Haya AhmedAlong a crowded street packed with makeshift homes for the displaced in south Gaza’s Rafah, Abu Samer sits slumped on a rickety chair outside his tent.
His mind and body weary from hunger and constant displacement over nearly two years, the Palestinian tries to catch a brief nap amid Gaza’s detritus on the sultry summer night.
But it turns out to be a futile exercise.
“I close my eyes, but sleep eludes me,” Samer, in his fifties, tells TRT World. “The noise, the fear and my restless thoughts, everything prevents me from sleeping. When I finally nod off, the sounds of explosions kick me awake.”
For Samer – as it is for Gaza’s two million-plus people – sleep is a luxury amid the pain and destruction inflicted by Israel.
Like many fathers, he sits guard in front of his tent while his wife and children try to get some sleep each night, sacrificing his own sleep and resting space for them.
“My neck and back hurt, and the chair is hard. But my heart is too soft to leave them without someone watching over them,” he says.
In Gaza, the scale of the ongoing war that has killed over 64,000 is not measured only by the number of bombs dropped or bullets fired, but also by the staggering number of sleepless nights Palestinians are having to endure.
This lack of sleep has had severe consequences.
Doctors say that hundreds of thousands of Palestinians are grappling with mental and physical ailments due to sleep deprivation, including severe post-traumatic stress disorder (PTSD), due to the incessant sound of exploding bombs, rumble of Israeli tanks and sonic boom of fighter jets overheard.
“What we are seeing in Gaza today resembles cases of psychological torture in prisons, where sleep deprivation is used as a means of breaking someone’s spirit,” says Mohammed S, a Gaza-based psychiatrist who only gave his first name for security reasons.
In every corner of the besieged enclave, through day and night, the sight of people trying desperately to get just a few minutes of sleep is a common sight – leaning against the remains of a standing wall, sat on the ground slumped over, or lying on part of a mattress shared with family among scores of others in vacant schools, temporary emergency shelters and tents for the displaced.
The breaking point
With thousands of houses and residential buildings completely destroyed, it is not uncommon to see people sleeping on top of each other in makeshift shelters made from pieces of plastic polymer sheeting or on sidewalks in the open air close to rubble and sewage.
Extended families of up to 25 people can be found crammed into small tents, with no individual sleeping space.
“I sleep on a backless chair and rest my head on my bag. The bag contains my identity papers; I keep them close so that I don’t lose them if we get bombed,” Musa’ed Hamdouna, an ex-UNRWA school caretaker from Rafah, tells TRT World.
It isn’t just the terrifying sound of bombs that keeps people awake. While daytime temperatures peak at 34 degree Celsius, the nights bring no respite.
Without electricity, air conditioning has become a distant dream.
Those who are lucky might manage a battery-powered fan, but it will just circulate hot air inside the tent. Still, it is a luxury only a few can afford.
“The heat is unbearable at the moment,” says Um Yaman, a mother living near the Al Shifa Medical Complex in North Gaza. “The tent is like an oven; there is no fan, no fresh air and no shade. The children sweat and toss and turn all night.”
“Recently, we have taken to sleeping outside on the sidewalk where it is slightly cooler, but the children wake up from the sounds of vehicles, air strikes and people screaming. My heart breaks for them, but there is nothing else I can do,” she tells TRT World.
If the overcrowding and hot summer nights aren’t causing a lack of sleep, the sheer fear and anxiety of war are causing insomnia, according to recent studies.
Palestinians find themselves living in a state of constant hypervigilance, which impacts the body’s ability to go to sleep.
A qualitative study conducted on 30 Palestinians in Rafah discovered additional reasons for their lack of sleep.
Parents said they did not sleep because they promised to watch over their children all night and keep them safe. Others said they slept in shifts due to the lack of space and so that they could wake the rest of their family if there was an air strike.
“We have seen extreme cases of people who have not slept for more than a week. It has taken them months to regain even just semi-normal sleep,” Dr Halima Abu Sakhila, a UN psychiatrist, tells TRT World.
Over time, a severe lack of sleep can have profound negative impacts on both physical and mental health, including lower immunity and anxiety, panic attacks and depression, which can lead to apathy, self-harm or aggressive behaviour.
In extreme cases, sleep deprivation can lead to hallucinations, convulsions and fatal high blood pressure.
For children, sleep deprivation can also cause frequent bedwetting, low mood, aggression, poor focus and chronic fatigue.
Mohammed S. says that insomnia and sleep disorders among Gaza’s population have reached unprecedented levels.
“Over 80 percent of patients visiting psychiatric clinics complain of chronic insomnia, nightmares and difficulty falling asleep. Even children have stopped sleeping normally, instead sleeping intermittently due to the constant anxiety they are experiencing.”
It is believed that around 79 percent of Gaza’s children currently suffer from frequent nightmares.
According to a December 2024 study, at least 96 percent of Gaza children believe that their death is imminent, making it impossible for them to go to sleep at night.
“My youngest child is two years old and has not slept through a single night since the war began. The noise from the planes keeps us awake all night. Even when the bombing pauses, we cannot rest; the feeling of fear does not allow us to sleep,” says Um Ibrahim, a mother of five from the Al Shati Camp.
Treatment for insomnia and sleep deprivation usually includes cognitive behavioural therapy, which could be offered remotely, although the lack of internet in Gaza poses a challenge, or the prescription of antidepressants, which are unfortunately in short supply in the enclave due to the restriction of medical aid.
When trauma moves at night
One phenomenon that has been on the rise in Gaza as a result of the population’s chronic sleep deprivation is sleepwalking among children.
Many mothers recount stories of their children rising from the floor in the middle of the night, opening closets or trying to walk out into the street while fast asleep.
Sleepwalking in children is linked to acute stress and often appears in environments where children have been exposed to trauma or long-term psychological pressure. It is also associated with PTSD. Many Gaza children have witnessed or experienced explosions and seen loved ones killed.
“My eight-year-old son started sleepwalking after our house collapsed on top of us. Every night he sleepwalks, going to our door as if he is trying to escape from something we cannot see,” Dima Shehab from Sheikh Radwan tells TRT World.
Psychiatrists in Gaza say chronic sleepwalking among Palestinian children is a direct consequence of the ongoing war and part of a broader spectrum of rising sleep disorders in the enclave.
“Sleepwalking is not just a sleep disorder,” says Mohammed S, “It’s also a subconscious message from the child that they feel that the threat of danger is not yet over.”
“It is the subconscious simulation of escape and can be a reenactment of a moment of survival that the child has not yet processed.”
Although sleep has not been classed as a fundamental human right, there is a growing movement of health bodies that argue it should be. Courts in some countries, such as the United States and India, have ruled sleep as a human right.
But for Palestinians in Gaza, stripped of their dignity by Israel and deprived of access to even the most basic needs, sleep has become a mirage in the haze of war – hanging heavy on their eyelids but yet still too far away from their tired minds and bodies.
