THE IMPACT OF MISSILE WARFARE ON SELF-REPORTED SLEEP QUALITY .1.

During the 1991 Gulf War, we investigated the effect of missile attack s through two telephone surveys of a large sample of an urban populati on that evaluated self-reported sleep quality, stress, fear, depressed mood, fatigue and power of concentration. We surveyed 1,045 people du ring the Gulf War itself, and we interviewed them again (excluding the chronic insomniacs) 30 days after the war. During the war, 51% of the subjects claimed to be suffering from disturbed sleep. Whereas 13% of the survey population had been chronic insomniacs before the war, 38% developed insomnia during the war. The war provoked reported stress ( 67.5% of subjects), depressed mood (50.9%), difficulties in concentrat ion (39.7%) and increased fatigue (25%). Four weeks after it ended, 19 % of the previously normal subjects were still suffering from insomnia ; 5% of the cases of insomnia were developed postbellum. Stress, depre ssed mood and impaired concentration were found to correlate significa ntly with subjectively evaluated insomnia. We concluded that modern mi ssile warfare may induce long-lasting insomnia in one-third of the pop ulation under threat. A small percentage may develop insomnia postbell um. The risk of developing long-lasting insomnia is higher in those wh o reported experiencing prolonged stress and depressed moods.