Changes in ischemic stroke occurrence following daylight saving time transitions

Dec 13, 2016Sleep medicine

Changes in stroke rates after daylight saving time shifts

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Abstract

Hospitalizations for ischemic stroke increased by 8% in the first two days following daylight saving time transitions.

A relative risk of 1.08 was observed for ischemic stroke hospitalizations during the first two days after the transition.
The observed increase in hospitalizations diminished over the following week, with a relative risk of 1.03.
Specific increases were noted on Monday (RR 1.09) and Thursday (RR 1.11) after the transition.
Women showed greater susceptibility to increases in ischemic stroke hospitalizations compared to men.
Individuals over 65 years of age had a 20% higher risk of hospitalization in the first two days after the transition.
Malignancy was associated with a 25% increased risk of hospitalization during the week following the transition.

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BACKGROUND: Circadian rhythm disruption has been associated with increased risk of ischemic stroke (IS). Daylight saving time (DST) transitions disrupt circadian rhythms and shifts the pattern of diurnal variation in stroke onset, but effects on the incidence of IS are unknown.

METHODS: Effects of 2004-2013 DST transitions on IS hospitalizations and in-hospital mortality were studied nationwide in Finland. Hospitalizations during the week following DST transition (study group, n = 3033) were compared to expected hospitalizations (control group, n = 11,801), calculated as the mean occurrence during two weeks prior to and two weeks after the index week.

RESULTS: Hospitalizations for IS increased during the first two days (Relative Risk 1.08; CI 1.01-1.15, P = 0.020) after transition, but difference was diluted when observing the whole week (RR 1.03; 0.99-1.06; P = 0.069). Weekday-specific increase was observed on the second day (Monday; RR 1.09; CI 1.00-1.90; P = 0.023) and fifth day (Thursday; RR 1.11; CI 1.01-1.21; P = 0.016) after transition. Women were more susceptible than men to temporal changes during the week after DST transitions. Advanced age (>65 years) (RR 1.20; CI 1.04-1.38; P = 0.020) was associated with increased risk during the first two days, and malignancy (RR 1.25; CI 1.00-1.56; P = 0.047) during the week after DST transition.

CONCLUSIONS: DST transitions appear to be associated with an increase in IS hospitalizations during the first two days after transitions but not during the entire following week. Susceptibility to effects of DST transitions on occurrence of ischemic stroke may be modulated by gender, age and malignant comorbidities.

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Changes in ischemic stroke occurrence following daylight saving time transitions

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