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Two methods of standardization\u2014<jats:italic>z<\/jats:italic>scores and unit\u2010scaled rate ratios (RRs)\u2014were used to compare seizure propensities following<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content>transitions to other time periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>As a percentile relative to all other weeks in a given year, absolute seizure counts in the week of<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content>fell below the median (DST seizure percentiles mean \u00b1 SD: 19.68\u00a0\u00b1\u00a016.25,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), which was concordant with weekday\u2010specific comparisons. Comparatively, RRs for whole\u2010week (1.06, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.02\u20101.10,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0054) and weekday\u2010to\u2010weekday (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>range 1.04\u20101.16, all<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) comparisons suggested a slightly higher incidence of seizures in the<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content>week compared to all other weeks of the year. However, examining the similar risk of the week preceding and following the<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content>\u2010transition week revealed no significant weekday\u2010to\u2010weekday differences in seizure incidence, although there was an unexpected, modestly decreased seizure propensity in the<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content>week relative to the whole week prior (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>0.94, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>0.91\u20100.96,<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Despite expectations that circadian and sleep disruption related to<jats:styled-content style=\"fixed-case\">DST<\/jats:styled-content>transitions would increase the incidence of seizures, we found little substantive evidence for such an association in this large, longitudinal cohort. Although large\u2010scale observational\/epidemiologic cohorts can be effective at answering such questions, additional covariates (eg, sleep duration, seizure type, and so on) that may underpin the association were not able available, so the association has not definitively been ruled out.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.14696","type":"journal-article","created":{"date-parts":[[2019,3,20]],"date-time":"2019-03-20T04:10:32Z","timestamp":1553055032000},"page":"764-773","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Daylight saving time transitions are not associated with increased seizure incidence"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8729-5224","authenticated-orcid":false,"given":"Logan D.","family":"Schneider","sequence":"first","affiliation":[{"name":"Stanford Center for Sleep Sciences and Medicine Stanford University Palo Alto California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E.","family":"Moss","sequence":"additional","affiliation":[{"name":"Seizure Tracker LLC Alexandria Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8370-2758","authenticated-orcid":false,"given":"Daniel M.","family":"Goldenholz","sequence":"additional","affiliation":[{"name":"Division of Epilepsy Beth Israel Deaconess Medical Center Harvard University Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","unstructured":"BarnesCM WagnerDT.Changing to daylight saving time cuts into sleep and increases workplace injuries.2009; 94.","DOI":"10.1037\/a0015320"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-4575(03)00015-0"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199604043341416"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(00)00032-0"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","unstructured":"Sipil\u00e4J RuuskanenJ RautavaP Kyt\u00f6V.Daylight Saving Time Transitions Incidence and In\u2010Hospital Mortality of Ischemic Stroke. 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