related stressors and bereavement. These findings showcase the need for conflict-sensitive sleep and mental-health services, systematic screening, and longitudinal monitoring for war-affected civilian populations. Support (if any)