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Semi-Annual Time Changes May Affect the Heart
Date:10/30/2008

Swedish researchers say heart attack rates change when clocks are adjusted

WEDNESDAY, Oct. 29 (HealthDay News) -- The end of daylight saving time is just about here, and it may pose problems more serious than adjusting sleep patterns.

Swedish researchers have found a jump in the number of heart attacks following the semi-annual one-hour time changes, although it's more pronounced in the spring.

"This was the very first study on this topic and further studies are needed," said Dr. Imre Janszky, of the Karolinska Institute in Stockholm, and co-author of a letter published in the Oct. 30 issue of the New England Journal of Medicine.

"However, we can certainly say that our study adds some further evidence that vulnerable individuals might benefit from avoiding sudden changes in their biological rhythms," Janszky said.

Those vulnerable individuals would include people already sleep deprived, other experts said.

"When somebody has sleep deprivation, obviously that deprivation does affect their health, including the possibility of having heart attack and stroke," said Susan Zafarlotfi, clinical director of the Institute for Sleep-Wake Disorders at Hackensack University Medical Center in New Jersey. "Those patients who do have a higher risk -- such as high cholesterol and, specifically, if they snore -- should be very, very careful with their time to bed and time to rise, not only for the fall back but also across the board."

The end of daylight saving time occurs Sunday, Nov. 2, when clocks are turned back one hour.

"Our circadian rhythm, which is the biological clock within the human body, gets its cues from time and light," Zafarlotfi explained. "This coming Sunday when we go backwards, our bodies are not going to be clocking so quickly, so the clinical consequences would be fatigue, tiredness and a little bit of lack of attention and lack of concentration."

For the new research, the study authors used a registry with information on all heart attacks occurring in Sweden since 1987. Then they compared how many heart attacks happened during each of the first seven days after "spring forward" and "fall back," and the average of how many occurred on the corresponding weekdays two weeks before and two weeks after the day of transition.

There was a spike in heart attacks for the first three weekdays after the change to daylight saving time in the spring, an effect that was more pronounced in women. In the fall, there was a slight drop in the number of heart attacks on the Monday after the transition, but more heart attacks by the time the following Friday rolled around; this effect was more pronounced in men, the researchers found.

Regardless of the time of year, the effects tended to be stronger for people younger than 65 than for those over 65.

The study authors hypothesized that the increase in risk was likely due to the negative effects of sleep deprivation on heart health.

The next step in the research would be to see if prolonged sleep might reverse the problem, especially given that people in western societies tend to lack sleep. Their average night's rest has decreased from 9 hours to 7.5 hours during the last century.

More information

Visit the National Sleep Foundation for more on getting a good night's rest.

How to Adjust to the Time Change

The one-hour time change can be a big adjustment for many people, but there are ways to minimize the disruption.

Dr. David Rapoport, director of the Sleep Disorders Center at New York University Langone School of Medicine in New York City, has these suggestions for individuals who already have sleep problems:

  • Go to bed at your regular time and wake up at the new time. "It's money in the bank. You've paid back a debt," Rapoport said.
  • Don't use the extra hour to work or party. "You will be using this freebie to add to your fun but not pay back your debt," he said.
  • Move your body into sync with what's happening outside in terms of light. For example, go for a 15-minute walk toward the end of the day while the sun is still out. "Walking facing the sun without sunglasses is an excellent way to push your clock back," Rapoport said. (In the spring, reverse this and take the walk in the morning.)

"In our society, almost everybody is sleep deprived and this is a golden opportunity to catch up on it," Rapoport said.



SOURCES: Imre Janszky, M.D., Ph.D., department of public health sciences, Karolinska Institute, Stockholm, Sweden; Susan Zafarlotfi, Ph.D., clinical director, Institute for Sleep-Wake Disorders, Hackensack University Medical Center, New Jersey; David Rapoport, M.D., director, Sleep Disorders Center, New York University Langone School of Medicine, New York City; Oct. 30, 2008, New England Journal of Medicine


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