Lunar phases are not related to the occurrence of acute myocardial infarction and sudden cardiac death

Effects of lunar cycle on fasting plasma glucose, heart rate and blood pressure in type 2 diabetic patients

The purpose of this study was to investigate the influence of lunar phases on fasting plasma glucose, heart rate, and blood pressure in type 2 diabetic patients. The present cross-sectional study was carried out during four phases, i.e., full moon (FM), first quarter (FQ), new moon (NM), and third quarter (TQ), of the lunar month. The study was conducted on 42 randomly selected patients (22 males and 20 females) from the Diabetes Clinic of Calcutta Medical College. Fasting plasma glucose (FPG) of each subject was determined and heart rate (HR) and blood pressure (BP) were measured at rest and during static exercise conditions, i.e., performance of a standard handgrip dynamometer test. The FPG level during the NM and FM was significantly higher (p < .001) than during the TQ and FQ for both males and females, respectively. The mean HR during static exercise during the NM and FM for both males and females was significantly higher than that during the FQ (p < .05) and TQ (p < .01). It appears from the present study that lunar phases may affect fasting plasma glucose level and cardiovascular functions of aged type 2 diabetic patients both at rest and during exercise.

Revisiting an ancient legend: Influence of the lunar cycle on occurrence of first-ever unprovoked seizures

BACKGROUND

The mythical effect of the lunar cycle on seizures has been debated over time. Previously healthy individuals presenting with first-ever seizures in whom investigations are negative often invoke questions about potential reasons including a full moon.

AIMS

To determine whether there is a temporal relationship between the occurrence of the first-ever unprovoked seizure and the lunar cycle.

METHODS

We studied adults who presented with a first-ever unprovoked seizure to two tertiary centres in Australia. Seizure onset time was obtained from the emergency department and ambulance documentations. We used Poisson regression modelling and incidence rate ratios (IRR) to determine whether seizures have a preponderance for a particular lunar phase. We performed further analysis on "first seizure epilepsy" and "first seizure not epilepsy" subgroups based on the International League Against Epilepsy criteria for a diagnosis of epilepsy after a single unprovoked seizure.

RESULTS

We analysed 1710 patients (38% females; median 39 yr), of whom 18% had epileptiform abnormalities on EEG and potentially epileptogenic lesions were detected on neuroimaging in 28%. Based on the EEG and imaging findings, 684 (40%) patients were categorized as "first seizure epilepsy" and 1026 (60%) "first seizure not epilepsy". The whole cohort and subgroup analysis demonstrated no significant difference in the seizure occurrence among the four lunar quarters.

CONCLUSIONS

First unprovoked seizures are not influenced by the lunar cycle. Patients pondering the cause of their first-ever unprovoked seizure can be reassured that the full moon was not responsible. This article is protected by copyright. All rights reserved.

Impact of lunar phase on outcomes following ST-elevation myocardial infarction

BACKGROUND

There is a long-held belief in the association between the full moon and extremes of human behaviour and adverse health consequences. Small-scale studies are conflicting; however, most suggest no clear association between lunar phase and occurrence of acute coronary syndromes.

AIMS

To evaluate the impact of the lunar phase, and in particular, the full moon phase, on the incidence and outcomes among ST-elevation myocardial infarction (STEMI) cases undergoing percutaneous coronary intervention (PCI).

METHODS

We conducted a multi-centre retrospective study from the Melbourne Interventional Group registry, including 7570 STEMI cases from six tertiary centres over a 12-year study period in Victoria, Australia, and performed statistical analysis using Stata software. Primary outcomes studied were the incidence of STEMI, the occurrence of major adverse cardiac and cerebrovascular events and mortality at 1 and 5 years in cases of STEMI undergoing primary or rescue percutaneous coronary intervention during the full moon between 2005 and 2017 in Victoria, Australia.

RESULTS

This study demonstrated neither significant difference in STEMI incidence (P = 0.61) nor of major adverse cardiovascular events across all lunar phases. Subgroup analysis confirmed no difference in outcomes during the full moon compared to a composite of other lunar phases.Kaplan-Meier survival estimates showed similar 30-day outcomes across lunar phases (P = 0.35) and when comparing full moon to a composite of other lunar phases (P = 0.45). Similarly, there was no significant difference in survival at 1 and 5 years between lunar phases (P = 0.68) or compared to the full moon phase (P = 0.51).

CONCLUSIONS

This study showed no significant difference in the incidence or cardiovascular outcomes and survival in patients with STEMI undergoing primary or rescue percutaneous coronary intervention during the lunar phases.

Full Moon and Out-of-Hospital Cardiac Arrest in Japan - Population-Based, Double-Controlled Case Series Analysis

Background: It is commonly believed that a full moon affects human behavior or the occurrence and outcome of various diseases; thus, the occurrence of out-of-hospital cardiac arrest (OHCA) might increase during full moon nights.

Methods and Results: This nationwide, population-based observational study consecutively enrolled OHCA patients in Japan with attempted resuscitation between 2005 and 2016. The primary outcome measure was the occurrence of OHCA. Based on the double-control method, assuming Poisson sampling, we evaluated the average number of OHCA events that occurred on full moon nights compared with that which occurred on control nights, which included events that occurred on the same calendar days 1 week before and after the full moon nights. A total of 29,552 OHCA that occurred on 148 full moon nights and 58,707 OHCA that occurred on 296 control nights were eligible for analysis. The occurrence of OHCA did not differ between full moon and control nights (199.7 vs. 198.3 per night; relative risk [RR], 1.007; 95% CI: 0.993–1.021). On subgroup analysis, compared with control nights, the RR of OHCA occurrence were 1.013 (95% CI: 0.994–1.032, P=0.166) and 0.998 (95% CI: 0.977–1.020, P=0.866) for cardiac and non-cardiac origins, respectively.

Conclusions: In this population, there was no significant difference in OHCA occurrence between full moon and control nights.

No association of moon phase with stroke occurrence

Stroke occurrence shows strong correlations with sleep disorders and even subtle sleep disturbances have been shown to affect ischemic stroke (IS) occurrence. Chronobiology also exerts effects, like the morning surge in IS occurrence. Lunar cycles have also been shown to affect sleep and other physiological processes, but studies on moon phases and its possible association with occurrence of stroke are rare and nonconclusive. Therefore, we studied the effects of moon phases on stroke hospitalizations and in-hospital mortality nationwide in Finland in 2004-2014. All patients aged ≥18 years with IS or intracerebral hemorrhage (ICH) as primary discharge diagnosis were included. Daily number of admissions was treated as a response variable while moon phase, year and astronomical season were independent variables in Poisson regression modeling. We found no association between moon phases and stroke occurrence. The overall occurrence rates did not vary between different moon phases for IS or ICH (p = 0.61 or higher). There were no differences between moon phases in daily admission rates among men, women, young and old patients for any of the stroke subtypes. There was no difference in in-hospital mortality with regard to moon phase for IS or ICH overall (p = 0.19 or higher), nor in subgroup analyses. There were no significant interactions between moon phase and astronomical season for stroke occurrence or in-hospital mortality. To conclude, in this over a decade-long nationwide study including a total of 46 million person years of follow-up, we found no association between moon phases and occurrence or in-hospital mortality rates of IS or intracerebral hemorrhage.

Relationship between lunar cycle and haemorrhagic complication rate in surgery

BACKGROUND

The aim of this study was to evaluate a possible relationship between lunar cycles and haemorrhagic complication rate in surgery.

MATERIALS AND METHODS

The possible relationship between moon phases and surgical outcome was tested by evaluating the haemorrhagic complication rate for 18,760 patients who underwent surgery between January 2001 and December 2008 at the National Institute for Cancer Research in Genoa. A total of 103 lunar phases were considered using Chi-square (χ²) test analysis, and patients were allocated a surgery date.

RESULTS

One hundred and sixty-seven haemorrhagic complications were observed. Three hundred and nine new moon phase days were analysed and 12 incidences of complications detected, with a 3.9% complication rate per day. In the waxing moon phase, 1184.5 d were analysed with 68 incidences of complications at a daily rate of 5.7%. In the full moon phase there was a 4.9% complication rate per day (15 incidences in 309 d), whereas in the waning moon phase, the 6% percentage rate per day resulted from 72 incidences in 1184.5 d.

CONCLUSIONS

No statistically significant correlations were found between moon cycles and postoperative haemorrhagic complications (p = .50).

Impact of the moon on cerebral aneurysm rupture

BACKGROUND

Several external and internal risk factors for cerebral aneurysm rupture have been identified to date. Recently, it has been reported that moon phases correlate with the incidence of aneurysmal subarachnoid hemorrhage (SAH), however, another author found no such association. Therefore, the present study investigates the influence of the lunar cycle on the incidence of aneurysmal rupture, the initial clinical presentation, and the amount of subarachnoid blood.

METHODS

Lunar phase and the particular day of the lunar cycle were correlated to the date of aneurysm rupture, aneurysm location, initial clinical presentation, and amount of subarachnoid blood assessed from CT scans of all patients treated for basal SAH in our department from 2003 to 2010.

RESULTS

We found no correlation between incidence of aneurysmal SAH, location of the aneurysm, initial clinical presentation, or amount of subarachnoid blood and the lunar cycle.

CONCLUSIONS

The moon influences neither the incidence of aneurysmal SAH nor the grade of initial neurological deterioration or amount of subarachnoid blood.

Lunar phase does not influence perioperative complications in total hip arthroplasty

INTRODUCTION

Lunar calendars, publishing recommendations for daily life, are gaining more and more attention in Germany, where 10.5% of the population believe in lunar effects on disease. A widespread and often heard belief is that a full moon has the most negative effects on surgical outcome. The present study evaluates the effects of lunar phase on perioperative complications in total hip arthroplasty.

MATERIAL AND METHODS

We performed a retrospective study with 305 patients being provided with a primary hip arthroplasty. To identify possible influences of the lunar phase on perioperative complications we investigated data such as operation length, blood loss and course of C-reactive protein that were collected during the patients' stay in the hospital and allocated them to moon illumination.

RESULTS

There were no significant differences in all collected data concerning the lunar phase (p > 0.05). Although not statistically significant, there were fewer operations during the full moon phase.

CONCLUSIONS

Therefore there is no evidence that lunar phase has an effect on perioperative complications in total hip arthroplasty. Fewer, though not significantly fewer, operations were performed during the full moon phase. Although this was not a prospective randomized trial, the statistical magnitude of the results does not support any recommendations for scheduling patients for total hip arthroplasty at any particular day of the lunar phase.

The influence of lunar phases on the occurrence of myocardial infarction: fact or myth? The MONICA/KORA Myocardial Infarction Registry

AIMS

The potential influence of lunar phases on the occurrence of myocardial infarction is still controversial. The purpose of the present study was to investigate the association of the lunar cycle on the occurrence of fatal and non-fatal myocardial infarction based on a myocardial infarction registry.

METHODS AND RESULTS

We studied 15,985 patients consecutively hospitalised with an acute myocardial infarction (AMI) between 1 January 1985 and 31 December 2007 with a known date of symptom onset who were recruited from a population-based myocardial infarction registry. The exact hour of AMI onset was known for 9813 events. Poisson regression analysis was performed to examine the relation between the lunar cycle and the occurrence of AMI. There was no association between new moon, full moon, waning moon and waxing moon and the occurrence of AMI. However, we observed that the three days after a new moon may be significantly protective for the occurrence of AMI, rate ratio (RR) 0.94 (95% CI 0.91-0.98), and the day before a new moon had a slightly negative effect (RR 1.06, 95% CI 1.00-1.12). Stratified analysis did not reveal any susceptible subgroups.

CONCLUSION

The moon phases did not show any apparent association with AMI occurrence. However, there might be a 'cardioprotective' time three days after a new moon.

Canine and Feline Epileptic Seizures and the Lunar Cycle: 2,507 Seizures (2000–2008)

Epileptic seizures in 211 canine and feline patients diagnosed with idiopathic epilepsy were evaluated for temporal significance in relation to the lunar cycle. Seizure counts were compared among each of the eight individual lunar phases, among each of eight exact lunar phase dates, and by percent of lunar illumination using generalized estimating equations. No statistical significance was found in any of these comparisons excluding a relationship between the onset of epileptic seizures and the phases of the moon. Alteration in anticonvulsant treatment or monitoring of canine and feline patients with idiopathic epilepsy at large was not warranted based on the lunar cycle.

Answering the myth: use of emergency services on Friday the 13th

OBJECTIVE

The aim of the study was to evaluate the risk of Friday the 13th on hospital admission rates and emergency department (ED) visits.

METHODS

This was a retrospective chart review of all ED visits on Friday the 13th from November 13, 2002, to December 13, 2009, from 6 hospital-based EDs. Thirteen unlikely conditions were evaluated as well as total ED volumes. As a control, the Friday before and after and the month before and after were used. χ(2) Analysis and Wilcoxon rank sum tests were used for each variable, as appropriate.

RESULTS

A total of 49 094 patient encounters were evaluated. Average ED visits for Friday the 13th were not increased compared with the Friday before and after and the month before. However, compared with the month after, there were fewer ED visits on Friday the 13th (150.1 vs 134.7, P = .011). Of the 13 categories evaluated, only penetrating trauma was noted to have an increase risk associated with Friday the 13th (odds ratio, 1.65; 95% confidence interval, 1.04-2.61). No other category was noted to have an increase risk on Friday the 13th compared with the control dates.

CONCLUSIONS

Although the fear of Friday the 13th may exist, there is no worry that an increase in volume occurs on Friday the 13th compared with the other days studies. Of 13 different conditions evaluated, only penetrating traumas were seen more often on Friday the 13th. For those providers who work in the ED, working on Friday the 13th should not be any different than any other day.

Relationship between lunar phases and serious crimes of battery: a population-based study

OBJECTIVE

The hypothesis of a lunar influence on human abnormal behavior is still widespread, although research has led to conflicting findings. Therefore, a population-based study to assess the influence of lunar phases on violent crimes was conducted.

METHODS

The study included all serious crimes of battery (aggravated assaults) committed in Middle Franconia (Bavaria, Germany) between 1999 and 2005 (n = 23 142). Data were analyzed regarding lunar phase, sex, and place of crime scene (outdoor vs indoor).

RESULTS

No significant associations between full, absent, and the moon's interphases and serious crimes of battery could be detected. Furthermore, a Fourier analysis was conducted that failed to produce an association between violence and the moon's phases.

DISCUSSION

Several possible explanations for the presented results are discussed including biological and social mechanisms.

CONCLUSIONS

The present study fails to find a significant association between lunar phases and crimes of battery.

The dark side of the moon: impact of moon phases on long-term survival, mortality and morbidity of surgery for lung cancer

Objective

Superstition is common and causes discomfiture or fear, especially in patients who have to undergo surgery for cancer. One superstition is, that moon phases influence surgical outcome. This study was performed to analyse lunar impact on the outcome following lung cancer surgery.

Methods

2411 patients underwent pulmonary resection for lung cancer in the past 30 years at our institution. Intra-and postoperative complications as well as long-term follow-up data were entered in our lung-cancer database. Factors influencing mortality, morbidity and survival were analyzed.

Results

Rate of intra-operative complications as well as rate of post-operative morbidity and mortality was not significantly affected by moon phases. Furthermore, there was no significant impact of the lunar cycle on long-term survial.

Conclusion

In this study there was no evidence that outcome of surgery for lung cancer is affected by the moon. These results may help the physician to quite the mind of patients who are somewhat afraid of wrong timing of surgery with respect to the moon phases. However, patients who strongly believe in the impact of moon phase should be taken seriously and correct timing of operations should be conceded to them as long as key-date scheduling doesn't constrict evidence based treatment regimens.

Does the lunar phase have an effect on sudden unexpected death in epilepsy?

The incidence of sudden unexpected death in epilepsy (SUDEP) in our epilepsy unit over an 8-year period was analyzed to determine a possible association between phase of the moon and SUDEP. Analysis revealed that the number of SUDEPs was highest in full moon (70%), followed by waxing moon (20%) and new moon (10%). No SUDEPs occurred during the waning cycle. These preliminary findings suggest that the full moon appears to correlate with SUDEP.

Impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhage: myth or reality?

OBJECTIVE

To investigate the impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhages.

METHODS

We retrospectively identified all patients admitted to the department of neurosurgery during 1992 and 2004 suffering from aneurysmal subarachnoid haemorrhage. The onset of bleeding was compared with the lunar phase.

RESULTS

We did not observe any significant impact of the lunar cycle on the incidence of aneurysmal subarachnoid haemorrhage in 717 consecutive patients (p=0.84).

CONCLUSION

The impact of the lunar cycle on aneurysmal subarachnoid haemorrhage is a myth rather than reality.

Human responses to the geophysical daily, annual and lunar cycles

Collectively the daily, seasonal, lunar and tidal geophysical cycles regulate much of the temporal biology of life on Earth. The increasing isolation of human societies from these geophysical cycles, as a result of improved living conditions, high-quality nutrition and 24/7 working practices, have led many to believe that human biology functions independently of them. Yet recent studies have highlighted the dominant role that our circadian clock plays in the organisation of 24 hour patterns of behaviour and physiology. Preferred wake and sleep times are to a large extent driven by an endogenous temporal program that uses sunlight as an entraining cue. The alarm clock can drive human activity rhythms but has little direct effect on our endogenous 24 hour physiology. In many situations, our biology and our society appear to be in serious opposition, and the damaging consequences to our health under these circumstances are increasingly recognised. The seasons dominate the lives of non-equatorial species, and until recently, they also had a marked influence on much of human biology. Despite human isolation from seasonal changes in temperature, food and photoperiod in the industrialised nations, the seasons still appear to have a small, but significant, impact upon when individuals are born and many aspects of health. The seasonal changes that modulate our biology, and how these factors might interact with the social and metabolic status of the individual to drive seasonal effects, are still poorly understood. Lunar cycles had, and continue to have, an influence upon human culture, though despite a persistent belief that our mental health and other behaviours are modulated by the phase of the moon, there is no solid evidence that human biology is in any way regulated by the lunar cycle.

The gravitation of the moon plays pivotal roles in the occurrence of the acute myocardial infarction

Acute myocardial infarction (AMI) is a social burden. However, being able to predict AMI could lead to prevention. A previous study showed only the relation between the lunar phase and the occurrence of AMI, but the period it takes for the moon to orbit around the earth and the period of the lunar phase differ. This study investigated the effect of the gravitation of the moon on AMI. Data was comprised of 1369 consecutive patients with first AMI at 5 hospitals from October, 1984 to December, 1997. The universal gravitation of the moon was calculated and compared to the earth onset time of AMI. Universal gravitation of the moon was derived by G*m/d(2) (G: universal gravitation constant, m: the mass of the moon, d: the distance between the center of the moon and the center of the earth). The relationship between m/d(2) and the cases of AMI was determined. There was an increase in cases, when there is a distance of more than 399864 km from the center of the earth to the center of the moon. The gravitation of more than 399864 km was determined to be weaker gravitation. It is confirmed that the number of AMI patients significantly increases at weaker gravitation periods in this multicenter trial. In conclusion, these results suggest that the gravitation of the moon may have an influence on the occurrence of AMI.

Association of environmental factors with the onset of status epilepticus

OBJECTIVE

The goal of the work described here was to investigate the influence of environmental factors on admissions of patients with status epilepticus (SE) to the intensive care unit (ICU).

METHODS

This retrospective cohort study analyzed all admissions to a university hospital ICU because of SE. Poisson regression and likelihood ratio tests were employed to determine associations between environmental factors and the incidence of SE.

RESULTS

Data on 184 patients (mean age: 57, range: 18-89) indicated a significant (P<0.0001) diurnal pattern, with admissions peaking between 4 and 5 PM and reaching a minimum in the early morning. No significant weekly, monthly, or seasonal pattern was observed. Admissions varied significantly across the lunar cycle (P=0.003), peaking at Day 3 after new moon and being minimal 3 days before new moon. The incidence of SE increased on bright days (P=0.04) and with the duration of daily sunshine (P=0.03). High relative humidity (P<0.01), high temperature (P<0.05), and dark days (P=0.02) were significantly protective factors. The incidence of SE on weekends was significantly lower in the subgroup of patients with known epilepsy (P=0.004), and the risk of nonconvulsive SE was significantly higher in summer (P=0.04).

CONCLUSIONS

Admissions of patients with SE to the ICU are significantly associated with several environmental protective and precipitating factors, such as diurnal, weekly, and lunar cycles and weather variables.

Cardiac arrest in public locations--an independent predictor for better outcome?

OBJECTIVE

Outcome after cardiac arrest is known to be influenced by immediate access to resuscitation. We aimed to analyse the location of arrest in relation to the prognostic value for outcome.

DESIGN

Retrospective review from prospective databases (ambulance routine documentation database and emergency department database on patients treated for cardiac arrest).

SETTING

Vienna (1.7 million inhabitants) ambulance service and tertiary care facility (university clinics).

PATIENTS

Two independent cohorts: (1) a population-based cohort of patients who were treated for cardiac arrest by the municipal ambulance service outside the hospital. The endpoint in this group was survival to hospital admission with spontaneous circulation. (2) A cohort of patients who were admitted to the emergency department after successful out of hospital resuscitation. The endpoint in this group was survival to 6 months with good neurological status (best Cerebral Performance Category 1 or 2 within 6 months).

MEASUREMENTS

We analysed whether the location of non-traumatic adult out-of-hospital cardiac arrest (public versus private place) was a predictor for good outcome.

RESULTS

PATIENTS who had cardiac arrest in a public location were more likely to arrive in hospital alive (39% versus 31%, crude OR 1.4, 95% CI 1.001-1.975, p=0.049) and were more likely to have a good neurological outcome after 6 months (35% versus 25%, crude OR 1.65, adjusted OR 1.59, 95% CI 1.07-2.36, p=0.023), compared to patients who had cardiac arrest in a non-public location.

CONCLUSION

Cardiac arrest in a public location is independently associated with a better outcome.

Are patient falls in the hospital associated with lunar cycles? A retrospective observational study

BACKGROUND

Falls and associated negative outcomes in hospitalized patients are of significant concerns. The etiology of hospital inpatient falls is multifactorial, including both intrinsic and extrinsic factors. Anecdotes from clinical practice exist in which health care professionals express the idea that the number of patient falls increases during times of full moon. The aim of this study was to examine in-hospital patient fall rates and their associations with days of the week, months, seasons and lunar cycles.

METHODS

3,842 fall incident reports of adult in-patients who fell while hospitalized in a 300-bed urban public hospital in Zurich, Switzerland were included. Adjusted fall rates per 1'000 patient days were compared with days of the week, months, and 62 complete lunar cycles from 1999 to 2003.

RESULTS

The fall rate per 1000 patient days fluctuated slightly over the entire observation time, ranging from 8.4 falls to 9.7 falls per month (P = 0.757), and from 8.3 falls on Mondays to 9.3 falls on Saturdays (P = 0.587). The fall rate per 1000 patient days within the lunar days ranged from 7.2 falls on lunar day 17 to 10.6 falls on lunar day 20 (P = 0.575).

CONCLUSION

The inpatient fall rates in this hospital were neither associated with days of the week, months, or seasons nor with lunar cycles such as full moon or new moon. Preventive strategies should be focused on patients' modifiable fall risk factors and the provision of organizational conditions which support a safe hospital environment.

The influence of the full moon on seizure frequency: myth or reality?

To investigate a possible relationship between seizure frequency and the lunar cycle, we reviewed the occurrence of seizures recorded in our epilepsy monitoring unit over a 3-year period. Analysis of the total number of seizures (epileptic plus nonepileptic) showed no significant association. A separate analysis revealed that for nonepileptic seizures, there was an increase at the full moon, and for epileptic seizures, an increase in the last quarter. We conclude that there is no "full moon" effect on seizures as a whole, although there is a possible effect on nonepileptic seizures.