Predicting sleep quality and duration in adulthood from war-related exposure and posttraumatic stress in childhood

Wars are potentially traumatic events for children, who may be exposed to numerous stressors during war, including witnessing and experiencing violence. Exposure to war stressors has been linked to a variety of symptoms in children, such as posttraumatic stress (PTS) symptoms, health problems, and somatic symptoms. Sleep problems are among the most commonly reported symptoms of children exposed to war traumas. For example, in a study of refugee children (ages 9-15) living in the Gaza Strip during armed conflict, 52% of children reported sleep problems. Another study of Israeli youth (ages 14-24) found that 58% reported sleep problems in the first week of the Gulf War. Studies connecting exposure to war trauma and sleep problems have primarily focused on the time period during or immediately following war. Longer-term studies examining war exposure in childhood and sleep are needed in order to understand whether war exposure in childhood predicts longer-term sleep problems or whether war exposure in childhood results in transient sleep problems that will resolve. This review, which includes a data-driven example, addresses this gap in the literature.