Spring Forward or Fall Back: Time-Change Sleep Problems


Bijoy E. John, MD, founder and medical director of Sleep Wellness Clinics of America (Nashville) and Sleep Fix Academy, discussed the health risks associated with daylight saving time changes.

Bijoy John, MD

Bijoy John, MD

Credit: PR by the Book

In most states in the US, there is a change in time twice a year—once in the spring, and once in the fall. The idea behind daylight saving time (DST) is to make better use of the available daylight during the longer days of the year by shifting an hour of daylight from the morning to the evening.

While DST may be good for businesses and longer summer days, there are consequences to such changes due to the misalignment of your internal circadian clock. With less sunlight in the mornings during DST, there is a higher risk of accidents and workplace injuries. DST can also lead to less time spent in sleep, especially in children, with a loss of 30 min­utes during weekdays, resulting in excessive daytime drowsiness and slower response times. There is also an increased incidence of heart attacks and heart rhythm irregu­larities associated with the first week of transition during DST.1,2

For decades, there has been an ongoing debate about doing away with the time changes. While there was talk of this becoming a permanent change in the US start­ing in November 2023, as of the writing of this article, the bill has yet to be passed. And so, we have to continue to proactively help our patients through these adjustments.

Consider sharing the following tips with your patients to help with time-change issues during the transitions until the US Congress makes the final decision.

  • Make sure you set your clock accordingly prior to going to sleep the night of the time change. The time officially changes at 2:00 am local time. For 2024, that is on Sunday, March 10 and Sunday, November 3.
  • Prepare to go to sleep 15 minutes earlier each day for four days in a row prior to the time change in the spring and wake up 15 minutes later each day for four days in a row prior to the time change in the fall.
  • Have a fixed sleep schedule. I recommend 10 pm to 6 am to most of my patients. Of course, shift or overnight workers may be on different schedules so help your patients adjust accordingly.
  • Get exposure to sunlight in the mornings.
  • Try to keep a good exercise regimen.
  • Take a short nap during the transition period, if needed.

While sleep related issues due to a time change may not impact most people beyond the first few days, I have seen several patients whose insomnia started after a time change, and they never got back on track. Being aware of this struggle and proactively addressing it can help your patients with overall sleep quality and good health.

1. Manfredini R., et al. “Daylight Saving Time and Acute Myocardial Infarc­tion: A Meta-analysis.” Journal of Clinical Medicine. 8 (3). March 2019: 404. pubmed.ncbi.nlm.nih.gov/30909587/.
2. Chudow, J.J., et al. “Changes in Atrial Fibrillation Admissions Following Daylight Saving Time Transitions. Sleep Medicine. (69) May 2020:155–158. pubmed.ncbi.nlm.nih.gov/32088351/.

Bijoy E. John, MD, is a board-certified physician and practicing sleep specialist currently in private practice with over 25 years of experience in Pulmonary/Critical Care and Sleep Medicine. Based in Nashville, TN, he treats both children and adults with various sleep disorders. John is the founder and medical director of Sleep Wellness Clinics of America (Nashville) and Sleep Fix Academy and serves as an Affiliate Assistant Professor at the University of Tennessee Health Science Center College of Medicine. His first book, Nobody's Sleeping: 7 Proven Sleep Strategies forBetter Health and Happiness (Morgan James Publishing), releases on March 12, 2024.

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