Thank you, Benjamin Franklin. He’s the one who’s ultimately responsible for the extra hour of sleep most Americans will get when we “fall back” at 2 a.m. Nov. 3 this year. Although he suggested the idea in 1784 as a way to save candles during winter mornings and nights, the practice didn’t become official in the U.S. until 1966, when Congress passed the Uniform Time Act. Their intention was the same, to save energy.  What Franklin and Congress in 1966 may not have considered is how losing and gaining sleep involuntarily twice a year affects us.  And even if they don’t have to get up to go to work, is it actually harder on older people?

According to Terry Cralle, a registered nurse and certified sleep educator, turning the clocks backward has a very real effect on seniors and their sleep.  “Several things can make the fall time change challenging in seniors, one of which is advanced sleep phase syndrome, or ASPS. ASPS is a circadian rhythm disorder that is more prevalent among older adults.”

Cralle said that while seniors may not be getting up to go to a job, and the way they sleep might be affected by age-related conditions, their sleep requirements don’t change. “Changes in sleep patterns occur with aging, but sleep needs don’t decline with age,” Cralle said. “However, the prevalence of sleep disorders tends to increase with age. Sufficient, restorative sleep is vitally essential to physical and psychological health and quality of life and remain a high priority in the 60 and over crowd.”

The twice-yearly time reset can negatively affect moods in all of us and may increase the risk of a heart attack or stroke. “Light is the most powerful regulator of our circadian rhythm. When we change the light exposure we get in the morning and at night, it throws that off,” said Jocelyn Cheng, M.D., a neurologist, sleep medicine specialist and vice chair of the Public Safety Committee for the American Academy of Sleep Medicine. “There are adverse health consequences and real-life consequences as a result of that.”

For most people, setting the clock ahead in the spring is the more dreaded change, with the average person getting about 40 minutes less sleep after “springing forward” for daylight savings time. Experts say it’s not unusual for a person’s sleep to be disrupted for days or weeks afterward.

Here are some ways these time clock disruptions can affect your body according to AARP.

1. May increase risk of heart attack and stroke – While the science isn’t settled on whether the time changes in the spring and fall are dangerous for heart health, experts have long said that daylight savings time takes a toll. One study found a 24% increase in heart attacks on the Monday after daylight savings time starts.  Another found the risk of stroke is 8% higher on the two days following the spring and fall time changes.  According to Donald Lloyd-Jones, M.D., chair of the Department of Preventative Medicine at Northwest University’s Feinberg School of Medicine, “We get established in these patterns and the body knows what to expect. When those patterns get disrupted, you tend to see differences in stress hormone levels and differences in blood pressure level.  Both of those things can be triggers for heart attacks and strokes that might not otherwise have happened.”

2. Low mood and depression – the early onset of darkness and shorter days after the fall rollback of the clocks can leave some feeling lethargic and out of sorts. When the body doesn’t get enough exposure to sunlight, it doesn’t make as much serotonin, the brain chemical responsible for lowering anxiety and boosting mood.  Also, bodies get less vitamin D, and vitamin D deficiency has been linked to depression and fatigue.  One study found that the fall clock change was associated with an 11% increase in depressive episodes.

3. Impaired decision-making – Scientists have long known that lack of sleep can affect the ability to think and make decisions. Studies show that people who don’t get enough sleep are more likely to take risks and make mistakes.  “The less sleep you get, the more likely you are to give in to impulses, and the less likely you are to make good choices,” said Sabra Abbott, M.D.

4. Difficulty with memory and focus– Lack of sleep negatively affects memory, attention span and focus, research shows. Experts say to expect to be more easily distracted and less productive for a few days after a daylight savings transition.

5. Appetite changes and cravings – People may feel hungrier than normal the week after the time change, making some more likely to overeat. It is partly because of the fluctuating hormone levels in the brain.  Even a small sleep deficit increases the hormone ghrelin, which makes us hungry, and suppresses the hormone Leptin, which helps us feel satisfied after eating.

6. Increases irritation – When people are tired, mood is affected. Even judges, who are supposed to be impartial, may be moodier in the days after day light savings begins; one study found that they dole our harsher sentences immediately after the shift.

How the end of daylight savings time can affect seniors with Alzheimer’s and dementia

As winter mornings and evenings become darker, people with dementia may find it difficult to differentiate between 6 a.m. and 6 p.m.  This can disrupt their circadian biological clock and make it hard for them and those who care for them to get enough sleep.

Sundowning refers to a group of worsening symptoms that occur in people with Alzheimer’s and dementia as evening approaches and the sun starts to set. These symptoms can include confusion, agitation, restlessness, anxiety, sadness, delusions, mood swings, energy surges and an overall decline in cognitive function.

While the exact cause of sundowning is not fully understood, it is believed to result from a combination of factors, including disruptions in the body’s internal clock and increased sensitivity to environmental changes. Light and darkness play a large role in controlling our circadian rhythm, the internal bodily process that signals when it is time to sleep and wake up.

Daylight savings time can significantly exacerbate the symptoms of sundowning in seniors with Alzheimer’s and dementia.  When we “fall back,” it can disrupt seniors’ internal clocks, making it challenging to adjust to the sudden time change.  As a result, the symptoms of sundowning may become more pronounced, leaving both the affected individuals and their caregivers facing increased difficulties during the adjustment period.

Supporting people with dementia when the clocks change

1. Prepare Saturday evening – try having dinner and going to bed an hour later on the Saturday night before the fall clock change so the person can still get their usual amount of sleep and wake up at their usual time on Sunday. In this way, the person’s routine will only be different for an evening rather than a full day.

2. Routine – Having a routine during the day and at bedtime can help regulate a person’s disrupted body clock. Doing regular activities at the same time each day – for example going out for a walk after breakfast, can help a person with dementia make sense of the time.

3. Outside time – Going outside and getting some gentle exercise during the day can help the person feel sleepier during the evening so they go to bed at their usual time. If the person is unable to go outside, the same effect can be created by ensuring there is lots of light in the home in the morning, or by sitting in front of a lamp or lightbox.

4. Auto-setting clocks – There are a range of radio-controlled and auto-setting clocks and watches available. There are also “Day and Night” clocks which have all the features of a traditional clock, but also include simple day and night visual symbols to help people with dementia distinguish the time of day.

— By Adrienne Miller, Forever Care Services Chief Care Officer

www.forevercareservices.com