Acute Myocardial Infarction and Daylight Saving Time Transitions: Is There a Risk?

Abstract

Available evidence on the risk of acute myocardial infarction (AMI) in the days after the spring daylight saving time (DST) transition suggests either a modest increase or no risk increase. Partial sleep deprivation and enhanced circadian clock misalignment have been implicated as the underlying mechanisms for increased AMI risk, probably via enhanced thrombo-inflammatory processes and activation of the sympathetic nervous system. Most of the studies, as we suggest as a perspective here, have used potentially inappropriate control periods, including the two post-transitional weeks, because adjustment after the spring DST transition lasts at least four weeks for all chronotypes and probably even beyond this period for late chronotypes. The most plausible conclusions, at the moment, for the risk of AMI after the spring DST transition are: (1) the risk is increased, (2) a relatively modest risk increase could be currently underestimated or in some studies undetected, (3) late chronotypes and/or individuals with high levels of social jetlag (a proxy for circadian clock misalignment) could be more affected by the phenomenon, and (4) underlying pathophysiological mechanisms should be further explored. As a significant part of world’s population continues to be affected by the biannual clock change, the question of increased AMI risk in the post-transitional period remains an intriguing public health issue.

Daylight Saving Time transitions and Cardiovascular Disease in Andalusia: Time Series Modeling and Analysis Using Visibility Graphs

“…Some studies highlight an increase in hospital admissions for AMI in the spring transition. 4,8,36,37 However, to our knowledge, only 2 studies showed an increased risk of AMI admissions associated with the autumn DST transition. Making it clear that any disruption of the circadian rhythm increases the risk of an acute CV event or MACE.…”

How Did You Sleep Tonight? The Relevance of Sleep Quality and Sleep–Wake Rhythm for Procrastination at Work

“…Finally, we found that the shift to DST aggravates later chronotypes' dependence on high-quality sleep to prevent procrastination the next day (Culić and Kantermann, 2021 ). Our findings thus reveal the consequences of the shift to DST, especially for later chronotypes.…”

A Data-Informed Perspective on Public Preferences for Retaining or Abolishing Biannual Clock Changes

“…In chronobiological terms, this may be framed as re-entrainment in the immediate weeks following the clock change versus ongoing increased circadian desynchrony/social jetlag under DST. This distinction may be important in understanding the adverse health and behavioral consequences associated with the spring transition to DST, and may be a contributor to the recent suggestion that the cardiovascular risk associated with the spring change to DST is understated due to the selection of inappropriate reference periods during which circadian desynchrony will still be high ( Čulić and Kantermann, 2021 ).…”

“…This is a highly pertinent issue given proposals in various jurisdictions where the options presented to the public are narrowed to yes/no questions on abolishing the clock changes and adopting permanent DST, potentially resulting in less chronobiologically favorable scenarios due to detrimental effects of increased year-round social jetlag (e.g., poorer sleep health, impaired mood and cognition, poorer cardiometabolic health) outweighing the benefits of eliminating the transitions (decreased risk of cardiovascular events and road traffic accidents in the week(s) following clock change). Such a risk/benefit calculation is complicated by uncertainties around the magnitude of effects of social jetlag in relation to health outcomes, and the ongoing discussion on risks associated with the transitions ( Čulić and Kantermann, 2021 ).…”

“… Bjorvatn et al (2021) reported that evening orientation was associated with a preference for abolition of the clock change, although the majority of all chronotype groupings assessed favored abolition and, with the exception of extreme morning types, endorsed a preference for permanent DST. As such, there is currently no convincing indication that preference for clock changes/permanent DST is influenced by chronotype to any meaningful extent, although individuals with later chronotypes/greater social jetlag may be most adversely impacted by permanent DST ( Čulić and Kantermann, 2021 ). Other factors that may influence preferences for clock changes are gender and age: in our survey, participants favoring abolition of clock changes were somewhat older and slightly more likely to be male, as they were in the Bjorvatn et al (2021) study.…”