Abstract
<title>Abstract</title> <p>Background Stress is a psychological reaction to challenges that exceeds coping capacity. It can lead to sleep disturbances like insomnia, which can negatively affect mental health and daily life, especially in conflict zones like Sudan. While university students are highly vulnerable to the psychological consequences of war, including distress and insomnia, limited research has been conducted to identify the relationship between war-induced stress and insomnia in Sudan following the outbreak of armed conflict in 2023. Aim This research aims to assess the relationship between insomnia and war-induced stress in Sudan among university students. Method This cross-sectional study was conducted from March to April 2025 among university students aged 17–35 in Sudan. A self-administered Arabic online questionnaire was distributed. It included socio-demographic data, the validated Perceived Stress Scale (PSS), the Insomnia Severity Index (ISI), and the Exposure to War (EW). Descriptive and inferential analyses were performed with p < 0.05 considered significant. Results The study included 922 participants with a mean age of 21.1 years, revealing moderate-to-high stress levels (PSS-14 mean = 29.8) and prevalent insomnia (ISI mean = 14.0) among participants, in addition to clinical insomnia among 49.1% of the sample. War exposure (82.3%) was correlated with stress and sleep disturbances; however, direct bomb exposure paradoxically correlated with insomnia (p = 0.019). Emigration from the family home was associated with increased insomnia (p = 0.022). Females represented 76.7% of the respondents and reported higher stress (p = 0.001) and insomnia (p = 0.002). Predictably, economic decline worsened insomnia (p = 0.010), while emigration increased stress but decreased insomnia severity (p < 0.001). Conclusion This study reveals a significant association between war-related stress and insomnia, especially among female students and internally displaced individuals, emphasising the urgent demand for accessible mental health and psychosocial support services.</p>