Sleep as a Component of Health in Areas of Armed Conflict and Disaster.

Sleep is a vital physiological and psychological process essential for overall health and well-being, yet it is often severely disrupted in areas affected by armed conflict and disasters. In these environments, civilians frequently become internally displaced or refugees, experiencing fragmented or reduced sleep due to factors such as constant noise from drones and airstrikes, overcrowded shelters, and pervasive fear for personal safety. These sleep disturbances, including but not limited to insomnia and nightmares, are not merely secondary effects of a conflict or disaster but can also exacerbate stress responses, weaken immune function, and increase the risk of psychological toll and manifestations such as anxiety and depression. Public health initiatives increasingly recognize sleep disruption as both a predictor and consequence of trauma, highlighting the need for targeted interventions. However, the implementation of such interventions is often hindered by resource constraints in conflict and disaster zones. Elevated cortisol levels and inflammatory cytokines have been linked to prolonged sleep loss, which can further intensify stress responses and increase susceptibility to infections. Addressing sleep disturbances is crucial for improving overall health outcomes for the affected population and facilitating recovery and reintegration as crises subside. Integrating sleep-focused strategies into humanitarian and public health responses is essential for mitigating the long-term psychological and physical impacts of conflict and disaster, ultimately supporting the restoration of healthier and more stable communities.