Sleeping under attack: Sleep disruption and next-day emotions during active wartime

Abstract

Background

Exposure to war is associated with marked impairments in both sleep and mental health, yet the short-term emotional consequences of war-related nighttime disturbances remain poorly understood. Leveraging nighttime air-raid alerts during the 2025 Israel-Iran war as a naturalistic manipulation, the present study examined their effects on civilians’ sleep and next-day emotions, testing sleep disruption as a mediator and evaluating the roles of siren timing and shelter characteristics.

Methods

A total of 1340 adults residing in Israel (74% female; n = 1140 exposed to nighttime sirens, n = 199 unexposed) were recruited during days 5–11 of the war. Participants completed an online survey assessing nighttime air-raid siren exposure, sheltering conditions, sleep duration, nocturnal wakefulness, and next-day anxiety-depression and mood.

Results

Exposure to nighttime air-raid sirens was associated with 39 fewer minutes of sleep and 34 additional minutes of nocturnal wakefulness compared to non-exposure. Exposed individuals also reported elevated anxiety-depression symptoms and reduced mood the following day. Sleep disruption fully mediated the relationship between nighttime siren exposure and next-day anxiety-depression, and partially mediated effects on mood. Moreover, the magnitude of sleep disruption varied by attack timing and shelter characteristics, with early-morning sirens and external sheltering associated with particularly poor outcomes.

Conclusions

Sleep disruption represents a key mechanism linking nighttime attacks to emotional harm in conflict-affected civilians. These findings identify sleep as a critical and modifiable intervention target for protecting mental health during wartime. Interventions to preserve or restore sleep may help mitigate the psychological toll of armed conflict on civilian populations.