The Impact of Daylight Saving Time on Sleep Disorders: Challenges for Patients With Insomnia and Circadian Rhythm Disruptions

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EP: 1.The Impact of Daylight Saving Time on Sleep Disorders: Challenges for Patients With Insomnia and Circadian Rhythm Disruptions

Daylight saving time involves advancing clocks by 1 hour in the spring and returning to standard time in the fall, disrupting the alignment between the sleep-wake cycle and natural light exposure. This shift can negatively impact sleep health by reducing total sleep duration, altering circadian rhythms, and increasing sleep fragmentation. Research indicates that daylight saving time contributes to higher rates of sleep deprivation, particularly in individuals with preexisting sleep disorders, and is associated with increased risks of metabolic, cardiovascular, and cognitive impairments.¹ The transition is especially challenging for those with rigid schedules, such as shift workers and students, who may struggle with prolonged circadian misalignment.

In collaboration with the American Academy of Sleep Medicine (AASM), NeurologyLive^® held a roundtable discussion where sleep experts shared their clinical perspectives on the health impacts of the time change as well as solutions. The panelists in this conversation included clinical psychologist Jennifer Martin, PhD, who serves as professor of medicine at UCLA and was recently the past president of the AASM, neurologist and sleep medicine specialist Karin Johnson, MD, who serves as the cochair of the Coalition for Permanent Standard Time and the vice president of Save Standard Time, and pulmonologist Seema Khosla, MD, FCCP, FAASM, who practices sleep medicine in Fargo, North Dakota.

In this first episode, sleep specialists examined the effects of daylight saving time on individuals with sleep disorders, with a focus on insomnia and circadian misalignment. They highlighted how the springtime change leads to acute and chronic sleep disruptions, particularly for those with early start times, shift work, or delayed sleep phase disorder. The conversation also explored strategies for mitigating these effects, including gradual schedule adjustments, prioritizing sufficient sleep, and addressing social jet lag. The experts emphasized that while some individuals may briefly experience improved sleep, overall, the transition can exacerbate existing sleep issues and contribute to long-term sleep deprivation.

Transcript edited for clarity.

Isabella Ciccone, MPH: Thank you all for joining this great discussion on the time change, which has been such a debated topic for the longest time. I feel this will be a valuable conversation to share with our audience in March, coinciding with the time change and World Sleep Day. To kick things off, our first question is: How do time changes for daylight saving time impact sleep patterns in patients with existing sleep disorders, such as insomnia? Dr. Martin, would you like to take this one first?

Jennifer Martin, PhD: Sure. People with chronic insomnia—meaning they struggle with falling asleep or staying asleep for months or even years—often experience worsening symptoms when their sleep schedule is disrupted. Interestingly, with this specific time change, Saturday night is shortened by one hour. Some people with insomnia actually sleep a little better for the first couple of nights, but they struggle with adjusting their sleep-wake schedule in relation to the rising and setting of the sun. So, while there might be a brief period of slightly better sleep due to the shorter night, it doesn’t last.

Seema Khosla, MD, FCCP, FAASM: That’s a really interesting point. I’m not sure it gets a lot of attention, but in our practice, when someone has a chronic sleep disorder, we try to establish a plan for the time change. It can be as simple as applying the general advice we give everyone—gradually adjusting bedtime, wake time, meal times, exercise, and light exposure. For those with sleep disorders, we emphasize that while they already have a condition, we don’t want to introduce additional sleep issues by not getting enough rest. During every visit, we stress the importance of adequate sleep so their underlying disorder doesn’t worsen.

Jennifer Martin, PhD: I also want to mention that any temporary improvement people with insomnia experience in the spring is followed by a temporary worsening in the fall. So, it’s not that their condition truly improves—it just seems slightly better for a couple of days. But when the night gets longer with the fall time change, symptoms get worse again.

Karin Johnson, MD: In general, studies show that most people experience greater sleep loss during the spring time change. This happens because we lose an hour of sleep and transition from standard time—which is more aligned with our natural rhythms—to daylight saving time, which is more misaligned. Some people with delayed sleep phase might welcome the later sunrises and sunsets because they prefer staying up later. However, for night owls, this shift actually pushes their schedule even later, making them more prone to social jet lag. This is especially true for children, who end up sleeping in even later on weekends compared to school or work days, making it harder for them to fall asleep at a reasonable time throughout daylight saving time.

Studies show that when sunset shifts an hour later, people lose about 19 minutes of sleep on average. This loss is especially pronounced for those who need to wake up before 8:30 a.m. If you have the luxury of sleeping in, you may not suffer as much chronic sleep loss. But for those with early start times—such as shift workers, parents, and anyone with a 7 a.m. workday—daylight saving time can make it harder to get enough sleep throughout the entire period.

REFERENCES
1. Sleep experts push for adoption of permanent standard time for public health, safety, and efficiency. News Release. American Academy of Sleep Medicine. Published January 27, 2025. Accessed March 13, 2025. https://aasm.org/sleep-experts-push-for-adoption-of-permanent-standard-time-for-public-health-safety-and-efficiency