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Changes in ischemic stroke occurrence following daylight saving time transitions.
Sleep Med. 2016 Nov - Dec; 27-28:20-24.SM

Abstract

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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Publisher Full Text (DOI)

Authors+Show Affiliations

Sipilä JO
Department of Neurology, North Karelia Central Hospital, Joensuu, Finland; Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.
Ruuskanen JO
Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland. Electronic address: jori.ruuskanen@tyks.fi.
Rautava P
Clinical Research Center, Turku University Hospital, Turku, Finland; Department of Public Health, University of Turku, Turku, Finland.
Kytö V
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Heart Center, Turku University Hospital, Turku, Finland.

MeSH

Age FactorsAgedBrain IschemiaCircadian RhythmComorbidityFemaleFinlandHospitalizationHumansMaleMiddle AgedMultivariate AnalysisProportional Hazards ModelsRisk FactorsSeasonsSex FactorsStrokeTime Factors

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27938913

Citation

Sipilä, Jussi O T., et al. "Changes in Ischemic Stroke Occurrence Following Daylight Saving Time Transitions." Sleep Medicine, vol. 27-28, 2016, pp. 20-24.
Sipilä JO, Ruuskanen JO, Rautava P, et al. Changes in ischemic stroke occurrence following daylight saving time transitions. Sleep Med. 2016;27-28:20-24.
Sipilä, J. O., Ruuskanen, J. O., Rautava, P., & Kytö, V. (2016). Changes in ischemic stroke occurrence following daylight saving time transitions. Sleep Medicine, 27-28, 20-24. https://doi.org/10.1016/j.sleep.2016.10.009
Sipilä JO, et al. Changes in Ischemic Stroke Occurrence Following Daylight Saving Time Transitions. Sleep Med. 2016 Nov - Dec;27-28:20-24. PubMed PMID: 27938913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in ischemic stroke occurrence following daylight saving time transitions. AU - Sipilä,Jussi O T, AU - Ruuskanen,Jori O, AU - Rautava,Päivi, AU - Kytö,Ville, Y1 - 2016/11/02/ PY - 2016/07/25/received PY - 2016/09/29/revised PY - 2016/10/19/accepted PY - 2016/12/13/entrez PY - 2016/12/13/pubmed PY - 2018/2/8/medline KW - Cerebrovascular disease KW - Chronobiology KW - Circadian rhythm KW - Circadian rhythm disturbance KW - Circadian rhythm misalignment SP - 20 EP - 24 JF - Sleep medicine JO - Sleep Med VL - 27-28 N2 - 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. SN - 1878-5506 UR - https://www.unboundmedicine.com/medline/citation/27938913/Changes_in_ischemic_stroke_occurrence_following_daylight_saving_time_transitions_ DB - PRIME DP - Unbound Medicine ER -