An Extra Hour of Sleep? Not for Everyone Living with Chronic Illness

Daylight saving time has become a hot-button topic over the years, with people sharing strong opinions about whether we should continue changing our clocks twice a year. I haven't given much thought to the debate itself, but I do know that I dread the physical adjustment every time it happens.

I hear people celebrating the extra hour of sleep we'll supposedly gain this weekend. I certainly appreciate a little extra time on a Sunday before facing another workweek, but my body is already so sensitive to changes in routine that adjusting the clocks adds another challenge to days that are difficult enough.

I'm tired all the time, and I'm most comfortable in my bed. That doesn't mean I'm actually comfortable, though. I spend much of the night tossing and turning because a position that brings relief to one part of my body aggravates another. Even when I find a comfortable position, I can't stay that way for long. The frustration builds, and all I want is a good night's sleep.

Restful sleep. There are fewer than a handful of mornings each year when I wake up genuinely refreshed, and I'm always amazed at how different those days feel.

Having an extra hour during the night doesn't mean I'll get an extra hour of restful sleep. It may just mean another hour of tossing and turning, my mind racing, waiting for the sun to come up. Everyone else in the house will sleep a little longer while I creep around trying to be quiet, waiting for the rest of the household to wake up so my day can really begin.

After the time changes, the brain fog seems worse, my body aches more, and it feels like it takes quite a while to adjust.

Usually, I don't give it too much thought. I'm aware of the time change when scheduling the following week, and I know I may have a few more difficult days ahead. It's something that happens twice a year, and I've always managed to get through it. I don't typically let myself get stressed about it.

This year feels different.

I've already been dealing with more exhaustion, more aches, new pains, and heavier brain fog than usual. I feel like it's constantly the middle of the night and I haven't slept at all. I can't find a comfortable position, and even watching television has become difficult. I find myself watching the same show over and over because I can't concentrate enough to follow a movie or something new.

I'm already struggling to get through my days, and now I'm worried about how my body will respond to another disruption when I feel so completely run down.

I know the clocks are only changing by an hour. I wish my body understood that, too.

From the Practice: Understanding Daylight Saving Time and Chronic Illness

For many people, turning the clocks back an hour seems like a minor adjustment. For those living with autoimmune diseases, chronic pain, or persistent fatigue, however, changes in sleep and daily routines can be more difficult to manage.

The connection between daylight saving time and chronic illness is worth exploring because even small disruptions to sleep and daily routines can be particularly challenging for people already managing pain, fatigue, and other persistent symptoms.

Our bodies operate on an internal 24-hour clock known as the circadian rhythm. This biological system helps regulate sleep, body temperature, hormone production, and immune function. It responds to environmental cues, particularly light and darkness, to help keep these processes on schedule.

Research has shown that immune activity and inflammation follow circadian patterns. In rheumatoid arthritis, for example, certain inflammatory substances fluctuate throughout the day, which may help explain why many patients experience increased joint pain and stiffness in the morning.

Sleep also plays an important role in how we experience pain and fatigue. Poor sleep can increase pain sensitivity, affect concentration, and make everyday activities feel more exhausting. For patients whose symptoms already interfere with restful sleep, even a relatively small disruption to their usual schedule may be noticeable.

Although research has established connections between circadian rhythms, immune function, and inflammation, there is limited evidence that the one-hour seasonal time change directly causes autoimmune disease flares. Still, patients may experience changes in their sleep quality, energy levels, or symptoms during the transition.

There are a few things that may help make the adjustment easier. Maintaining consistent sleep and wake times, getting natural light in the morning, and keeping regular meal and activity schedules can help support the body's internal clock. It's also important to allow time for rest and avoid pushing through significant fatigue simply because the clock says you should be ready for the day.

If you notice worsening pain, unusual fatigue, increased brain fog, or other changes that persist beyond the adjustment period, discuss them with your healthcare provider. New or worsening symptoms should not automatically be attributed to the time change.

At Radiant Rheumatology, we understand that managing chronic illness involves much more than monitoring laboratory results or prescribing medication. Sleep quality, fatigue, daily functioning, and the ways symptoms affect your life are all important parts of your care.

An extra hour on the clock doesn't necessarily mean an extra hour of restorative sleep. If you're struggling, those experiences deserve to be heard and taken seriously.