How to Manage the Time Change

Oct 14, 2026 | Your Health

Changing the clocks by an hour can disrupt your sleep and leave you tired for a few days. It can also throw off your circadian rhythm, your body’s internal clock.

Andrew Varga, MD, PhD, a neuroscientist and physician at the Mount Sinai Respiratory Institute Integrative Sleep Center, explains how the time change affects your body—and what you can do to help adjust.

“In our Sleep Disorders Program, we research, diagnose, and treat sleep issues such as insomnia, sleep apnea, and changes in circadian rhythms,” says Dr. Varga. “And we know that twice a year, everyone experiences a pretty dramatic shift in their biological rhythms because of the time change.”

How does the time change affect your body?

Any time change, including travel to another time zone, can force your body to adjust its internal clock. Your circadian rhythm is a roughly 24-hour cycle that responds to light and darkness. It helps control when you sleep and wake, along with other body processes.

When your body clock does not match the time on the clock, you may lose sleep and feel tired. The time change is also linked with increases in heart attacks, strokes, and car crashes caused by sleepy driving.

How long does it take to adjust?

It depends on how large the time change is and your age.

For a one-hour clock change, most people adjust within a few days. Larger changes, such as travel to Europe or Asia, can take about a week. Older adults may need two weeks or more.

What can help you adjust before bedtime?

“There are several things that I recommend to patients in my practice,” says Dr. Varga.

Take a low dose of melatonin.

I recommend a dose of 0.5 to 1 milligram of melatonin, at most, about three hours before the bedtime you want. If you want to go to bed at 11 pm, for example, take it between 7 and 8 pm.

This dose is much lower than many melatonin products, which may contain up to 10 milligrams. A low dose more closely matches the slow rise in melatonin your body normally produces in response to cues such as light, food, and physical activity.

I don’t recommend a higher dose for adjusting your body clock. Some people take higher doses to feel sleepy right away, but it’s not recommended for long-term use. If you have been taking melatonin regularly, especially at higher doses, I suggest to my patients to take a break and use it only when you want to adjust your body clock.

Cognitive Behavioral Therapy for Insomnia, a treatment that uses practical exercises and changes in thoughts and habits to support healthy sleep, may help during a break from melatonin.

Limit blue light at night.

After taking melatonin, try to reduce blue light. Avoid phones, tablets, TVs, and other screens when possible. If you still want to use screens, try a blue-light filter or blue-blocking glasses. The glasses can also reduce light from overhead sources.

What is blue light?

Blue light is part of the light that reaches your eyes. White light contains blue light along with other types of light. Many screens give off a higher share of blue light, even though you may not notice it.

Blue light is a strong signal to your body clock. That is why reducing blue light at night may help when you are trying to adjust your sleep schedule.

What can help you wake up after the time change?

“In the morning, light decreases the amount of melatonin in your body,” says Dr. Varga. “This is one of the cues, known as ‘zeitgebers,’ that help you wake up in the morning. To help this process, there are a couple of things I recommend to patients.”

Get plenty of blue light in the morning.

The morning is the time when you want plenty of blue light. I primarily recommend natural outdoor light, but if you awaken well before sunrise, I recommend blue-light boxes, therapeutic devices that emit small amounts of blue light, for adjusting the body clock.

If you travel often, especially between the United States and Europe or Asia, I suggest placing a blue light box on your kitchen table in the morning. You can eat breakfast or have coffee while the light shines toward your face for 20 minutes.

Use social and environmental cues

Light is the strongest cue that helps reset your body clock. But eating and exercise are other cues that can help your body know it is time to be awake. Morning meals and physical activity may help you adjust to the new schedule.

Should I Do a Monthly Breast Self-Exam? The Answer Might Surprise You.

Updated on Oct 14, 2026 | Your Health

Experts say monthly breast self-exams are no longer necessary—doing this less frequently is okay, as long as you know your breasts well.

Research has shown that recommending monthly self-exams hasn’t actually saved lives. A number of organizations, such as the American Cancer Society, have stopped recommending monthly breast self-exams, while others say doing a self-exam periodically can help women notice changes they may want to discuss with their doctor.

Experts agree the most important steps are getting an annual clinical breast exam and a mammogram every year after age 40.

In this Q&A, breast surgical oncologist Tara Balija, MD, FACS, explains some of the steps women should take to monitor their breast health.

“It’s important to know your breasts, because the earlier we find cancer, the easier it is to treat,” she says. “You can do a breast self-exam every so often to be aware of changes, but you don’t need to do it every month.”

Keeping track of your breast health is becoming even more important, she adds, as doctors are seeing more young women develop breast cancer, as young as age 20.

 

Should I do a breast self-exam every month?

You can, but you don’t have to, says Dr. Balija.  Research shows that a monthly breast self-exam doesn’t make much of a difference in terms of mortality. If anything, the studies found that women who regularly do self-exams end up having more biopsies that came back healthy. Biopsies are tests that analyze a small piece of breast tissue.

In response, many organizations stopped recommending that women examine their breasts every month. Instead, we recommend you check your breasts occasionally, to stay aware of any changes.

If I want to do a self-exam, what’s the best way, and when should I do it?

I tell patients the best time of the month to examine themselves is the first day after their period ends, when their breasts are the “quietest” and less enlarged from menstrual cycle hormonal fluctuations. The National Breast Cancer Foundation provides a step-by-step guide.

Tara Balija, MD, FACS

 

What should a woman do to maintain her breast health?

Once you reach age 40, you should get a mammogram every year and have a clinical exam by a doctor. This means your primary care doctor, gynecologist, or breast specialist if you have one. (Most women will have a breast specialist only if they’ve had cancer or are at high risk.) Having a child before age 30 offers some protection for developing breast cancer.

How do you know if you’re at high risk of breast cancer?

The best way to find out your risk is to get a lifetime breast cancer risk assessment between ages 25 and 30, according to Dr. Balija. There are several of these tools that you can find online. The Tyrer-Cuzick Model is the most up-to-date approach. This model looks at your personal and family medical history. Sometimes a woman is at high risk because of her family history or a genetic mutation. For others, it can be a combination of risk factors. Some doctors go through the assessment with each of their patients.

If the model shows you are at high risk, we can start screening early. We can, for instance, recommend an annual MRI in addition to a mammogram. This allows us to detect breast cancer at an earlier stage, when treatment is often more effective, says Dr. Balija.

When should women begin watching out for breast cancer?

I recommend women begin thinking about breast cancer well before they turn 40 and discuss this with their doctor. I definitely have more young patients with breast cancer than in the past. In our office, we see a few patients in their early 20s each year, Dr. Balija says.

Why are more young people being diagnosed with breast cancer?

The rates of breast cancer in young people have been increasing every decade. And these are women who didn’t have any family history or genetic mutation. That suggests that maybe we are all just more exposed to things that cause cancer, like processed foods and microplastics, according to Dr. Balija.  But we don’t really know what is causing this increase.

Learn more about the Center of Excellence for Breast Cancer at the Mount Sinai Tisch Cancer Center

Advancing Skin Health in People With Down Syndrome: A New Clinical Trial Seeks Participants

Sep 21, 2026 | Your Health

“Families often tell us that skin disease affects much more than the skin,” says Benjamin Ungar, MD, Director of the Alopecia Center of Excellence at Mount Sinai and a study investigator. “These diseases can be very uncomfortable to live with, and that can affect your confidence, sleep, school work, and participation in everyday activities.”

Researchers at the Icahn School of Medicine at Mount Sinai and Columbia University Medical Center are conducting a pioneering study to evaluate potential treatments for inflammatory skin diseases in people with Down syndrome. They aim to set new standard-of-care protocols for treating atopic dermatitis (eczema) and alopecia areata in this patient population.

For many people with Down syndrome, skin conditions can be more than an occasional irritation. Chronic inflammation, persistent itching, recurring rashes, and autoimmune hair loss can affect sleep, daily activities, social interactions, and overall quality of life.

Yet despite the burden these conditions place on individuals and families, there has been limited research focused specifically on treating inflammatory skin diseases in the Down syndrome community.

Now, Emma Guttman-Yassky, MD, PhD, Waldman Professor and Chair of Dermatology at the Icahn School of Medicine, together with Dusan Bogunovic, PhD, professor of pediatric immunology at Columbia University Vagelos College of Physicians and Surgeons, are working on a National Institutes of Health (NIH)-sponsored clinical trial examining a medication approved by the Food and Drug Administration, abrocitinib, for atopic skin diseases and alopecia areata in adults and adolescents with Down syndrome

“Given how common inflammatory skin diseases are in this population, particularly atopic dermatitis and alopecia areata, we want to ensure that safe and effective treatments are available, and that we specifically understand the effects that they have on the immune response in people with Down syndrome,” says Dr. Guttman.

Understanding inflammation in Down syndrome

Researchers have increasingly recognized that people with Down syndrome may be more likely to experience inflammatory and autoimmune conditions. Skin disorders, including eczema and other atopic diseases, can be particularly common and difficult to manage, often with higher levels of systemic inflammation in this population.

While many treatments are available for inflammatory skin conditions in the general population, there is still much to learn about how effective these therapies are for people with Down syndrome.

“Families often tell us that skin disease affects much more than the skin,” says Benjamin Ungar, MD, Director of the Alopecia Center of Excellence at Mount Sinai and a study investigator. “These diseases can be very uncomfortable to live with, and that can affect your confidence, sleep, school work, and participation in everyday activities. By studying these conditions more closely, we hope to identify treatment approaches that improve quality of life.”

The trial is designed to help answer important questions about inflammation, treatment response, and long-term management of atopic skin diseases in individuals with Down syndrome.

A study built with the community in mind

What makes this effort unique is its emphasis on community engagement, experts say.

Before launching the study, researchers sought input directly from people with Down syndrome, family members, caregivers, friends, and advocates. The study team believes that listening to those with lived experience is essential to designing research that is meaningful, accessible, and responsive to the needs of the Down syndrome community.

Why participation matters

Clinical trials are the foundation of medical progress. Breakthrough treatments typically begin with patients and families who choose to participate in research.

By enrolling in this study, participants may help researchers:

• Better understand inflammatory skin disease in Down syndrome.
• Evaluate the effectiveness of this treatment in this population.
• Advance scientific knowledge about immune-related conditions in people with Down syndrome.
• Inform future treatment approaches and standards of care.

“Importantly, participation also helps ensure that people with Down syndrome are represented in research,” says Dr. Ungar. “Historically, many populations with unique medical needs have been underrepresented in clinical studies, limiting opportunities to develop evidence-based care tailored to their experiences.”

Looking toward the future

While no single study can answer every question, researchers hope this trial will be an important step toward improving the understanding and treatment of inflammatory skin diseases in individuals with Down syndrome.

“As the study continues, we remain committed to partnering with the Down syndrome community and advancing research that reflects the priorities of patients and families,” says Dr. Ungar.

Interested in learning more?

Email Giselle Singer, Clinical Research Program Director, at giselle.singer@mssm.edu for details about potential enrollment and research opportunities. Our team is working closely with the Down syndrome community to ensure participant experiences and perspectives help in the success of the study and future research efforts.