A fragile ceasefire has brought a few days of quiet to Israel, giving people a chance to breathe, if only partially. Yet some still hear rocket sirens—even when none are sounding. This phenomenon, known as pseudo-hallucinations (perceptions without external stimuli), is linked to a heightened risk of post-traumatic stress disorder (PTSD) symptoms following exposure to war, according to a new Israeli study.
Researchers from Ariel University said it was important to identify auditory hallucinations early. Doing so can be critical for directing individuals toward appropriate mental health interventions and preventing the worsening of their condition.
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Children take cover during a rocket siren in Tel Aviv
(Photo: Reuters/ Violeta Santos Moura)
The study, recently published in the Journal of Psychiatric Research, reveals a significant correlation between hearing non-existent sirens and an elevated risk of PTSD and complex PTSD symptoms, particularly in the aftermath of prolonged exposure to conflict since October 7.
Understanding the findings
Prof. Menachem Ben-Ezra, Prof. Yaira Hamama-Raz, Prof. Eli Leshem, and Dr. Yafit Levin, surveyed 2,028 Jewish adults aged 18–85. Participants were asked whether they had experienced auditory hallucinations, such as phantom sirens, since October 7.
Nearly 60% of respondents reported hearing sirens or siren-like noises when no alarms were sounded.
Of those, 13.2% described these hallucinations as occurring frequently (9.2%) or almost constantly (4%).
Participants who experienced phantom sirens were 1.9 times more likely to exhibit PTSD symptoms and 2.2 times more likely to show symptoms of complex PTSD than those in the control group.
The study also highlighted that individuals directly exposed to traumatic events—such as the death or injury of a loved one or knowing a hostage—were 1.88 times more likely to experience auditory hallucinations if they exhibited PTSD symptoms and 1.96 times more likely if they showed complex PTSD symptoms.
While pseudo-hallucinations are not uncommon—affecting 6% to 15% of the general population—the study emphasizes their unique connection to war-related trauma. Unlike psychotic hallucinations, those who experience phantom sirens typically recognize the sounds as unreal shortly afterward.
Researchers stress that identifying these auditory hallucinations as a "warning sign" can guide targeted treatments to prevent further mental health deterioration. The findings have global relevance, offering insights into the psychological toll of prolonged conflict in regions like Ukraine, where civilians face similar war-induced stressors.
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Sirens are life-saving signals, prompting individuals to seek shelter during attacks. For some, the constant state of threat may trigger a heightened state of alertness, causing them to “search” for sirens even when none exist. This hypervigilance underscores the urgent need for comprehensive mental health support to address the widespread psychological aftermath of extended warfare.
The study’s authors advocate for systemic therapeutic interventions, emphasizing the importance of early detection and response. These measures could mitigate the long-term mental health impacts of war, not just in Israel but in conflict zones worldwide.