番茄社区

Medical errors increased the week after the spring switch to daylight saving time (DST) in a large healthcare system, an observational study showed.

Safety-related incidents stemming from human errors increased by 18.7% (95% CI 5.6%-33.6%, P=0.004) in the week after the spring time change, reported Bhanu Prakash Kolla, MD, of the Mayo Clinic in Rochester, Minnesota, and co-authors, at the virtual SLEEP 2020, a joint meeting of the American Academy of Sleep Medicine (AASM) and Sleep Research Society.

The increase in human-error safety incidents after the fall time change was not significant (4.9%, 95% CI -1.3% to 11.5%, P=0.12).

"Our study was the first to examine patient safety incidents as it pertains to daylight saving time," Kolla told 番茄社区. "It demonstrated there was a significant increase in human error-related patient safety incidents in the week following the 'spring forward' date."

The findings reinforce what other studies have shown: that heart attacks, , and other events may be affected by the spring time change, noted Shalini Paruthi, MD, of St. Louis University School of Medicine in Missouri, who wasn't involved with the study.

"The most important concept is for adults to get 7 or more hours of sleep, every single night," Paruthi told 番茄社区.

"Studies are recognizing that there are poorer outcomes after the spring time change -- especially on that Monday after losing an hour of sleep and for the next couple of days -- before adjusting to sleep deprivation," she said.

In their study, Kolla and colleagues tracked voluntarily reported patient safety-related adverse events that occurred 7 days before and 7 days after spring and fall time changes in a large healthcare organization with sites in multiple states from 2010 to 2017. They looked at safety incidents in all inpatient, outpatient, and ambulatory care settings, identifying which events likely resulted from human errors.

Over the 8-year period, there were more adverse events -- human and all (this included equipment failures, defective systems, and system breakdowns) -- in the 7 days after the time change.

After the spring time change, human errors climbed from 1,625 to 1,902, while all errors increased from 2,699 to 2,812. After the fall time change, human errors rose from 2,087 to 2,189, and all errors increased from 3,007 to 3,207.

The estimated 18% human-error increase in spring was significantly greater than the 5% human-error increase in the fall, Kolla noted.

The results are from a single health care system and should be considered preliminary, Kolla cautioned. "The study will need to be replicated," he said.

This week, AASM issued its first , saying public health and safety would benefit from abolishing seasonal time changes and switching to a fixed, national, year-round standard time.

"Existing data support the elimination of seasonal time changes in favor of a fixed, year-round time. DST can cause misalignment between the biological clock and environmental clock, resulting in significant health and public safety-related consequences, especially in the days immediately following the annual change to DST," AASM members wrote in the Journal of Clinical Sleep Medicine. "A change to permanent standard time is best aligned with human circadian biology and has the potential to produce beneficial effects for public health and safety."

The position statement was supported by other groups, including the American College of Chest Physicians, the National Safety Council, and the National Parent Teacher Association.

In July, an AASM survey of about 2,000 U.S. adults found that in favor of a national, fixed, year-round time, and 11% opposed it. A 2019 AASM poll showed that after the clocks move forward an hour for DST.

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