In the early days of the war, Sofia Tsarenko, 22, would drink with friends in Ukraine to relax. She soon found that without a bottle of wine, her anxiety would become so unbearable that she could not fall asleep.
But as the war dragged on, Ms. Tsarenko said, her anxiety got worse and she became increasingly irritable. The wine stopped helping. It was only when she tried sleeping pills and antidepressants that she was able to get some relief.
“I felt like angels were taking me to sleep,” said Ms. Tsarenko, who lives in the eastern city of Dnipro.
Russia’s full-scale invasion of Ukraine has killed thousands of people and wounded tens of thousands more. But the toll is not just physical: Three years of war have wrought immense psychological harm. Now sleep deprivation has become a national health crisis in Ukraine, experts and psychologists say, citing near-nightly drone attacks as a key driver.
In towns and cities across the country each night, Ukrainians lie awake in bed, listening and waiting for the sounds of Russian drones buzzing like lawn mowers in the sky, then for the explosions. Drone strikes have only intensified since U.S.-mediated peace talks began, according to Ukrainian officials. And Russia appears to be increasingly targeting urban areas, as with a huge and deadly strike in Kyiv on Thursday, adding to civilians’ anxiety and causing more sleepless nights.
Chronic sleep deprivation has a profound impact on psychological well-being, according to experts. Sometimes referred to as “sleep debt,” it can cause anxiety and irritability, along with depression and other more severe mental health concerns, they say.
The World Health Organization said in February that nearly half of Ukrainians reported having mental health concerns. And sales of antidepressants surged by 46 percent in Ukraine last year, according to an analysis of its own trade by Liki24.com, a major drug distributor in the country.
It is impossible to know how much of that is directly linked to sleep deprivation, and Ukrainians have plenty of reasons to be anxious, from fears about friends or relatives at the front, to uncertainty about how and when the war will end. But sleep deprivation only adds to the toll, experts and doctors in Ukraine said.
Dr. Davyd Shcherbyna, a psychiatrist and co-founder of a chain of medical clinics in Kyiv, said that half of his patients had sleep disorders and that many of those who seek assistance for it were also suffering from depression.
“The very first thing a person loses under stress is sleep,” he said, adding that he found mothers particularly difficult to treat. Some resist medication, he said, out of fear that they would not wake up for air-raid alarms and therefore fail to take children to a shelter in the event of an attack.
Those air-raid alarms themselves have a negative affect on mental health because they disrupt the natural sleep cycle, according to Sofiya Vlokh, a psychiatrist and researcher at Lviv National Medical University in Ukraine.
The World Health Organization said in February that nearly half of Ukrainians reported having mental health concerns.
“Many Ukrainians are suffering,” Ms. Vlokh said. She stressed that sleep deprivation was a concern not only because it can cause severe mental health disorders but also because, even under the best of circumstances, it can affect overall well-being and productivity.
That rings true for Tetyana Horobchenko, 41, who lives near a Ukrainian air base in Vasylkiv, near Kyiv, that is frequently targeted by Russian drones and missiles. She hides in the bathroom with her husband, cat and dog during attacks — then struggles to go back to sleep when they end. Instead, she said, she stays up scrolling through the news on her phone.
“Sometimes it feels like the lack of sleep doesn’t affect me, but when I compare myself to the other version of myself that had enough sleep, I see that we are different people,” she said.
Drones, of course, are not the only cause of anxiety. In Lviv, in western Ukraine, where air-raid alarms are less frequent, Volodymyr Behlov, 38, said fears about the future kept him awake at night.
“I felt that I lost tomorrow,” said Mr. Behlov, who manages cultural events. Those worries, he said, led him to get a prescription for the antidepressants that have helped him sleep.
But pills do not always work, nor are they an option for everyone. Hanna Lesiuk, 50, who lives on the outskirts of Kyiv, said that she took antidepressants but still became physically ill each time she heard explosions.
Others say they use alternative tactics to feel safer or to coax themselves to sleep. Some bed down in hallways, away from windows. In the Vinnytsia region of central Ukraine, Zoya Zhuk, 41, wraps herself in a 15-pound weighted blanket. In western Ukraine, Maria Kysil, 33, places a medical kit with a tourniquet on her bedside table.
In Kyiv, Valentyn Maidaniuk, a 26-year-old who works at an aviation university, said that he tried to reason it out. “When I can’t sleep, I often think about how strong my building is,” he explained.
Maryna Hrudiy, 39, a consultant on psychological health, adopted a physical change along with a prescription for antidepressants. She used to lie awake, scared that a strike would bury her 6-year-old daughter under rubble in a different room. Now she takes pills and shares a bed with her.
Children are not immune to stress or sleeplessness either. Oksana Khodak, 45, was prescribed sedatives when her anxiety levels became unbearable. Then she found out that Yaroslava, her 14-year-old daughter, had also been lying awake at night and noticed that the teenager’s hands would tremble. Now Yaroslava, too, takes sleeping pills and anti-anxiety medication.
“I thought I was handling it well with my daughter, as we often talk, and if it’s a scary night, I hug her,” said Ms. Khodak, who lives in Zaporizhzhia, in southern Ukraine. Realizing that Yaroslava was also struggling so much psychologically, she added, “just tore me apart.”
Although it was exhaustion that drove Olena Churanova, 37, to see a psychiatrist — “I started feeling like I no longer cared if a drone would hit my flat,” she said — medication can’t change the reality of the war.
“Overall,” she said, “it scares me that all this became our routine: Air sirens, sleeping in the corridor, antidepressants.”
Nataliia Novosolova contributed reporting from Kyiv; and Yurii Shyvala from Lviv, Ukraine.
Maria Varenikova covers Ukraine and its war with Russia.
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