A neurologist explains the medical evidence, and why this shift is worse than the fall time change
by Beth Ann Malow, Professor of Neurology and Pediatrics, Vanderbilt University
As people in the U.S. prepare to set their clocks ahead one hour on Sunday, March 12, 2023, I find myself bracing for the annual ritual ofย media storiesย aboutย the disruptions to daily routinesย caused by switching from standard time ย to daylight saving time.
About one-third of Americans say they donโt look forward to these twice-yearly time changes. And nearly two-thirdsย would like to eliminate them completely, compared to 21% who arenโt sure and 16% who would like to keep moving their clocks back and forth.
But the effects go beyond simple inconvenience. Researchers are discovering that โspringing aheadโ each March is connected with serious negative health effects, including an uptick inย heart attacksย andย teen sleep deprivation. In contrast, the fall transition back to standard time is not associated with these health effects, as my co-authors and I noted in aย 2020 commentary.
Iโve studied the pros and cons of these twice-annual rituals for more than five years as aย professor of neurology and pediatricsย and the director of Vanderbilt University Medical Centerโs sleep division. Itโs become clear to me and many of my colleagues that the transition to daylight saving time each spring affects health immediately after the clock change and also for the nearly eight months thatย Americans remain on daylight saving time.

The strong case for permanent standard time
Americans are split on whether theyย prefer permanent daylight saving timeย orย permanent standard time.
However, the two time shifts โ jolting as they may be โ are not equal. Standard time most closely approximates natural light, with the sun directly overhead at or near noon. In contrast, during daylight saving time from March until November, the clock change resulting from daylight saving time causes natural light to be present one hour later in the morning and one hour later in the evening according to clock time.
Morning light is essential for helping to set the bodyโs natural rhythms: Itย wakes us up and improves alertness. Morning light also boosts mood โ light boxes simulating natural light are prescribed for morning useย to treat seasonal affective disorder.
Although the exact reasons why light activates us and benefits our mood are not yet known, this may be due to lightโs effects onย increasing levels of cortisol, a hormone thatย modulates the stress responseย or the effect ofย light on the amygdala, a part of the brain involved in emotions.
Adolescents also may beย chronically sleep deprived due to school, sports and social activities. For instance, manyย children start school around 8 a.m.ย or earlier. This means that during daylight saving time, many young people get up and travel to school in pitch darkness.
The body of evidence makes a good case for adopting permanent standard time nationwide, as I testified at aย March 2022 Congressional hearingย and argued in aย recent position statementย for the Sleep Research Society. The American Medical Association recentlyย called for permanent standard time. And in late 2022,ย Mexico adopted permanent standard time,,ย citing benefits to health, productivity and energy savings.

ย ย ย ย ย ย ย ย ย ย ย ย Sunday, Nov. 5th
The biggest advantage of daylight saving time is that it provides an extra hour of light in the late afternoon or evening, depending on time of year, for sports, shopping or eating outside. However, exposure to light later into the evening for almost eight months during daylight saving time comes at a price. This extended evening light delays the brainโs release of melatonin, the hormone that promotes drowsiness, which in turn interferes with sleep andย causes us to sleep less overall.
Because puberty also causesย melatonin to be released later at night, meaning that teenagers have a delay in the natural signal that helps them fall asleep, adolescents areย particularly susceptible to sleep problemsย from the extended evening light. This shift in melatonin during puberty lasts into our 20s.
The โwestern edgeโ effect
Geography can also make a difference in how daylight saving time affects people. One study showed that people living on the western edge of a time zone, who get light later in the morning and later in the evening,ย got less sleepย than their counterparts on the eastern edge of a time zone.
This study found that western-edge residents had higher rates of obesity, diabetes, heart disease andย breast cancer, as well as lower per capita income and higher health care costs. Other research has found thatย rates of certain other cancers are higherย on the western edge of a time zone.
Scientists believe that these health problems may result from aย combination of chronic sleep deprivation and โcircadian misalignment.โ Circadian misalignment refers to a mismatch in timing between our biological rhythms and the outside world. In other words, the timing of daily work, school or sleep routines is based on the clock, rather than on the sunโs rise and set.
This video takes a deeper dive โ all the way back to 1895 โ into the history of daylight saving time.
A brief history of daylight saving time
Congress instituted year-round daylight saving timeย during World War I and World War II, andย once again during the energy crisisย of the early 1970s.
The idea was that having extra light later into the afternoon would save energy by decreasing the need for electric lighting. This idea has since beenย proved largely inaccurate, as heating needs may increase in the morning in the winter, while air conditioning needs can also increase in the late afternoon in the summer.
Another pro-daylight saving argument has been that crime rates drop withย more light at the end of the day. While this has been proved true, the change is very small, andย the health effects appear to outweighย the benefits to society from lower rates of crime.
After World War II, designating the start and end dates for daylight saving time fell to state governments. Because this created many railroad scheduling and safety problems, however, Congress passed theย Uniform Time Act in 1966. This law set the nationwide dates of daylight saving time from the last Sunday in April until the last Sunday in October. In 2007,ย Congress amended the actย to expand the period in which daylight saving time is in effect from the second Sunday in March to the first Sunday in November โ dates that remain in effect today.
The Uniform Time Act allows states and territories to opt out of daylight saving time, however. Arizona and Hawaii are on permanent standard time, along with Puerto Rico, the U.S. Virgin Islands, Northern Mariana Islands, Guam and American Samoa.
Now, many other states are considering whether toย stop falling back and springing ahead. Several U.S. states have legislation and resolutions under consideration to support permanent standard time, while many others have been or areย considering permanent daylight saving time. Legislation and resolutions for permanent standard time have increased from 15% in 2021 to 31% in 2023.
In March 2022, the U.S. Senateย passed the Sunshine Protection Act ย in a bid toย make daylight saving time permanent. But the House did not move forward with this legislation. Florida Sen. Marco Rubioย reintroduced the billย on March 1, 2023.
The spike in activity among states seeking to break from these twice-yearly changes reflects how more people are recognizing the downsides of this practice. Now, itโs up to legislators to decide whether we end the time shift altogether, and to choose permanent standard or daylight saving time.
[This is an updated version of an articleย originally published on March 10, 2022 written by Beth Ann Malow, Professor of Neurology and Pediatrics at Vanderbilt University. Both articles were published on The Conversation. For tips on how to prepare for the time change, read “Daylight Saving Time: Not Every Clock Can Change.”
