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Currently, scientists "don't know exactly why poor sleep seems to increase vulnerability to things like depression, anxiety, and post-traumatic stress disorder," he says.

His barrister Alisdair Williamson KC told the Court of Appeal that it should consider fresh evidence that his client suffered from complex post-traumatic stress disorder and ADHD.

Nickerson: Obviously post-traumatic stress and trauma are these very complicated, multilayered things, but one thing that we’ve always been interested in is the extent to which people, on a psychological and physiological level, are able to adapt to these different high-stakes, dangerous situations.

At least a part of post-traumatic stress is a positive adaptive strategy to survive.

When Rafa arrived in October 2023, he was suffering from post-traumatic stress disorder, respiratory problems caused by allergies, nightmares and insomnia, according to a psychological evaluation written by his therapist at the orphanage.