While the promise of longer evenings can be appealing to many after a long, dark winter, the looming "spring forward" comes with a range of potential health concerns.

Losing just one hour of sleep can throw off our internal clocks in ways that ripple through our health, spiking risks for heart problems, groggy commutes and restless nights. As the debate over daylight saving time ticks on, local experts are urging people to take this seasonal shift seriously.

The annual daylight saving time is set to begin at 2 a.m. Sunday, March 9. And setting those clocks ahead one hour can take some adjusting.

"We have this central clock in our brain, in the hypothalamus. It keeps our internal biological processes synchronized to the outside world," said Matthew Lehrer, an assistant professor of psychiatry at the University of Pittsburgh. This clock is strongly controlled by light exposure: Morning sunlight signals wakefulness while nighttime darkness promotes sleep, he said in an email.

Over the years, that clock has evolved to be adaptable to changes in day length, but it's unable to adjust quickly to a large shift, which is what happens during the twice-annual time change. Most people take three to seven days to fully adjust, though those with more rigid internal clocks may take longer, he said.

"It's really an antiquated system," said Mallory Ciuksza, an internal medicine doctor at St. Clair Health. "Medically speaking, we do have data that it causes significant health outcomes that aren't beneficial."

According to a 2020 study published in the PLOS Computational Biology journal, researchers found four prominent, elevated risk clusters associated with the time changes that occur in November and March: cardiovascular diseases, injuries, mental and behavioral disorders, and immune-related diseases, such as colitis, an inflammation of the colon. While the majority of disease risk elevations were relatively modest — only a few percentage points higher than normal — some negative health effects spiked up to 10%.

The study estimated that each spring shift was associated with 150,000 incidences of negative health effects in the U.S. and 880,000 globally.

"Studies show a 24% rise in heart attacks on the Monday following the transition" and an overall elevated risk for a two-week period afterward, said Kristina Lenker, assistant professor of psychiatry and behavioral science at the Penn State College of Medicine.

"There is also an elevated risk of strokes during this period. Additionally, car accidents increase by about 6% in the week after the time change, resulting in more fatal crashes. These risks are attributed to sleep deprivation, circadian misalignment and environmental changes," she said in an email. The effects are most pronounced in the week following the time change, with some impacts lasting up to two weeks.

When patients bring up their daylight saving time adjustment problems, Dr. Ciuksza sees it as an opportunity to promote "real self-care."

"So in medicine, self-care isn't bathrobe time, right? It's not Korean skin care. It's more the stuff that you don't want to do for the first 10 minutes, like going for a walk, going to bed early, doing your exercise, reducing your caffeine consumption," all of which have been shown to reduce problems associated with heart disease and with inflammation, she said.

In addition, Dr. Ciuksza advises her patients to maintain "good sleep hygiene," which means things like "turning the lights off, turning your cell phone off and your screens off for about an hour before you intend to go to sleep, making sure that you do have some form of exercise throughout the day," even just a 15-minute post-dinner walk. She also noted that meditation can positively affect everything from ease of falling asleep to anxiety, heart disease and high blood pressure. "So doing some meditation before you go to bed can help to focus your mind and get you prepared for sleep, even if your circadian rhythms are challenging."

Certain groups are more vulnerable to the short-term health effects, said Lenker. "These include adolescents and teenagers, who experience 'social jet lag' due to their naturally delayed circadian rhythms."

"Social jet lag" refers to the mismatch between a person's internal body clock and their social schedule and is especially evident in those who stay up far later on the weekends than on weekdays.

Additionally, shift workers already accustomed to irregular schedules face exacerbated circadian misalignment, and older adults have reduced flexibility in their circadian rhythms, making adjustment more difficult, Lenker said. People with preexisting sleep disorders, such as insomnia or sleep apnea, may also see their conditions worsen with the time change. Early birds and night owls too may struggle more than most to adjust to the new schedule.

All of these groups share a higher risk for negative impacts such as fatigue, cognitive impairments, cardiovascular issues and mood disturbances, she said.

Clocking the past

Benjamin Franklin first satirically introduced the idea of daylight saving time in a 1784 essay, "An Economical Project," which was published in the Journal de Paris, according to the Franklin Institute. He suggested that if Parisians would simply rise with the sun, they'd save money on candles and lamp oil. The founding father went on to suggest a number of tongue-in-cheek penalties for those who resisted shifting their waking to align with the sun, such as being taxed for window shutters and setting limits on candle purchases, among other sanctions.

But the idea for modern daylight saving time is generally credited to George Hudson, an entomologist from New Zealand, who proposed the idea in 1895 to accommodate his after-work hobby of summertime bug hunting, according to National Geographic.

The idea did not gain global acceptance until World War I, when coal was costly and the energy-saving practice was branded a necessary war effort by nations on both sides of the conflict. On March 9, 1918, the Congress enacted its first daylight saving law and also adopted the Standard Time Act, which defined time zones in the U.S.

Wake-up call

The oft-debated practice should be retired, all three experts agreed.

"The evidence is clear that permanent Standard Time is healthier. Humans require adequate morning light so that our internal biological rhythms synchronize properly to the local time," said Lehrer. "Earlier sunrises, which occur on Standard Time, are therefore the most conducive for health. Many studies show that a lack of exposure to morning light leads to health problems including sleep and metabolic disorders, depression and cardiovascular disease."

Lenker pointed out that a more natural circadian alignment promotes improved sleep patterns, quality and duration. It also improves cognitive function, mood and overall well-being, and the extra daylight provides better driving conditions for the morning commute. "Standard Time is particularly beneficial for adolescents and young adults, who have a biological tendency towards later sleep times."

Plenty of legislation has been introduced over the years at both the state and federal levels to eliminate the practice. In Pennsylvania, state Rep. Russ Diamond, R-Lebanon, has introduced yet another bill to end daylight saving time in the state. The bill, which boasts 12 bipartisan co-sponsors, was last referred to the Intergovernmental Affairs & Operations committee on Jan. 16.

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