Sleeping under the threat of the Scud: war-related environmental insomnia

The influence of the Scud missile attacks during the Persian Gulf war on the sleep of the Israeli population is described. Our study group comprised a random sample of 200 people (mean age 41.13 +/- 15.32) who were contacted by telephone during the third week of the war and interviewed about their sleep. Overall, 28% of the entire sample complained about sleep: 10% complained about mid-sleep awakenings, 4.5% on difficulties falling asleep, and 13.5% about the combination of the two. People living in the Tel Aviv and Haifa areas complained significantly more than those in the rest of the country. Women complained significantly more than men, and people with lower education complained significantly more than people with higher education. Only 3% of the sample reported using sleeping pills. During the war actigraphic sleep recordings in 19 adults living in the Tel Aviv and Haifa areas did not reveal any measurable decrease in sleep quality in comparison with pre-war recordings. Possible explanations for the discrepancy between the subjective and objective assessments are discussed.