Panic attacks are most likely to happen after 3pm, while at night the symptoms of stomach ulcers may feel worse.
Research is increasingly showing that the risk and severity of symptoms vary hugely at different times of the day and night.
‘Like almost all life on the planet, much of human physiology and behaviour is controlled, modulated or at least fine-tuned by an internal 24-hour timer,’ says Professor Russell Foster, circadian neuroscientist at the University of Oxford and the John Radcliffe Hospital.
10AM: Joint pain and stiffness are worse in the morning
This 24-hour or circadian cycle is orchestrated by a biological pacemaker located in an area of the brain at the base of the skull called the hypothalamus.
The cycle controls a range of biological processes and fluctuations in hormones, all of which can raise the risk of certain conditions and symptoms.
Here we reveal the key times of day when certain symptoms strike, and how to beat the clock to protect yourself.
6am: Heart attacks
The risk of heart attack and stroke begins to rise from 6am, with most happening around 10am. Research in the American Journal of Hypertension shows that between 6am and noon there is a 40 per cent higher risk of a heart attack and a 49 per cent increased risk of stroke.
The authors suggest that as the body begins to stir and start daily activities, it needs more oxygen, and so compounds are released that cause a rise in blood pressure. Peaking levels of the adrenal hormone cortisol also boost blood pressure.
In people at risk, this increases the chances of a heart attack. One theory says the increased pressure can break off a fatty deposit in the artery and block blood supply.
For the same reason, nose bleeds peak now.
Studies show the risk is the same whatever time people get up.
Researchers are now investigating whether blood pressure drugs should therefore be taken at night or first thing in the morning.
7AM: GOUT PAIN
Gout is caused by high levels of uric acid, which form crystals around the joints causing pain, most commonly in the foot.
Research from Russia, published in the journal Chronobiology International, shows that uric acid concentration in the blood peaked at 7am, when it is 2.8 fold higher than at 11pm, when concentration is at its lowest. The timing may be due to a build-up during sleep.
8AM: ALLERGIES
Allergy symptoms, such as itching eyes and a running nose, are at their worst in the morning. Muriel Simmons of Allergy UK says: ‘This is likely to be due to the fact that movement in the house, such as throwing back the bedclothes, causes dust mites and other allergens to rise in the atmosphere.’
9AM: Migraines are more frequent at this time, which may be down to blood pressure rising in the early hours
9AM: MIGRAINES
If you’re a migraine sufferer, you’re most at risk of an attack between 8am and 10am, according to researchers from the Cleveland Clinic in the U.S.
They also found a dramatic decrease in frequency between 8pm and 4am. The researchers suggest this may be down to blood pressure rising in the early hours — one possible cause of migraines is blood vessels in the head expanding, triggering pain, nausea and, in some cases, visual disturbances.
10AM: ARTHRITIS PAIN
‘Joint pain and stiffness are worse in the morning,’ says Dr Alan Silman, medical director of Arthritis Research UK.
‘This may be a result of inactivity during the night, but may also be related to the naturally varying levels of cortisone and other hormones the body produces.
‘One option is to take a slow-acting anti-inflammatory drug just before going to bed. This will then work through the night to minimise pain in the morning.’
1PM: MAXIMUM SUPPLENESS
The best time to do an exercise class or visit the physiotherapist is from 1pm. According to a study at Washington University, body temperature peaks between 1pm and 4pm, at around two degrees warmer than in the morning.
This means muscles are more supple now, lowering the risk of injury from exercise.
2PM: PREVENT ASTHMA
The best time to take asthma medication is 2pm. A single dose of inhaled steroid early in the afternoon has a protective effect against asthma worsening at night, according to researchers at the University of Sao Paulo.
Other research showed that a 3pm dose of prednisone, to reduce airway inflammation, was superior to the same drug given at 8am.
1PM: Muscles are more supple now, lowering the risk of injury from exercise
3PM: PANIC ATTACKS
This is the most likely time for the onset of panic attacks and anxiety. According to a study from the University of Michigan, the risk of attacks remains high until 7pm. Only 10 per cent of attacks occurred before 10am. ‘Results indicate that people with anxiety disorders tend to experience increased symptoms later in the day,’ the researchers say. They pointed to the fact that the body’s circadian rhythm causes the nervous system to be more active at this time, but they also said the afternoon may simply be a time when stressful events of the day have built up.
4PM: RUNNING NOSE
According to a study at Quebec University, symptoms of coughs and common colds start to peak from about now. One theory is that hormones involved in the production of antibodies that fight infection are less active in the afternoon, weakening the immune system’s defences and triggering an increase in symptoms.
5PM: OSTEOARTHRITIS
Symptoms begin to build up in the late afternoon and early evening, according to a Texas Tech University report. The best time to take an anti-inflammatory drug such as ibuprofen is thought to be noon, so the medication becomes active at the right time.
7PM: STOP HEARTBURN
While heartburn can strike at any time, a study at Kansas University compared morning and evening use of proton pump inhibitors for gastro-oesophageal reflux, and found that overall heartburn symptoms were eased in 71 per cent of patients who had in the afternoon and evening, compared to 42 per cent of those who had it in the morning.
This may be because the drug will act throughout the night, when reflux can be exacerbated by lying down to sleep, says Marcus Harbord, consultant gastro-enterologist at Chelsea & Westminster Hospital.
9PM: STOMACH ULCERS
Symptoms of ulcers peak at this time, probably because this is when the body digests food. Pharmacists at the University of Texas found that medication such as H2-receptor antagonists are most effective when taken at bedtime.
10PM: ECZEMA
Seven out of 10 people with inflammatory skin conditions, including psoriasis and eczema, experience increased symptoms around this time. Patients with other conditions, ranging from scabies to chronic renal failure, also suffer from nocturnal itching.
A study at Wake Forest University in the U.S. suggests this could be due to changes in skin temperature. Warmer body temperatures have been linked to increased itching because of its effects on nerve endings. Skin also loses water at night, which can trigger a dry, itchy feeling. Another theory is that there are daily cycles in compounds involved in the sensation of itch, as there are with pain.
11PM: This is the peak time for women to go into labour
‘People with allergic skin conditions tend to suffer extreme irritation at night, which is usually due to the body heat generated by bedclothes,’ says Muriel Simmons from Allergy UK.
‘Every movement in bed triggers a release of house dust mite allergens. So those with disturbed sleep are inadvertently stirring up the allergens on a frequent basis and pushing their immune system to the boundaries.’
11PM: LABOUR PAINS
This is the peak time for women to go into labour. Changing hormones are thought to be one factor involved, although another theory is that the body is most relaxed at this time. Some experts think women may have evolved this way so that they are giving birth under cover of darkness.
4AM: ASTHMA
Many asthma sufferers find that wheezing peaks at this time. They have the highest levels of markers of inflammation at 4am, which can signal a tightening of the airways, according to research at Harvard University. Theories include increased exposure to allergens at night, cooling of the airways, the reclining position, or hormonal changes. ( dailymail.co.uk )
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