http://www.sleep-journal.com/article/S1389-9457%2816%2930222-2/abstract?cc=y=
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Jori O. RuuskanenCorrespondence information about the author Jori O. RuuskanenEmail the author Jori O. Ruuskanen
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Highlights
- •Ischemic stroke (IS) occurrence is altered after daylight saving time transitions.
- •Occurrence rate of the following first two days, but not the whole week, is elevated.
- •Altered occurrence is more apparent in women than in men.
- •Patients with malignancy and those over 65 years of age are more susceptible.
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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