Abstract
BACKGROUND: The August 4, 2020 Beirut port explosion caused widespread destruction and psychological distress. This study evaluates long-term effects on sleep disturbances and trauma, focusing on proximity to the blast site. METHODS: We surveyed 248 adults residing in Lebanon during the explosion using the Insomnia Severity Index (ISI), Impact of Events Scale-Revised (IES-R), and Patient Health Questionnaire (PHQ-4). RESULTS: Overall, 62.1% reported insomnia symptoms. Clinically significant insomnia was more common within 6 km of the explosion (28.8%) than beyond (16.8%; p = 0.024). Direct exposure (injury, property damage) was linked to higher insomnia rates (p = 0.002). Logistic regression showed proximity (OR = 2.17, p = 0.025) and female gender (OR = 2.40, p = 0.035) increased insomnia likelihood. Proximity was also associated with increased alcohol (p = 0.017) and recreational drug use (p = 0.030). CONCLUSION: These findings demonstrate the long-lasting impact of the Beirut explosion on sleep health and related substance use. They underscore the importance of integrating sleep-focused interventions into mental health disaster response to improve recovery outcomes.