A ReLACSing Blog #1: Daylight Saving Time Should be Put to Rest

Today marks the anniversary of one of the great societal health-related punishments known as “spring forward”. A practice that emerged in the early 20th century, Daylight Saving Time (DST) in the US effectively throws the circadian switch twice a year on a population of more than 300 million people. Today, we lose an hour of sleep and alter the sensitive biological clocks of most of our population simultaneously, and until November, we bear the long-term effects of increased sleep deprivation and misalignment of our biological clocks with sunrise and sunset. 

While rumblings are increasing against the practice, most state and national officials still hesitate to reverse course on the idea. However, the population is more and more focused on sleep health (thank you, wearables), so there is hope for movement on this issue in the future. Thankfully, some states have already done away with DST (here’s to you Hawaii, Arizona) several decades ago and there could be states in the future that pass legislation to break off from the switch. However, the majority of us had to set the clocks forward last night and maybe some of you could sleep in this morning, an “extra” hour later, but tomorrow and Tuesday and Wednesday, the nation will be paying the price. It will not only be the feeling like a truck hit you when the alarm goes off Monday morning for work or school. The ever-so-slightly increased risk of this shift and the sleep loss, multiplied by 300 million citizens, leads to a significant cascade of unfortunate calamities. It is not the feeling of getting hit by a truck with the early alarm but the fact that more trucks will be hitting things in general this week. There will be a significant uptick in car accidents, heart attacks, workplace incidents, productivity loss, and my favorite, irritable judges handing down harsher sentences to criminals this week of the year. From a sleep perspective, it is subtly damaging to day-to-day function, particularly in the early spring and late fall, to be waking up in utter darkness and be bathed in sunlight just before bedtime.  

OK, so I admit there are some perks to DST. For instance, one can travel up to Northern Michigan in June and watch the sunset over the lake (insert picture) and enjoy the civil twilight until 10:15 pm. It is great to go to that 7 pm Little League game in the late summer and not have the umpire end the game early due to dusk on a field with no artificial lighting. It is great to get off work in March and it be light outside, having a sense that there is still some time to enjoy the evening after a hard day of work. For me, the biggest benefit is that if my kids wake up and invade my bedroom, it will now be 6:30 am and not 5:30 am like during standard time…err…ooops! It is still 5:30 am to my body! Changing the time on the clock does not change the circadian rhythm. 

Speaking of circadian rhythms and kids, for those of you who have children or remember your children when they were school-age, you may recall how they basically woke up at the same time every day regardless of when they went to sleep. Children roughly 6-12 years old have wonderful biological clocks. This week, however, the child that was waking up at 6:30 am every day will struggle to make it to school on time as you will find the child asleep at 7:15 am on Monday and you’ll have to shake them to wake them and get them to the bus stop on time. This should be a reminder of the non-trivial effect of moving the clock forward by an hour.

Children are an excellent example to busy adults of how we should maintain a sleep schedule. The most important aspect, as roosters can attest, is the time you wake up, and the time you go to bed should follow. The healthiest sleepers get a full night of sleep and wake up naturally at the same time every day, more commonly seen in children, less so in adults, and quite a unicorn in a sleep clinic. Today should remind all of us of the power of the circadian rhythm, and not just that governing bodies should eliminate this ill-advised practice and return us all to Standard Time, but we should strive to maintain a consistent wake time every day of the week to function at our best. I cannot tell you how many patients I have seen for a second opinion for “narcolepsy type 2” and “idiopathic hypersomnia”, and in most cases, the cause is not an unknown “condition” with no known biological explanation, but a severe disruption of the body’s biological clock. Most of these individuals would benefit from a strict sleep-wake schedule and elimination of naps, rather than a bumping up of their amphetamine-based stimulant medication. I’ll stop there as many a future blog will address this issue in the field of sleep medicine…

With the sun setting very late during DST, particularly for those of us on the western end of the time zones, there could be a significant mismatch, as much as 1-2 hours, between the onset of darkness and our social bedtime that is based on the clock time. Light suppresses the brain’s release of melatonin, a hormone that surges around bedtime helping us to enter a deeper state of sleep. We may be losing sleep quality due to the lack of darkness in the time leading to bed. The corollary is the sun may rise, particularly this week and in November, long after we wake up. The biological clock is close to 24 hours, but for most people, it is slightly more. Our brains rely on light and other natural cues to shift us back to 24 hours. The morning light when we wake up is probably the strongest factor to align the body clock other than consistency in wake time. These less apparent factors lead to significant health effects when spread over a population and over many years.  

The American Academy of Sleep Medicine (AASM) in recent years has put out a position statement supporting the elimination of DST. If the majority of sleep and circadian rhythm scientists think it’s a bad idea, it probably is a bad idea for one’s sleep and one’s health. Of course, health is not the only concern, but other arguments, like the later sunset reduces artificial light and energy consumption, have turned out to be invalid.

Two major points here to summarize: set a consistent wake up time for every day of the week and contact your senator or congressperson and tell them that Daylight Saving Time should be put to rest!

-Andy Berkowski, MD

ReLACS Health