November marks the end of daylight savings time, the time in March when we have to set our clocks forward. Daylight savings time is often praised for giving us an extra hour of sunshine at the end of the day, which is much welcomed after a long cold winter, but it also marks the beginning of sleep problems for many Americans.

By putting the clocks forward in the spring, we lose an hour of sleep. For me, this loss of sleep causes daytime sleepiness for a few weeks before my body adjusts to waking up “an hour earlier.” For others, this can lead to the development of sleep disorders and, when the days get shorter in the fall, mood changes from seasonal affective disorder can emerge.

Loss of sleep may be even more detrimental for shift workers. As reported by the author of our cover story, approximately 5% to 10% of people who work outside of the traditional 9 to 5 schedule, including health care workers, develop shift work disorder (SWD). Shift work affects the body’s normal circadian rhythms and results in excessive sleepiness. Sleeping less than 7 hours a night can increase the risk of developing cardiovascular disease, metabolic disorders, cognitive impairment, and even cancer.


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Primary care clinicians play a vital role in screening patients for sleep disorders such as insomnia, sleep apnea, narcolepsy, and SWD. A detailed clinical history, sleep log, and actigraphy can help practitioners diagnose these conditions.

With the end of daylight savings time and the onset of shorter days and longer nights, now is the time to get out those light boxes, spend time outdoors when you can, prioritize sleep, and exercise to keep mentally and physically healthy throughout the winter. Seek the care of a mental health or sleep professional for help managing SWD or seasonal affective disorder. 

As we say goodbye to fall and hello to winter, we here at The Clinical Advisor would like to wish everyone a happy and healthy holiday season and New Year!

Nikki Kean, Director
The Clinical Advisor