Medical Errors Jump After 'Spring Forward' to Daylight Saving Time

Megan Brooks

September 08, 2020

The week after the annual "spring forward" to daylight saving time (DST) might not be the best time to seek medical care.

Researchers found a statistically significant increase in patient safety–related incidents in the week following the annual change to DST.

"Patient safety errors are an important and preventable cause of morbidity. Every year with daylight saving time, healthcare workers have less time in bed, which can result in sleep deprivation. Sleep deprivation can increase the risk of errors," lead investigator Bhanu Kolla, MD, Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota, told Medscape Medical News.

The findings were presented at Virtual SLEEP 2020, the 34th annual meeting of the Associated Professional Sleep Societies, and published August 12 in the Journal of General Internal Medicine.

High-Risk Period?

Using data from a large healthcare organization with facilities in multiple states, the researchers examined the change in reported patient safety–related incidents in the week after transition into and out of DST from 2010 to 2017.

Safety-related incidents likely resulting from human error jumped by 18.7% (95% CI, 5.6 to 33.6%; P = .004) in the week after the spring change.

On an absolute basis, for the 8-year period overall, human error–related safety incidents rose from 1625 in the week prior to DST to 1902 in the week after. All safety-related incidents rose from 2699 before to 2812 after DST.

There was a nonsignificant 4.9% (95% CI, –1.3 to 11.5%; P = .12) increase in human error–related safety events following the transition out of DST in the fall, when clocks go back 1 hour providing an opportunity for an extra hour of sleep.

"Our results indicate that the week following the spring time change might be a high-risk period for patient safety–related incidents. Healthcare organizations should factor this in and develop countermeasures to reduce this risk," Kolla said in a statement.

"These findings will need to be replicated in larger multicenter trials," Kolla told Medscape Medical News. In the meantime, healthcare organizations "should consider mitigation measures — delayed start times or other safety measures — to reduce risk following this time change," Kolla added.

Time to Sunset DST?

Weighing in on the research for Medscape Medical News, Saul Rothenberg, PhD, from the Sleep Center at Greenwich Hospital, Connecticut, said this study is "consistent with many articles that point to the negative consequences of changing our clocks to DST and EST [Eastern Standard Time] in the spring and fall, respectively."

"The literature generally supports a greater misalignment of our internal and social clocks during DST than EST, with the impact of time shift affecting vulnerable populations more — those who are sleep deprived to begin with, and those with pre-existing sleep and health problems," said Rothenberg.

As reported by Medscape Medical News, in the interests of patient safety, the American Academy of Sleep Medicine (AASM) recently called for the elimination of DST in favor of permanent year-round standard time.

The recommendation has garnered strong support from multiple medical and other high-profile organizations.

"Permanent, year-round standard time is the best choice to most closely match our circadian sleep-wake cycle," M. Adeel Rishi, MD, lead author of the AASM position statement and vice chair of the AASM Public Safety Committee, said in a news release.

The study had no specific funding. Kolla and Rothenberg have disclosed no relevant financial relationships.

Virtual SLEEP 2020: 34th Annual Meeting of the Associated Professional Sleep Societies: Abstract 0173. Presented August 28, 2020.

J Gen Intern Med. Published online August 12, 2020. Abstract

For more Medscape Neurology news, join us on Facebook and Twitter.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.