Selected Podcast
Spring Forward: How Sleep is Affected by Daylight Savings Time
Dr. Anita Bhola tells listeners how to prepare and adjust to daylight savings time.
Featuring:
Anita Bhola, MD
Anita Bhola, MD, Medical Director of the St. Luke's Cornwall Hospital Center for Sleep Medicine clinic in Cornwall, NY, is a board-certified physician in Internal, Pulmonary, Critical Care and Sleep Medicine. Her practice includes both consultations with patients suffering from sleep disorders and interpretation of sleep studies. She has lectured extensively on many topics in sleep medicine at professional symposiums and to patients in community settings. She actively participates in A.W.A.K.E meetings, a sleep apnea patient support group. Her article about how sleep disorders can impact women and their careers was recently published in U.S. News & World Report. Transcription:
Melanie Cole, MS (Host): Turning the clock forward or back for daylight savings time is always difficult, especially if you have children. Losing an hour in the spring can leave you feeling so tired while that extra hour in the fall can be like woohoo yeah. We get this extra hour to sleep. But it really plays havoc with your body. Today my guest is Dr. Anita Bhola. She’s the medical director of the St. Luke’s Cornwall Hospital’s sleep center. Dr. Bhola, give us a little lesson in normal sleep patterns first. Then we’ll talk about how daylight savings really affects them.
Anita Bhola, MD, FCCP, FAASM (Guest): Hi Melanie. So, in terms of normal sleep patterns, as we know, we’re programmed to sleep each night. Sleep is considered means of restoring our bodies and our minds. This was once considered to be a passive state, but now we know that our brain can actually be more active during certain periods of sleep than we’re awake. Now our sleep patterns are normally controlled by two interacting systems. This explains why, under normal conditions, we are typically awake during the day and we sleep during the night. These two systems are the following. There’s the internal biological clock, which is housed in the superchiasmatic nucleus in our brain. The other system is called a sleep-wake homeostatic drive.
So, sleep patterns can be effected by a number of factors including your age and how much sleep you’ve gotten or how awake you’ve been and a bunch of environmental factors. One of the most important external factors that controls our sleep pattern is exposure to light. This does so either directly by making it difficult to fall asleep when we’re exposed to light, or indirectly by influencing the timing of our internal clock. Therefore, it also effects our preferred time to sleep. Of course, we know that people have different types of sleep patterns. Some people are night owls. Some are morning larks. Some folks get the sleep that they want to feel productive the next day, and others are chronically sleep deprived.
So, in terms of your next question, which is how does daylight savings time effect sleep patterns. Well, as you know, the daylight saving time was implemented over a hundred years ago and the idea was to maximize our daylight waking hours. The idea was that shifting our clocks to adjust the length of the day would add extra hours of daylight during the summer season, hence it’s also called summer time. This is, as opposed to standard time, which occurs in fall. Now contrary to popular belief, it used to be thought that American farmers wanted to have the daylight saving time so that they could have more time in the field, but we know that that’s not true. Daylight saving time actually officially came into play sometime during World War II with the idea of saving energy. There are about 70 countries or so around the world that practice this. The United States, barring Hawaii and Arizona, all other states do use daylight saving time.
Now this coming weekend, which is Sunday March 10th, at 2:00 in the morning will mark the beginning of daylight saving time and the end of standard time. So, what happens during daylight saving time is that we move our clock forward by an hour at this designated weekend in spring, which changes from year to year, but it’s more or less sometimes in March. Hence, it’s called spring forward. This is as opposed to fall back when we move our clocks back an hour in fall to mark an end of daylight saving time and the return to standard time.
The way our sleep pattern is impacted with daylight saving time is that when we wake up on Sunday morning and our clock has changed at 2:00 in the morning, we would have lost an hour of precious sleep. This can effect your circadian and your sleep patterns and also cause our internal clocks to become out of sync. Even though it seems like a small one hour shift in the sleep cycle, it can actually effect your sleep pattern for up to a week or so.
Host: Wow. Great information, Dr. Bhola, you're such a great educator. You explain everything so very clearly. Which is tougher on our bodies, falling back or springing forward?
Dr. Bhola: Well, it is thought that springing forward is tougher on our bodies than falling back because we’re losing an hour of sleep as opposed to gaining an hour of sleep in fall. Although, I will say that a number of people don’t take advantage of gaining that hour of sleep in fall. However, in spring we’re losing an hour. That’s why this is tougher on our bodies. So, you can feel groggy and this can have a serious impact on your mood, on your motor skills and your appetite, and even on your heart. There’s been some studies in the American Journal of Cardiology and in some Swedish journals which have shown that on the Sunday marking daylight saving time, there has been a slight increase in the number of heart attacks. We also know that traffic accidents increase during this time.
That both, whether you’re a morning lark or a night owl, you adjust better to the time change in fall, but you don’t adjust well to the time change in spring. In fact, the population that is hit the hardest by this one hour loss of sleep in spring are people who are night owls. In other words, who have delayed sleep times. Individuals who are sleep deprived, in other words, those who get less than six hours of sleep will be hit pretty hard. Those who don’t have a regular sleep schedule. As well as patients who have sleep disorders can be hit hard. In fact, I have some patients that are let’s say in jobs that involved public safety—like metro or bus drivers—and I caution them that they really have to be careful with this time change.
Host: Then let’s talk about some of the things that we can do. I, Dr. Bhola, am one of those people that definitely takes advantage of that extra hour in the fall. Boy, I sure do love that and that makes Saturday night. Sometimes people think that they get that extra hour to stay up later, and that doesn’t really make sense. But I’d like you to tell us what you would like us to do before this happens, before daylight saving time, before the time change. Then ways that we can adjust once it happens. And certainly, tell us about our kids. I remember when my kids were little, I would mess around with the clock just to get them to go to bed at the same time and try and get them to get that extra hour. So, give us your best advice. How can we adjust to all of this?
Dr. Bhola: Before we go into daylight saving time, what you can do is you can start dimming your lights earlier this week leading up to the time change and try to go to bed about 15 minutes earlier every night starting about four nights before, which would be pretty much today which is Wednesday. So, if you actually put yourself in bed 15 minutes earlier every day, by the time you reach the weekend hopefully this will ease you into the change and make the transition less abrupt and you’ll be well adjusted. Because if you try to sleep an hour earlier just the night before, the Saturday night, that may cause difficulties falling asleep because it’s not so easy to fool your internal body clock. So, try to go to bed 15 minutes earlier every night for about four days leading up to daylight saving time, which is on Sunday is very helpful.
Otherwise, this lost hour of sleep can be very difficult when you get up on Monday morning. Especially for those who have to go to school and who have to go to work. As I mentioned, it’s important for teens to make this change because especially if they're driving themselves to school, as I mentioned, there are a lot of car accidents that happen around daylight saving time. Usually it will take about a week or so to normalize, but sometimes it can take up to two weeks to make the transition. If this post-time change grogginess continues for more than two weeks, you should consider consulting a sleep specialist.
Now some of the things that you can do to adjust after daylight saving time happens—which is Sunday morning onwards—is, if possible, go and spend at least an hour outside in the sunlight on Sunday to help adjust your body clock to the time change because light is a great means of advancing your body clock. Also try and take a short nap on Sunday if need be, but a short nap, not a long one, so you feel more rested on Monday morning. Go to bed at your normal time on Sunday night. However, if you have the ability to get a few minutes late on Monday morning without being late for work, give yourself those extra few minutes and grab a cup of coffee. On Monday morning, try and sit near the sunlight so that, again, you're advancing your internal body clock. Most important, when you're driving to work next week, remember the sunrise will occur and hour later. It may still be dark a few days in the morning. So, there’s going to be a lot of sleep deprived drivers out there on the road so just be very careful.
Now, in terms of children, how do you adjust children? Well, if you have an infant or a toddler, you can try cutting their naptime by about a third or so this week and even over the weekend to prepare them for an early bedtime. You can use blackout shades for your children’s bedrooms to fool them into thinking that it’s time to go to bed. You can change the clock as you mentioned. These are some of the things that we can do to adjust kids to this new time. Also trying and getting them out every day for an hour really does help so that they’re exposed to sunlight.
Host: What great information. Dr. Bhola, you are just such an excellent guest. As always, giving us real workable, usable advice for what we’re going through in our daily lives and how important sleep is and quality sleep. Wrap it up for us. Give us your best advice about adjusting to the time changes that we go through and how they effect our body.
Dr. Bhola: Assess your sleep situation. It’s possible that during the course of the year, you’ve been using a lot of electronics close to bed time and you're drifting more and more towards a later and later bed time during the course of winter. You may be finding yourself more and more sleep deprived. So, this is a good time with the time change to assess your sleep situation and what changes you can make, and also how your sleep situation if effecting your life and your health, your relationships, your productivity, your ability to drive your car safely.
So, this is a time to set your intention by first making sure that you're getting enough sleep. Enough sleep would be seven to nine hours for adults and at least eight to ten hours for teens. Because if you're short on sleep, this will make you less alert and impair your memory and put strain on your relationships. We know that it increases accident proneness and also comorbidities such as high blood pressure and diabetes. So first and foremost, make sure you're getting enough sleep.
The second thing is you can also reset your sleep habits as well as your body clock by just following good sleep hygiene tips. Make sure you have a good bedtime routine. Go to bed and get up at the same time, even on weekends. You should have a winddown period at night. Maybe read a book, other relaxing activities or take a warm bath. Shut off electronic devices at least an hour before bedtime. This is really important. I cannot even emphasize this enough how this plays havoc with our sleep in today’s age.
Also, don’t expose yourself to bright light when it’s dark. So, if you have to get up to go to the bathroom, just install a little night light in your bathroom so you don’t have to turn the light on in the middle of the night. Keep your bedroom cool, dark, and quiet and use a good mattress. Try and expose yourself to natural light during the day as much as possible. Exercise regularly, but not close to bedtime. You need to keep your core body temperature on the cooler side when you're trying to go to bed. Avoid heavy meals close to bedtime. Also avoid caffeine and alcohol late in the day because these can interfere with sleep. Avoid nicotine at all times, but especially close to bedtime. If you're stressed out, try and make a worry list and deal with it during the day, and then just give yourself permission to relax at night and go to bed.
So, if you try making these changes now to improve your sleep, you can increase the odds that your body will be well prepared when it’s time to turn the clock either back or forward. On another note, I just want to mention that the National Sleep Foundation has this week long camping, it’s called the sleep awareness week, and this year it begins immediately after daylight saving time. So, it’s from March 10th to the 16th. If you go on the National Sleep Foundation website, you will find a whole host of information on this website to educate you on sleep issues, which I highly encourage everybody to read.
Host: It is great information. Dr. Bhola, as always, really just such important information for people to hear, and things that they might not even realize when they hear you say these things that these are changes, little changes, that we can make. Thank you so much for coming on today and sharing your expertise. This is Doc Talk presented by St. Luke’s Cornwall Hospital. For more information, please visit stlukescornwallhospital.org. That’s stlukescornwallhospital.org. I’m Melanie Cole. Thanks so much for tuning in.
Melanie Cole, MS (Host): Turning the clock forward or back for daylight savings time is always difficult, especially if you have children. Losing an hour in the spring can leave you feeling so tired while that extra hour in the fall can be like woohoo yeah. We get this extra hour to sleep. But it really plays havoc with your body. Today my guest is Dr. Anita Bhola. She’s the medical director of the St. Luke’s Cornwall Hospital’s sleep center. Dr. Bhola, give us a little lesson in normal sleep patterns first. Then we’ll talk about how daylight savings really affects them.
Anita Bhola, MD, FCCP, FAASM (Guest): Hi Melanie. So, in terms of normal sleep patterns, as we know, we’re programmed to sleep each night. Sleep is considered means of restoring our bodies and our minds. This was once considered to be a passive state, but now we know that our brain can actually be more active during certain periods of sleep than we’re awake. Now our sleep patterns are normally controlled by two interacting systems. This explains why, under normal conditions, we are typically awake during the day and we sleep during the night. These two systems are the following. There’s the internal biological clock, which is housed in the superchiasmatic nucleus in our brain. The other system is called a sleep-wake homeostatic drive.
So, sleep patterns can be effected by a number of factors including your age and how much sleep you’ve gotten or how awake you’ve been and a bunch of environmental factors. One of the most important external factors that controls our sleep pattern is exposure to light. This does so either directly by making it difficult to fall asleep when we’re exposed to light, or indirectly by influencing the timing of our internal clock. Therefore, it also effects our preferred time to sleep. Of course, we know that people have different types of sleep patterns. Some people are night owls. Some are morning larks. Some folks get the sleep that they want to feel productive the next day, and others are chronically sleep deprived.
So, in terms of your next question, which is how does daylight savings time effect sleep patterns. Well, as you know, the daylight saving time was implemented over a hundred years ago and the idea was to maximize our daylight waking hours. The idea was that shifting our clocks to adjust the length of the day would add extra hours of daylight during the summer season, hence it’s also called summer time. This is, as opposed to standard time, which occurs in fall. Now contrary to popular belief, it used to be thought that American farmers wanted to have the daylight saving time so that they could have more time in the field, but we know that that’s not true. Daylight saving time actually officially came into play sometime during World War II with the idea of saving energy. There are about 70 countries or so around the world that practice this. The United States, barring Hawaii and Arizona, all other states do use daylight saving time.
Now this coming weekend, which is Sunday March 10th, at 2:00 in the morning will mark the beginning of daylight saving time and the end of standard time. So, what happens during daylight saving time is that we move our clock forward by an hour at this designated weekend in spring, which changes from year to year, but it’s more or less sometimes in March. Hence, it’s called spring forward. This is as opposed to fall back when we move our clocks back an hour in fall to mark an end of daylight saving time and the return to standard time.
The way our sleep pattern is impacted with daylight saving time is that when we wake up on Sunday morning and our clock has changed at 2:00 in the morning, we would have lost an hour of precious sleep. This can effect your circadian and your sleep patterns and also cause our internal clocks to become out of sync. Even though it seems like a small one hour shift in the sleep cycle, it can actually effect your sleep pattern for up to a week or so.
Host: Wow. Great information, Dr. Bhola, you're such a great educator. You explain everything so very clearly. Which is tougher on our bodies, falling back or springing forward?
Dr. Bhola: Well, it is thought that springing forward is tougher on our bodies than falling back because we’re losing an hour of sleep as opposed to gaining an hour of sleep in fall. Although, I will say that a number of people don’t take advantage of gaining that hour of sleep in fall. However, in spring we’re losing an hour. That’s why this is tougher on our bodies. So, you can feel groggy and this can have a serious impact on your mood, on your motor skills and your appetite, and even on your heart. There’s been some studies in the American Journal of Cardiology and in some Swedish journals which have shown that on the Sunday marking daylight saving time, there has been a slight increase in the number of heart attacks. We also know that traffic accidents increase during this time.
That both, whether you’re a morning lark or a night owl, you adjust better to the time change in fall, but you don’t adjust well to the time change in spring. In fact, the population that is hit the hardest by this one hour loss of sleep in spring are people who are night owls. In other words, who have delayed sleep times. Individuals who are sleep deprived, in other words, those who get less than six hours of sleep will be hit pretty hard. Those who don’t have a regular sleep schedule. As well as patients who have sleep disorders can be hit hard. In fact, I have some patients that are let’s say in jobs that involved public safety—like metro or bus drivers—and I caution them that they really have to be careful with this time change.
Host: Then let’s talk about some of the things that we can do. I, Dr. Bhola, am one of those people that definitely takes advantage of that extra hour in the fall. Boy, I sure do love that and that makes Saturday night. Sometimes people think that they get that extra hour to stay up later, and that doesn’t really make sense. But I’d like you to tell us what you would like us to do before this happens, before daylight saving time, before the time change. Then ways that we can adjust once it happens. And certainly, tell us about our kids. I remember when my kids were little, I would mess around with the clock just to get them to go to bed at the same time and try and get them to get that extra hour. So, give us your best advice. How can we adjust to all of this?
Dr. Bhola: Before we go into daylight saving time, what you can do is you can start dimming your lights earlier this week leading up to the time change and try to go to bed about 15 minutes earlier every night starting about four nights before, which would be pretty much today which is Wednesday. So, if you actually put yourself in bed 15 minutes earlier every day, by the time you reach the weekend hopefully this will ease you into the change and make the transition less abrupt and you’ll be well adjusted. Because if you try to sleep an hour earlier just the night before, the Saturday night, that may cause difficulties falling asleep because it’s not so easy to fool your internal body clock. So, try to go to bed 15 minutes earlier every night for about four days leading up to daylight saving time, which is on Sunday is very helpful.
Otherwise, this lost hour of sleep can be very difficult when you get up on Monday morning. Especially for those who have to go to school and who have to go to work. As I mentioned, it’s important for teens to make this change because especially if they're driving themselves to school, as I mentioned, there are a lot of car accidents that happen around daylight saving time. Usually it will take about a week or so to normalize, but sometimes it can take up to two weeks to make the transition. If this post-time change grogginess continues for more than two weeks, you should consider consulting a sleep specialist.
Now some of the things that you can do to adjust after daylight saving time happens—which is Sunday morning onwards—is, if possible, go and spend at least an hour outside in the sunlight on Sunday to help adjust your body clock to the time change because light is a great means of advancing your body clock. Also try and take a short nap on Sunday if need be, but a short nap, not a long one, so you feel more rested on Monday morning. Go to bed at your normal time on Sunday night. However, if you have the ability to get a few minutes late on Monday morning without being late for work, give yourself those extra few minutes and grab a cup of coffee. On Monday morning, try and sit near the sunlight so that, again, you're advancing your internal body clock. Most important, when you're driving to work next week, remember the sunrise will occur and hour later. It may still be dark a few days in the morning. So, there’s going to be a lot of sleep deprived drivers out there on the road so just be very careful.
Now, in terms of children, how do you adjust children? Well, if you have an infant or a toddler, you can try cutting their naptime by about a third or so this week and even over the weekend to prepare them for an early bedtime. You can use blackout shades for your children’s bedrooms to fool them into thinking that it’s time to go to bed. You can change the clock as you mentioned. These are some of the things that we can do to adjust kids to this new time. Also trying and getting them out every day for an hour really does help so that they’re exposed to sunlight.
Host: What great information. Dr. Bhola, you are just such an excellent guest. As always, giving us real workable, usable advice for what we’re going through in our daily lives and how important sleep is and quality sleep. Wrap it up for us. Give us your best advice about adjusting to the time changes that we go through and how they effect our body.
Dr. Bhola: Assess your sleep situation. It’s possible that during the course of the year, you’ve been using a lot of electronics close to bed time and you're drifting more and more towards a later and later bed time during the course of winter. You may be finding yourself more and more sleep deprived. So, this is a good time with the time change to assess your sleep situation and what changes you can make, and also how your sleep situation if effecting your life and your health, your relationships, your productivity, your ability to drive your car safely.
So, this is a time to set your intention by first making sure that you're getting enough sleep. Enough sleep would be seven to nine hours for adults and at least eight to ten hours for teens. Because if you're short on sleep, this will make you less alert and impair your memory and put strain on your relationships. We know that it increases accident proneness and also comorbidities such as high blood pressure and diabetes. So first and foremost, make sure you're getting enough sleep.
The second thing is you can also reset your sleep habits as well as your body clock by just following good sleep hygiene tips. Make sure you have a good bedtime routine. Go to bed and get up at the same time, even on weekends. You should have a winddown period at night. Maybe read a book, other relaxing activities or take a warm bath. Shut off electronic devices at least an hour before bedtime. This is really important. I cannot even emphasize this enough how this plays havoc with our sleep in today’s age.
Also, don’t expose yourself to bright light when it’s dark. So, if you have to get up to go to the bathroom, just install a little night light in your bathroom so you don’t have to turn the light on in the middle of the night. Keep your bedroom cool, dark, and quiet and use a good mattress. Try and expose yourself to natural light during the day as much as possible. Exercise regularly, but not close to bedtime. You need to keep your core body temperature on the cooler side when you're trying to go to bed. Avoid heavy meals close to bedtime. Also avoid caffeine and alcohol late in the day because these can interfere with sleep. Avoid nicotine at all times, but especially close to bedtime. If you're stressed out, try and make a worry list and deal with it during the day, and then just give yourself permission to relax at night and go to bed.
So, if you try making these changes now to improve your sleep, you can increase the odds that your body will be well prepared when it’s time to turn the clock either back or forward. On another note, I just want to mention that the National Sleep Foundation has this week long camping, it’s called the sleep awareness week, and this year it begins immediately after daylight saving time. So, it’s from March 10th to the 16th. If you go on the National Sleep Foundation website, you will find a whole host of information on this website to educate you on sleep issues, which I highly encourage everybody to read.
Host: It is great information. Dr. Bhola, as always, really just such important information for people to hear, and things that they might not even realize when they hear you say these things that these are changes, little changes, that we can make. Thank you so much for coming on today and sharing your expertise. This is Doc Talk presented by St. Luke’s Cornwall Hospital. For more information, please visit stlukescornwallhospital.org. That’s stlukescornwallhospital.org. I’m Melanie Cole. Thanks so much for tuning in.