er visits on full moon

Dark side of the moon

‘full moon madness’ in the er: myth or reality, is there actually an increase in admissions and strange happenings in the emergency room when the moon is full emergency physicians weigh in..

Through centuries, the full moon has been associated with an array of strange phenomena, from witchcraft and werewolves to spikes in crime, traffic accidents and hospital admission rates.

Does the full moon really correlate to a rise in emergency room visits? Anecdotal evidence may say yes, but so far research hasn’t documented a strong link.

A 2011 study published in the World Journal of Surgery found that more than 40% of medical staff believe that lunar phases can affect human behavior, even though most studies find no direct correlation between the full moon and hospital admission rates.

A real occurrence?

In the view of many ER physicians, however, including AOA President John W. Becher, DO, “full moon madness” is a real phenomenon. Dr. Becher, who has practiced emergency medicine for nearly 40 years, recalled his experiences as chairman of emergency services at AtlantiCare Regional Medical Center in Atlantic City, New Jersey, where he is currently director of osteopathic medical education.

Adjacent to the center’s emergency department is an 11-bed psychiatric emergency center. “You could almost tell the phase of the moon by how crowded that area of the ED was,” says Dr. Becher. “Anytime the moon was full, that area was overflowing.”

Paul J. Allegretti, DO, agrees that the emergency department seems busier when the moon is full. He’s the program director for the emergency medicine residency at Midwestern University/Chicago College of Osteopathic Medicine (MWU/CCOM) in Downers Grove, Illinois. “I think people are sicker and it seems like more unusual things happen when the moon is full, though I don’t think I could ever prove it,” he says.

‘That’s just the nature of the ER’

Eric Moon, DO, an emergency room physician at St. Bernard Hospital in Chicago, has worked exclusively nights since he began practicing 12 years ago.

“For as long as I’ve worked in the emergency department, whenever there’s a full moon, invariably someone will make a comment about how it’s going to be a rough night,” he says. But Dr. Moon says chalking up eventful night shifts to the full moon is an incorrect assumption of cause and effect. “We frequently have crazy nights in the emergency room when the moon is full because that’s just the nature of the ER, no matter what phase the moon is in,” he explains.

What’s your take?

Is “full moon madness” a real phenomenon or a myth? Share your thoughts in the comments.

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I completely concur that we seem to have higher volumes and more bizarre presentations during a full moon.

I DISAGREE.

Full moon, plus 4th of July plus numerous other factors have appeared to increase weirdness in the hospital where I worked for quite a few years.

NEXT FULL MOON ON HALLOWEEN 31/OCT./2020

Agree with the Chief and Mark- increased volumes with high acuity of critical care and psych issues often seen with the full moon especially on Mondays!

Full moon+Monday+First of the month+Cool weather+Cold purple at 8pm= one heck of a night!!!

I DISAGREE. ALSO NEXT FULL MOON ON HALLOWEEN WILL BE 31/OCT/2020

NEXT FULL MOON ON HALLOWEEN 31/OCT/2020

NEXT FULL MOON HALLOWEEN 31/OCT/2020

If the next full moon falls on Halloween this week, it will be a bad example here in Chicago because it is not only Halloween, but also a Saturday. Chicago bars are open until 5am on Saturdays. Daylight savings falls on Halloween this year. The clock reset will give people an extra hour of intoxication. Bars will essentially be open until 6am here! I argue that any extra madness can be attributed to these other factors!

My experience strongly suggests that that are busier nights w/ a full moon. Wish that I had done a research paper on this- are there any EM residents out there reading this? or faculty?

Practicing EMED 30 years. Full moon seems to increase usual craziness. My unproven theory which the students and residents are probably tired of hearing, is that when a low pressure front approaches summer or winter ,the ER gets Very busy then decreases when past.

Yes it does!

Full moon and behavior data: http://faculty.washington.edu/chudler/moon.html

Dr. Conte, Please tell us WHY you so strongly disagree! We are interested to learn the reason you so adamantly state your opinion. Do you have good evidence the moon has no effect on the psyche.

Not only him, others but rare few across “Interwebs” to have the very same opinion.

And especially (not finger-pointing) the busier nights expense m”experiences” of EMTs.

I’m a counselor who evaluated people in the ER and the phenomenon is real. Period.

It could be that there is more light from the moon and so people are generally more active. Does the level of activity during a full moon vary depending on cloud coverage?

I just said the same thing without seeing your comment first.

The reasoning for this strange occurrence could be explained by the possibility that when there’s a full moon it’s brighter at night, leading to the possibility of more activity at night in general. If true, this would most likely cause an increase in ER visits in general.

More conception and deliveries w full moon, ICU Pts do worse. More alcohol and condoms sold and used. Just as the moon affects the tides…. our bodies are 80% water, it pulls on it like the ocean. Mostly the gravitational pull, less light affect, but some. It also relates to feeling better with high barometric rather than low.

The moon’s gravity has no effect on bounded water, that is, water inside the body.

As a 20 year , full time paramedic (active, on the streets , in a busy system) I’ll throw my two cents in.. I average at least 2 psych calls in a 12 hour shift, since 1997. They vary . Suicide attempts/gestures, depression , hallucinations, you name it. I still work night shift , full time . The amount of psych-related call does not increase because of the moon cycle. It may seem that way to some providers because the ‘full moon ‘ is a convenient source of blame. The holiday season doesn’t have a higher suicide rate either. Again, that’s a myth and an easy reason to blame … I respond to suicide attempts as much in July as in December The fact (because I’ve worked over 40,000 emergency 911 calls, I can state this as such) is that it is human nature to find reason, a cause, or something to blame for any and everything in life … As far as conceptions and births ..that’s out my scope … I hope the conception thing is right. A full moon can be quite romantic ..

I worked in the UK health service for two years dealing with emergency calls, so I experienced 24 full moons. There was no pattern and nor was there any attempt to increase staff cover on that date. It wasn’t ever mentioned. I’m not aware of any medical centre that takes account of the full moon in its roster of staff. People are strange all year round.

Supermoon 1/1-2/2018, the clinic was definitely crazier today dispenser nurse blames full supermoon

Much more rational response than anything else so far here. Scary that such a huge proportion of medical personnel are prey to superstition instead of enlightened by science. They should be convincingly ctiticizing defects in all the careful attempts to confirm the claim if they believe there is a real effect. Careful definitions of variables and consistent record keeping for a reasonable period of time should reveal even a mild effect, much more convincingly than their general impressions.

With statistics and large samples thereof, it shouldn’t be hard to crack this old chestnut, should it?

Of course its higher on and around full moon vs new moon. Visibility is like day light at night on a full moon, it means increased hours of activity, its innate, our ancestors would hunt these nights. More activity, more accidents, same goes for crime. You want evidence, give me the raw data, not some confirmation bias paper from some weirdo source. Opponents, why you look mad? I thought you supposed to be happy with facts. You look like you wanted me to be wrong on everything HAHAHA

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Dear Doctor: Is it true that there are more hospital emergency room visits during a full moon?

• Published: Jan. 18, 2024, 6:07 a.m.

Do more people visit the ER during a full moon? Getty Images Getty Images

• Dr. Keith Roach

DEAR DR. ROACH: Is there any truth to the belief that there are more hospital admissions or emergency room visits during a full moon? -- N.D.G.

ANSWER: As many as 40% of medical staff do believe that the moon affects ER visits and admissions, but the definitive answer is no. Multiple large studies have shown that there is no correlation to the number or type of ER visits during a full moon. One of my ER colleagues tells me that she thinks the ER staff doesn’t really believe it, and it’s just an expression that people say when they are busy. I’m not convinced that’s the case for everyone.

Humans are very good at finding patterns -- so good that we often see them even when they aren’t there. I can attest to the fact that during a particularly busy night in the ER, someone will often say that it must be a full moon. The times when there actually was a full moon tend to reinforce the belief, while the times that there wasn’t a full moon tend to be forgotten.

Careful observation with objective endpoints is necessary to prove or disprove this hypothesis. It is ironic that even people who use science all the time can make this mistake.

DEAR DR. ROACH: I am a 79-year-old man in relatively good health. I don’t take any medications. I recently visited a cardiologist regarding some heart palpitations that I have been experiencing. After a review of my laboratory tests, history and physical exams, and my electrocardiogram (EKG), the doctor told me that everything seemed fine.

A month after this visit, I went into my patient portal and reviewed the EKG, and to my surprise, it stated that there was an infarction in the septum. I read online that this can be a silent heart attack. The cardiologist didn’t mention these results at any time, so I called his office and spoke to his nurse, who relayed my concerns to him.

The nurse replied that the doctor had re-reviewed the EKG, and the result was a false positive. He said that there was no reason to be concerned, nor to have the EKG repeated. What do you think? -- Anon.

ANSWER: An EKG is a very useful, inexpensive, noninvasive way of finding out information about the heart. Unfortunately, the results are not always definitive.

I reviewed the EKG that you sent me, and you have a pattern called a QS in leads V1 and V2 (the electrical wires that attach to the chest). Although this can indicate a heart attack in the septum (the part of the heart between the ventricles), this is not the case approximately 80% of the time.

I agree with your cardiologist that it is very unlikely to represent a serious condition like a heart attack, especially given your excellent overall health. However, if you were my patient, the next time you came in, I would probably recheck the EKG with very careful attention to the placement of the leads. If the abnormal finding disappeared, you can be 100% certain that this EKG finding does not represent a heart attack.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.

(c) 2022 North America Syndicate Inc.

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Think Twice

Do emergency room visits increase during a full moon.

Photo from Time and Date

Nicole Kell

Many clinicians believe there may be more emergency room visits during a full moon. Some refer to this phenomena as “full moon madness”.  World Journal of Surgery published the results of a survey in 2011 that found “more than 40% of medical staff believe that lunar phases can affect human behavior, even though most studies find no direct correlation between the full moon and hospital admission rates.”

T hese types of false associations are a common consequence of the human mind’s skill at rationalization and pattern formation. It is why humans invented science: we need objective measurement to be sure we are not fooling ourselves or being fooled by others. This association has been addressed in several published studies, with the majority, and in particular those with better data, showing no association.  

https://thedo.osteopathic.org/2015/10/full-moon-madness-in-the-er-myth-or-reality/

https://www.ncbi.nlm.nih.gov/pubmed/15166467

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Does a Full Moon Make People Go to ER?

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Full Moon Madness, Reality or Myth?

We are all excited about watching the Super Snow Moon, which according to NASA will be the “biggest and brightest of 2019”. The full moon has been captivating human beings since the dawn of time and has been the main character in countless stories and legends. From werewolves, and vampires to ghostly apparitions.

ER’s are no strangers to full moon lore, there is no shortage of stories told by emergency room staff regarding crazy situations and unusual patient count during a full moon.

This is so much so the case, that even the Wall Street Journal published an article on the subject. In the article, they interviewed clinical staff from several hospitals and ER’s across the country and asked them to recount what it was like to work in an ER during a full moon.[/vc_column_text][us_image image=”25352″ size=”full”][vc_column_text]According to those interviewed, not only did a full moon mean an increase in patients, but they also said they treated more patients with rare ailments or injuries.

However, there is a little bit of a controversy between what hospital and ER staff see and believe compared to what studies have found.

One study from the American Journal of Medicine in which the data of one emergency room over 4 years was evaluated, concluded there were no significant increases in ER visits on full moon nights.

But other studies including one published in the Journal of Clinical Psychology did find a link between criminal behavior and psychiatric crises and the moon face. One study found that some crimes including rape, assault, drunkenness, and disorderly conduct occurred more frequently 3-days before to and after a full moon.[/vc_column_text][us_image image=”25353″ size=”full”][vc_column_text]So, is the full moon madness a reality or a myth? The answer is complicated as you can see. From our experience, our emergency centers on average see an increase of 6.75% in the number of patients we treat during the full moon. This happens consistently enough to suggest there is some truth to the idea that the full moon does have an influence on human behavior and health.

Whether you believe the moon has an influence over you or not, the best advice we can give you is to put aside all myths and if you get a chance catch a glimpse of the beautiful full moon. Nevertheless, it’s wise to always be careful and vigilant in any activity you do. Remember, an accident can occur any day at any time, while you are work, school, at the gym, while out to dinner, or even at home, full moon or not.

The good news is, Altus Emergency Centers will always be there to care of you and your loved ones. We are open 24 hours a day, seven days a week, on holidays and especially during full moons.[/vc_column_text][/vc_column][/vc_row]

BREAKING: Charges dropped against top golfer Scottie Scheffler after his arrest at the PGA Championship

Moon myths: How real are lunar health effects?

The moon holds a mystical place in the history of human culture, so it's no wonder that many myths — from werewolves to induced lunacy to epileptic seizures — have built up regarding its supposed effects on us.

"It must be a full moon," is a phrase heard whenever crazy things happen and is said by researchers to be muttered commonly by late-night cops, psychiatry staff and emergency room personnel.

It's been a long time since the Big Cheese revealed any new secrets as important as this week's announcement that traces of water exist all across its surface. Coincidentally, a study this week found zero connection between the full moon and surgery outcomes.

In fact a host of studies over the years have aimed at teasing out any statistical connection between the moon — particularly the full moon — and human biology or behavior. The majority of sound studies find no connection, while some have proved inconclusive, and many that purported to reveal connections turned out to involve flawed methods or have never been reproduced.

Reliable studies comparing the lunar phases to births, heart attacks, deaths, suicides, violence, psychiatric hospital admissions and epileptic seizures, among other things, have over and over again found little or no connection.

One possible indirect link: Before modern lighting, the light of a full moon have kept people up at night, leading to sleep deprivation that could have caused other psychological issues, according to one hypothesis that awaits data support.

Below, I'll review several studies — the good, the bad and the in between — but first some basic physics:

The moon, tides and you The human body is about 75 percent water, and so people often ask whether tides are at work inside us.

The moon and the sun combine to create tides in Earth's oceans (in fact the gravitational effect is so strong that our planet's crust is stretched daily by these same tidal effects).

But tides are large-scale events. They occur because of the difference in gravitational effect on one side of an object (like Earth) compared to the other. Here's how they work ( full explanation of tides ):

The ocean on the side of Earth facing the moon gets pulled toward the moon more than does the center of the planet. This creates a high tide. On the other side of the Earth, another high tide occurs, because the center of Earth is being pulled toward the moon more than is the ocean on the far side. The result essentially pulls the planet away from the ocean (a negative force that effectively lifts the ocean away from the planet).

However, there's no measurable difference in the moon's gravitational effect to one side of your body vs. the other. Even in a large lake, tides are extremely minor. On the Great Lakes, for example, tides never exceed 2 inches, according to the National Oceanic and Atmospheric Administration (NOAA), which adds, "These minor variations are masked by the greater fluctuations in lake levels produced by wind and barometric pressure changes. Consequently, the Great Lakes are considered to be essentially non-tidal."

That's not to say tides don't exist at smaller scales.

The effect of gravity diminishes with distance, but never goes away. So in theory everything in the universe is tugging on everything else. But: "Researchers have calculated that a mother holding her baby exerts 12 million times the tide-raising force on the child than the moon does, simply by virtue of being closer," according to Straightdope.com, a Web site that applies logic and reason to myths and urban legends.

Consider also that tides in Earth's oceans happen twice every day as Earth spins on its axis every 24 hours, bringing the moon constantly up and down in the sky. If the moon's tugging affected the human body, one might presume we'd be off balance at least twice a day (and maybe we are).

Studies of full moon effects Here are some of the reputable studies in peer-reviewed journals that have failed to find connections:

EPILEPSY : A study in the journal Epilepsy & Behavior in 2004 found no connection between epileptic seizures and the full moon, even though some patients believe their seizures to be trigged by the full moon. The researchers noted that epileptic seizures were once blamed on witchcraft and possession by demons, contributing to a longstanding human propensity to find mythical rather than medical explanations.

PSYCHIATRIC VISITS: A 2005 study by Mayo Clinic researchers, reported in the journal Psychiatric Services, looked at how many patients checked into a psychiatric emergency department between 6 p.m. and 6 a.m. over several years. They found no statistical difference in the number of visits on the three nights surrounding full moons vs. other nights.

EMERGENCY ROOM VISITS: Researchers examined 150,999 records of emergency room visits to a suburban hospital. Their study, reported in American Journal of Emergency Medicine in 1996, found no difference at full moon vs. other nights.

SURGERY OUTCOMES : Do doctors and nurses mess up more during the full moon? Not according to a study in the October 2009 issue of the journal Anesthesiology. In fact, researchers found the risks are the same no matter what day of the week or time of the month you schedule your coronary artery bypass graft surgery.

Not all studies dismiss lunar influence.

PET INJURIES : In studying 11,940 cases at the Colorado State University Veterinary Medical Center, researchers found the risk of emergency room visits to be 23 percent higher for cats and 28 percent higher for dogs on days surrounding full moons. It could be people tend to take pets out more during the full moon, raising the odds of an injury, or perhaps something else is at work — the study did not determine a cause.

MENSTRUATION: This is one of those topics on which you will find much speculation (some of it firm and convincing-sounding) and little evidence. The idea is that the moon is full every month and women menstruate monthly. Here's the thing: Women's menstrual cycles actually vary in length and timing — in some cases greatly — with the average being about every 28 days, while the lunar cycle is quite set at 29.5 days. Still, there is one study (of just 312 women), by Winnifred B. Cutler in 1980, published in the American Journal of Obstetrics & Gynecology, that claims a connection. Cutler found 40 percent of participants had the onset of menstruation within two weeks of the full moon (which means 60 percent didn't). If anyone can tell me how this oft-cited study proves anything, I'm all ears. Also, one should be skeptical that in the intervening 29 years, nobody seems to have produced a study supporting Cutler's claim.

ANIMALS GONE WILD : A pair of conflicting studies in the British Medical Journal in 2001 leaves room for further research. In one of the studies, animal bites were found to have sent twice as many British people to the emergency room during full moons compared with other days. But in the other study, in Australia, dogs were found to bite people with similar frequency on any night.

SLEEP DEPRIVATION: In the Journal of Affective Disorders in 1999, researchers suggested that before modern lighting, "the moon was a significant source of nocturnal illumination that affected [the] sleep–wake cycle, tending to cause sleep deprivation around the time of full moon." They speculated that "this partial sleep deprivation would have been sufficient to induce mania/hypomania in susceptible bipolar patients and seizures in patients with seizure disorders." Best I can discern, however, these oft-cited suggestions have never been tested or verified with any numbers or rigorous study of any kind.

Myths persist If one presumes that modern lighting and mini-blinds have pretty much eliminated the one plausible source of human-related moon madness, why do so many myths persist?

Several researchers point out one likely answer: When strange things happen at full moon, people notice the "coincidental" big bright orb in the sky and wonder. When strange things happen during the rest of the month, well, they're just considered strange, and people don't tie them to celestial events. "If police and doctors are expecting that full moon nights will be more hectic, they may interpret an ordinary night's traumas and crises as more extreme than usual," explains our Bad Science Columnist Benjamin Radford . "Our expectations influence our perceptions, and we look for evidence that confirms our beliefs."

And that leads to this final note, which is perhaps the biggest logical nail in the coffin of the moon madness myths:

The highest tides occur not just at full moon but also at new moon, when the moon is between Earth and the sun (and we cannot see the moon) and our planet feels the combined gravitational effect of these two objects. Yet nobody ever claims any funny stuff related to the new moon (except for the fact that there is more beach pollution at full and new moon ...).

Top 10 Amazing Moon Facts

Top 10 Unexplained Phenomena How Moon Phases Work

In The Water Cooler , Imaginova's Editorial Director Robert Roy Britt looks at what people are talking about in the world of science and beyond. Find more in the archives and on Twitter .

WIAT Birmingham

Do full moons really lead to more ER visits? This Alabama doctor says yes

Posted: July 5, 2023 | Last updated: April 3, 2024

A 30-year doctor says it’s not just an old tale that emergency rooms fill up on full moons. There’s a legitimate term for it. And it’s also the time when doctors see “some of the more interesting things that occur.”

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Does the full moon increase ER visits? Is this a myth or a fact?

• by Michael Simpson

Years ago, my girlfriend was the trauma department director, and she constantly claimed that there were more ER visits during a full moon. Now, I was much nicer to her than I would be to an anti-vaxxer, so I kind of laughed. But I wasn’t so sure.

Then I kept hearing that claim from who I thought were rational and sane physicians. They just firmly believed that ER visits skyrocketed during a full moon. I knew there would be data out there to support or debunk this claim, so today, as we approach a full moon, to find out what’s out there.

Let’s take a look at the evidence, and hopefully, settle the question for a long time. And I’m going to take bets that several ER physicians will post in the comments their anecdotes that “prove” their beliefs.

ER visits and a full moon — what say the evidence?

Believe it or not, this topic has been the subject of actual research published in real peer-reviewed medical journals. This simplifies my life because I thought I would have to dig through some obscure database, and then actually have to pull out my ancient statistical analysis “skills” to decipher the data. Lucky for me, someone has already done the hard work for me.

In a paper published in March 1996 in the American Journal of Emergency Medicine , emergency physicians David A Thompson, MD and Stephen L Adams, MD examined 150,999 patient visits to an ED (emergency department) during the four-year study period. While this emergency department experienced 49 full moons over that period, there was no statistical difference in emergency room visits between a full moon and other days. The authors concluded:

No significant differences were found in total patient visits, ambulance runs, admissions to the hospital, or admissions to a monitored unit on days of the full moon. The occurrence of a full moon has no effect on ED patient volume, ambulance runs, admissions, or admissions to a monitored unit.

In an article published in Nursing Research , Jean-Luc Margot, Ph.D., Professor, Department of Earth, Planetary, and Space Sciences and Department of Physics and Astronomy, University of California, Los Angeles, examined whether the full moon had any effect on birth rates or hospital admission rates. Basically, Margo re-analyzed data from a paper that claimed that the full moon had a positive effect on the rates of birth and hospital admissions. Dr. Margot concluded:

Their report contains a number of methodological and statistical flaws that invalidate their conclusions. Reanalysis of their data with proper procedures shows no evidence that the full moon influences the rate of hospital admissions, a result that is consistent with numerous peer-reviewed studies and meta-analyses. A review of the literature shows that birth rates are also uncorrelated to lunar phases.

In a paper published in Pediatric Emergency Care , the researchers analyzed pediatric psychiatric ED visits between 2009 and 2011. Patients aged between 4 and 21 years presenting to Miami Children’s Hospital ED with a primary psychiatric complaint were included in the study. The authors found:

Our results failed to show a statistical significance when comparing the number of pediatric psychiatric patients presenting to a children’s hospital ED during a full moon and a non-full moon date.

In an article published in May 2019 in Circulation Reports , Japanese researchers examined a total of 29,552 OHCA (out-of-hospital cardiac arrest) that occurred on 148 full moon nights and 58,707 OHCA that occurred on 296 control nights. What did they conclude?

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

In an article published in July 1989 in the Annals of Emergency Medicine, the authors examined a total of 1,444 trauma victims admitted to the hospital during one calendar year. Full moons were defined as three-day periods in the 29.531-day lunar cycle, with the middle day being described in the world almanac as the full moon. Once again, the authors concluded, “that the belief in the deleterious effects of the full moon on major trauma is statistically unfounded.”

I could keep going, but I think I’m going to bore the reader. The overwhelming majority of papers published on this topic showed that there was no increase in ER visits, trauma, psychiatric emergencies, or anything during a full moon.

There are no biologically plausible links between the full moon and sudden emergencies. Now it’s possible that a full moon might be responsible for automobile accidents , but the effect is small and might just become statistical noise over a year.

I think this full moon myth is largely based on anecdotes and confirmation bias . On the evenings of a full moon, maybe the physicians and nurses in the emergency room remember patient visits more than on other days, and then it feels like the full moon has something to do with it.

But this belief has real-world consequences. Many emergency departments add extra staff on full moon evenings. And that comes at added cost to the hospital.

As Kaiser Permanente’s Chair of Emergency Medicine Chiefs, Karen Murrell, MD had to say:

For over thirty years in the ED, working in a variety of settings, I have heard about the effects of the full moon hundreds of times from ED staff of all levels. Some hospitals even rearrange staffing unnecessarily and at cost. While there may be a random bad year when some hospitals have an increase in patients, it is comforting to know that this has nothing to do with the status of the moon and we can base our staffing predictions on real-time data.

• Coates W, Jehle D, Cottington E. Trauma and the full moon: a waning theory . Ann Emerg Med. 1989 Jul;18(7):763-5. doi: 10.1016/s0196-0644(89)80014-9. PMID: 2735596.
• Kamat S, Maniaci V, Linares MY, Lozano JM. Pediatric psychiatric emergency department visits during a full moon . Pediatr Emerg Care. 2014 Dec;30(12):875-8. doi: 10.1097/PEC.0000000000000291. PMID: 25407032.
• Margot JL. No evidence of purported lunar effect on hospital admission rates or birth rates . Nurs Res. 2015 May-Jun;64(3):168-73; discussion 173-5. doi: 10.1097/NNR.0000000000000086. PMID: 25756232; PMCID: PMC4418782.
• Onozuka D, Nishimura K, Hagihara A. Full moon and traffic accident-related emergency ambulance transport: A nationwide case-crossover study . Sci Total Environ. 2018 Dec 10;644:801-805. doi: 10.1016/j.scitotenv.2018.07.053. Epub 2018 Jul 11. PMID: 29990928.
• Román EM, Soriano G, Fuentes M, Gálvez ML, Fernández C. The influence of the full moon on the number of admissions related to gastrointestinal bleeding . Int J Nurs Pract. 2004 Dec;10(6):292-6. doi: 10.1111/j.1440-172x.2004.00492.x. PMID: 15544585.
• Sado J, Morikawa K, Hattori S, Kiyohara K, Matsuyama T, Izawa J, Iwami T, Kitamura Y, Sobue T, Kitamura T. Full Moon and Out-of-Hospital Cardiac Arrest in Japan　- Population-Based, Double-Controlled Case Series Analysis . Circ Rep. 2019 May 8;1(5):212-218. doi: 10.1253/circrep.CR-18-0030. PMID: 33693140; PMCID: PMC7889489.
• Thompson DA, Adams SL. The full moon and ED patient volumes: unearthing a myth . Am J Emerg Med. 1996 Mar;14(2):161-4. doi: 10.1016/S0735-6757(96)90124-2. PMID: 8924138.
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The full moon and ED patient volumes: Unearthing a myth

Research output : Contribution to journal › Article › peer-review

To determine if there is any effect of the full moon on emergency department (ED) patient volume, ambulance runs, admissions, or admissions to a monitored unit, a retrospective analysis of the hospital electronic records of all patients seen in an ED during a 4-year period was conducted in an ED of a suburban community hospital. A full moon occurred 49 times during the 4- year study period. There were 150,999 patient visits to the ED during the study period, of which 34,649 patients arrived by ambulance. A total of 35,007 patients was admitted to the hospital and 11,278 patients were admitted to a monitored unit. No significant differences were found in total patient visits, ambulance runs, admissions to the hospital, or admissions to a monitored unit on days of the full moon. The occurrence of a full moon has no effect on ED patient volume, ambulance runs, admissions, or admissions to a monitored unit.

• emergency department

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• Emergency Medicine

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• 10.1016/S0735-6757(96)90124-2

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• patients INIS 100%
• volume INIS 100%
• emergencies INIS 100%
• moon INIS 100%
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• Patient Nursing and Health Professions 100%
• Ambulance Nursing and Health Professions 66%

T1 - The full moon and ED patient volumes

T2 - Unearthing a myth

AU - Thompson, David A.

AU - Adams, Stephen L.

N2 - To determine if there is any effect of the full moon on emergency department (ED) patient volume, ambulance runs, admissions, or admissions to a monitored unit, a retrospective analysis of the hospital electronic records of all patients seen in an ED during a 4-year period was conducted in an ED of a suburban community hospital. A full moon occurred 49 times during the 4- year study period. There were 150,999 patient visits to the ED during the study period, of which 34,649 patients arrived by ambulance. A total of 35,007 patients was admitted to the hospital and 11,278 patients were admitted to a monitored unit. No significant differences were found in total patient visits, ambulance runs, admissions to the hospital, or admissions to a monitored unit on days of the full moon. The occurrence of a full moon has no effect on ED patient volume, ambulance runs, admissions, or admissions to a monitored unit.

AB - To determine if there is any effect of the full moon on emergency department (ED) patient volume, ambulance runs, admissions, or admissions to a monitored unit, a retrospective analysis of the hospital electronic records of all patients seen in an ED during a 4-year period was conducted in an ED of a suburban community hospital. A full moon occurred 49 times during the 4- year study period. There were 150,999 patient visits to the ED during the study period, of which 34,649 patients arrived by ambulance. A total of 35,007 patients was admitted to the hospital and 11,278 patients were admitted to a monitored unit. No significant differences were found in total patient visits, ambulance runs, admissions to the hospital, or admissions to a monitored unit on days of the full moon. The occurrence of a full moon has no effect on ED patient volume, ambulance runs, admissions, or admissions to a monitored unit.

KW - Full moon

KW - ambulance

KW - emergency department

KW - patients

UR - http://www.scopus.com/inward/record.url?scp=0029876183&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029876183&partnerID=8YFLogxK

U2 - 10.1016/S0735-6757(96)90124-2

DO - 10.1016/S0735-6757(96)90124-2

M3 - Article

C2 - 8924138

AN - SCOPUS:0029876183

SN - 0735-6757

JO - American Journal of Emergency Medicine

JF - American Journal of Emergency Medicine

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Assessment of effects of moon phases on hospital outpatient visits: An observational national study

1 Research Quality Management Section, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Kingdom of Saudi Arabia

Aldilas Achmad Nursetyo

2 Center for Health Policy Management, Universitas Gadjah Mada, Indonesia

Usman Iqbal

3 Health ICT, Department of Health, Tasmania, Australia

4 Global Health and Health Security Department, College of Public Health, Taipei Medical University, Taipei, Taiwan

5 International Center for Health Information Technology, Taipei Medical University, Taiwan

Phung-Anh Nguyen

6 Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan

7 Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan

8 Research Center of Health Care Industry Data Science, College of Management, Taipei Medical University, Taipei, Taiwan

Wen-Shan Jian

9 School of Hospital Health care Administration, Taipei Medical University, Taiwan. No 250 Wu-Hsing Street, Taipei 110, Taiwan

Yu-Chuan Li

10 Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taiwan. No 250 Wu-Hsing Street, Taipei 110, Taiwan

11 Research Center of Cancer Translational Medicine, Taipei Medical University, Taiwan

Shabbir Syed-Abdul

A vast amount of literature has been conducted for investigating the association of different lunar phases with human health; and it has mixed reviews for association and non-association of diseases with lunar phases. This study investigates the existence of any impact of moon phases on humans by exploring the difference in the rate of outpatient visits and type of diseases that prevail in either non-moon or moon phases.

We retrieved dates of non-moon and moon phases for eight years (1st January 2001–31st December 2008) from the timeanddate.com website for Taiwan. The study cohort consisted of 1 million people from Taiwan's National Health Insurance Research Database (NHIRD) followed over eight years (1st January 2001–31st December 2008). We used the two-tailed, paired-t-test to compare the significance of difference among outpatient visits for 1229 moon phase days and 1074 non-moon phase days by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from NHIRD records.

We found 58 diseases that showed statistical differences in number of outpatient visits in the non-moon and moon phases.

Conclusions

The results of our study identified diseases that have significant variations during different lunar phases (non-moon and moon phases) for outpatient visits in the hospital. In order to fully understand the reality of the pervasive myth of lunar effects on human health, behaviors and diseases, more in-depth research investigations are required for providing comprehensive evidence covering all the factors, such as biological, psychological and environmental aspects.

1. Introduction

A vast amount of literature has been conducted in this field for investigating the association of different lunar phases with mental health, physical health, various diseases and human reproduction. The literature has mixed reviews in terms of association and non-association of diseases with lunar phases. Some studies have found the linkage of the birth month with neurological, reproductive, endocrine, immunological and inflammatory diseases in the lifespan [1] – [12] . Similarly, some studies have found a link between the moon and psychiatric, neurological and vascular illnesses [1] , [2] , [13] – [18] . On the other hand, some studies have found the non-association / non-correlation of lunar phases with the medical conditions ranging from cardiac arrest to mental pathologies [18] – [24] . Similarly, few detailed review and meta-analysis found insufficient or very less evidence to support the relationship between lunar cycles and human biology, birth, health aspects and other related activities [25] – [27] . Moreover, some studies assessing the influence of the moon on the seizure, ischemic stroke and heart attack have shown inconclusive results [18] , [28] – [30] .

With the advancement of technology, the existence of various online databases has enabled different data analysis, exploration and mining options. The availability of online databases, like dateandtime.com website [31] , which deals with the time and dates related information, such as calendar, world clock, time zones, weather, sun and moon, and other calculators, has facilitated the time and dates based analysis. One of the important features provided by this database is the provision of data based on the lunar calendar. The scope of Electronic Medical Records (EMR) or Electronic Health Records (EHRs), which is the digital version of paper-based health information, varies globally [15] . Though the primary purpose of using EHR is to provide accurate, real-time and up-to-date patient information to the healthcare professionals in order to facilitate patient care and treatment; but secondarily EHR can also be used as an invaluable resource for supporting research, such as epidemiological, observational, safety and quality improvement research. In addition to the main feature of providing the administrative healthcare support, the Administrative Healthcare Databases (AHDB), such as Pharmacy and Health Insurance Databases, are also an important resource for health studies, e.g. population-based health monitoring and disease management studies. Though these systems are mainly used for billing and administration, they can also be used by researchers for mining the long-term data in order to see the impact of health interventions on healthcare systems in the real world [32] . Publically released in the year 2000, Taiwan's National Health Insurance Research Database (NHIRD) [33] is one of the largest administrative healthcare databases in the world and has been used for variety of research studies. By combining the above mentioned timeanddate.com database [31] and NHIRD [33] , our research utilizes 1 million patients data covering time period of eight years (from 1 st January 2001 to 31 st December 2008) from NHIRD and dates of moon phases for eight years' time period (from 1 st January 2001 to 31 st December 2008). It investigates the existence of possible differences in the rate of outpatient visits and the type of diseases that prevail in lunar phases (“lluminated fraction < 50%” vs. “illuminated fraction >50%”). We refer to phases with illuminated fraction < 50% as ‘non-moon phases’ and phases with illuminated fraction > 50% as ‘moon phases’. To the best of our knowledge, this is the first of its kind study that provides observational evidence by following the rates of outpatient visits over lunar months with one of the largest sample size, i.e. 1 million cohort.

The methodology of this study is explained in the following three phases:

Phase 1: For this study, the third quarter and new moon phases were defined as ‘non-moon phase’, and the first quarter and full moon phases were defined as ‘moon phase’ [16] . We retrieved dates of moon phases for eight years of study period from January 2001–December 2008 from the website timeanddate.com. We excluded the lunar new year week (non-moon phase) and all the Sundays in the study period. The lunar new year starts on a new moon day (non-moon phase) with one-week vacation. The hospital outpatient clinics and general physicians' offices are closed for the entire week. This is followed by a slight rise in outpatient visits in the following week, which is the first-quarter period of the moon phase. Therefore, we have excluded one non-moon phase (Lunar new year week) and the following week (moon phase). However, Saturdays and bank holidays were included because outpatient clinics work half-day at that time, and there was also no significant difference between the number of bank holidays in the non-moon and moon phases. Table 1 shows the characteristics of the population's age and sex, and the number of visits per day in each phase. We used Chi-square test to compare observed number of hospital visits in the moon and non-moon phases. P-value indicates the statistical significance of the difference.

Phase 2: We analyzed the outpatient visits for 1229 moon phase days and 1074 non-moon phase days by using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - 3 digit codes [31] . Our analysis included only the primary diseases (first disease code from the prescriptions) for each visit and diseases with over 1000 visits in the study period. As there were fewer days in the non-moon phase than in the moon phase, therefore we estimated the rate of outpatient visits per day for each primary disease. Since this is a secondary analysis of data, therefore no IRB approval was required.

Phase 3: We used the two-tailed, paired-t-test to compare the significance of the difference, if any, in the number of outpatient visits in both moon and non-moon phases for each disease, over 88 lunar months of the study period.

The results of the analysis showed that there were 58 diseases that showed statistical differences in number of outpatient visits in the non-moon and moon phases. We also estimated the mean difference per 1000 visits (see Figure 1 ). The results showed the diseases pertaining to ‘Acute Pulmonary Heart Disease’, ‘Injury to Blood Vessels of Lower Extremity and Unspecified Sites’ and ‘Coal Workers’ Pneumoconiosis' to be outstanding with a mean difference of 67.62, 60.65 and 47.76 respectively more visits in the moon phase. Meanwhile, ‘Cholera’, ‘Intestinal Helminthiases’ and ‘Disorders of Kidney and Ureter’ were outstanding in the non-moon phase with a mean difference of 46.60, 28.14 and 18.01 more visits, respectively.

4. Discussion

For the comparative analysis, the results from our study were compared with the previous related studies in this field. The results from the study conducted by Kazemi-Bajestani [34] using 5431 patient sample showed a slight increase for visits to psychiatric emergency room in the period of the full moon, as well as a significant increase in the severity of illness and aggressive behaviors in the start and end of moon cycles. In another study, Ahmad [2] investigated the link of lunar phases with medically unexplained stroke for the admissions of 7219 patients, found significant increase during the full moon phases, and reported no admission variation in the other significant days. But these individual studies do not appear to withstand scrutiny and meta-analyses show no effect. A different study from Finland [35] looked at the data involving 2111 male and 494 female victims from Oulu for suicidal occurrences during different lunar phases. The results revealed that there was a statistically significant gender difference during winter season in the lunar phases of suicides where full moon accounted for 40% of suicides in female and 24.3% in male. In addition, the association of full moon was statistically significant for premenopausal women that were younger than 45 years of age only. It raised the question that why only females (premenopausal females) showed the winter suicide peak at full moon, and acknowledged that universally there is no consensus for synchrony between the menstrual cycle and the moon phase.

Moreover, the study from Alhumoud [36] using 62,203 sample patients found that lunar cycle had no effects on hospital emergency room visits by mentally ill patients. Yang [37] using 559 patients analysis found that the environmental factors, such as full moon phase or supermoon event are not responsible for the increased visits to emergency departments for renal colic.

Although previous studies investigated the lunar phase effects on patients with specific conditions or diseases, e.g. Kazemi-Bajestani [34] and Alhumoud [36] looked at psychiatric patients, Yang [37] studied patients with renal colic disease, and Ahmad [2] considered stroke condition; they were having limited sample size. On the other hand, our study considered a wide domain of all outpatient visits during the time period of eight years, and the cohort consisted of 1 million population. Some aspects of a study from Boland [3] were similar to our work, as it had a large cohort, but it only evaluated the seasonality dependent disease risks effect based on the birth month, reported 55 significantly dependent diseases, and evaluated SNOMED-CT codes in terms of clinical contents. In comparison to that, our study reported 58 diseases, and showed statistical differences in non-moon and moon phases covering 88 lunar months in terms of clinical records, moreover our work was based on ICD-9 CM codes.

To the best of our knowledge, our study provided the first observational evidence by following the rates of outpatient visits over 88 lunar months with 1 million sample size. This study revealed the diseases which were prevalent either in the non-moon or moon phases. Figure 1 showed that diseases from all categories presented significant variations in outpatient visit rates in the moon phase. The utilization of 1 million cohort from NHIRD over the time period of eight years covers wide aspects of outpatient visits and diseases, therefore our study had certain limitations. The number of visits in the outpatient departments was extracted from NHIRD through e-Claims from Taiwan's hospitals / clinics. In general, the same patient could visit the hospitals multiple times in different phases of the moon, but we only considered the number of visits and reasons of the visits to the hospitals. For example, if a patient with hypertension visited the hospital 10 times a year, we counted the number of his visits in both moon phases and non-moon phases, and accumulated these differences for all the patients with hypertension visiting hospitals for eight years. We assumed that if there is no effect of moon phase, the number of visits will not be significantly different for eight years.

In our approach, we did not perform the Generalized Linear Mixed Models (GLMMs) and Generalized Estimating Equation (GEE) analysis methods because we were not claiming any casual relationships or effects of the moon, but were merely reporting the observations.

Though the patients' visits were held in multiple hospitals, but all hospitals had the same coding standards provided by NHIRD, as we used the ICD-9 CM codes. In addition, patients usually received 3 to 5 disease codes for each visit, where the first codes represented the reasons of the visits and other codes represented the co-morbidities or chronic conditions, e.g. if a diabetic patient visited the hospital with a lung problem, pulmonary heart disease would be the first code; therefore no code adjustment was required.

The moon's influence on the gravity, magnetic flux, atmospheric pressure, luminosity of the earth, and how moon affects human disease pathogenesis and behaviors, requires further in-depth investigation. These findings will reignite debate among researchers and clinicians as to find the truth about the myth of lunar effects on human health, behaviors and diseases.

We would also like to acknowledge that we excluded both the lunar new year holiday week and the following week. The lunar cycle is 29.53 days. There are 14.765 days of “non-moon phases” and 14.765 days of “moon phases”. By removing the new year week and the week following that, we removed 50% of the non-moon events during that cycle, but they removed only 47% of the moon events during that cycle. This procedure might introduce a substantial and systematic over-counting of “moon phase” events compared to “non-moon phase” events.

It is important to mention that due to our study limitations, we only considered the physiological changes / biological effect of lunar phases on the outpatient visits; but there are also other factors, such as psychological and environmental aspect that can have an impact on patients' health and behaviors along with diseases. The related literature also elucidated the influence of gravitational pull on the human body and other similar aspects in this field. Hence, the future studies should be conducted in order to understand all the triggering factors and to have a holistic picture. Similar to our future work suggestions, some review articles, e.g. Zimecki [40] also discussed that the exact mechanism through which the moon affects behavior and physiology is still not clear and has to be further investigated.

5. Conclusions

To the best of our knowledge, this unique study provided the first observational evidence by following the rates of outpatient visits over 88 lunar months using 1 million cohort and identified 58 diseases with significant variations through statistical differences. This data would allow other researchers to confirm that the counts are accurate, to independently compute the differences, and to perform independent statistical tests in the future. Finally, in order to fully understand this phenomenon, more in-depth research investigations are required that should provide comprehensive evidence by covering all the factors, such as biological, psychological and environmental aspects in this domain.

Acknowledgments

Not applicable.

Conflict of interest: The authors declare that they have no conflict of interest.

It’s a Full Moon Tonight

To determine whether or not psychiatric emergencies or ED visits or EMS runs are related to the full moon phase of the lunar cycle, one must minimize anecdotal experience and bias and evaluate the actual data in an objective and scientific way.

It’s an almost universal belief among emergency medical personnel that patient volumes and patient behavior are affected by the phases of the moon. Particularly, many believe that EMS calls, ED visits, childbirth, psychiatric behavior and numerous other things increase during the full moon phase of the lunar cycle. But, is this belief true? Most will recount their personal experience with things that occurred in their life during full moons. However, as with many things, belief does not always translate into reality.

For many years, the term “lunacy” was used to describe insanity and mental illness. Someone who had “lunacy” was described as being a “lunatic.” The term lunatic was actually derived from the Latin word lunaticus , which literally means “of the moon.”

Prior to the modern era, many illnesses were thought to be caused by the moon including mental illness and epilepsy. For many years, the terms “lunatic” and “lunacy” were used in the legal setting to describe people with mental illness. Fortunately, with a better understanding of most disease processes, these terms are now considered archaic.

In order to determine whether or not psychiatric emergencies or ED visits or EMS runs are related to the full moon phase of the lunar cycle, one must evaluate the actual data in an objective and scientific way. This is the only way to minimize anecdotal experience and bias. Interestingly, this has been done for several conditions, although the scientific literature specifically for EMS is limited.

To study this, it is first necessary to define a full moon or full moon phase. Most studies define a full moon as a three-day period beginning the day before the full moon and ending the day after the full moon. Some will use a five-day period beginning two days before the full moon and ending two days after the full moon.

The lunar cycle consists of multiple phases of the moon based upon how much of the lighted part of the moon is visible. This is often reported as the lunar month that is defined as the time between two successive full moons. There are approximately 29.5 days in a lunar month although these vary somewhat during the year. There are approximately 13 lunar months in a Gregorian year and the number of full moons in a calendar year will vary.

It is believed by some of the gravitational pull of the moon, which causes the tides, can have an effect on the human body causing behavioral and physiologic changes. However, in humans, this has not been identified. Some conditions have been investigated in terms of the effect of the lunar cycle on them. Here are a few examples:

1. Are heart attacks and cardiac arrests more common during a full moon? In a New Jersey study, researchers did a retrospective analysis of northern New Jersey EDs from January 1, 1988, to December 31, 1998. They then looked at the incidence of cardiac arrest during the previously defined full moon phase. They evaluated 2,370,233 ED visits during the study. There were 6,827 patients with a diagnosis of cardiopulmonary resuscitation. The occurrence of cardiopulmonary resuscitation was not more common during the full moon interval. 1

An Austrian study retrospectively looked at 368 cardiac arrest and 872 episodes of acute myocardial infarction over a six-year period (1992—1998). They concluded that lunar phases do not appear to correlate with acute coronary events leading to myocardial infarction or sudden death. 2

2. Do intracranial aneurysms rupture more often during full moon periods? It has been thought by some that the development of acute neurologic and vascular orders may be related to the phase of the moon. In one study, researchers looked at patients admitted to the hospital for ruptured intracranial aneurysms between 2011 and 2014. Overall, 186 patients were found with these conditions. They determined that the phases of the moon were not associated with the incidence of intracranial aneurysm rupture. 3 Other studies reached the same conclusion. 4 One found ruptures were actually more common when the moon was least luminated (i.e., new moon). 5

3. Are kidney stones more common during a full moon? Some have thought that the gravitational effect of the full moon can cause the movement of kidney stones, and thus there is an increased incidence of kidney stone during full moon phases. In a Swiss study, researchers evaluated all patients greater than 18 years of age who went to the ED in Bern over a 11- year interval with renal colic. There was a total of 1,500 consecutive patients who presented with kidney stones during the study interval. They were unable to associate an increased incidence of kidney stones with the full moon phase. 6 A similar study at the University of Nebraska come to the same conclusion. 7

4. Are psychiatric emergencies more common during a full moon? It is assumed by many that a full moon causes worsening psychosis for patients with mental illness. However, the available scientific evidence reveals this to be a false belief. A 2017 study of 1,857 who presented to their ED with a psychiatric component found no difference in the number of visits during a full moon phase. 8 A Mayo Clinic study found no association between psychosis and a full moon. 9 The same holds true for pediatric psychiatric patients. 10 A German study found no association between suicide and a full moon. 11

5. Is childbirth more common during a full moon? A longstanding belief is that the number of childbirths increase during a full moon phase. However, this is not the case. An Irish study of 10,027 deliveries over an 18-month period found no increase in deliveries during the full moon phase. 12 Multiple other studies have failed to find an association between childbirth and a full moon. 13—15

6. Are emergencies more common during a full moon? For the most part, there is no evidence that ED visits, EMS runs or similar emergencies occur more frequently during a full moon phase. An Illinois study evaluated ED visits over a four-year interval (1989—1993). They concluded that there was no relationship between ED volume, ambulance runs, admissions, or admissions to monitored care during the full moon phase. 16

A German study looked at the incidence of trauma during various lunar phases as well Friday the 13th and during the twelve Zodiac signs and found no association. 17 There was no increase in dog bites during a full moon. 18 Interestingly, there appears to be an increased incident of motorcycle collisions during the full moon phase. However, this was thought to be from driver distraction because of the full moon. 19 Otherwise, a full moon has no impact on the occurrence of emergencies. 20

So, how did these beliefs develop and why do they persist? First, they have been passed down from times when many medical problems were generally believed to be related to the lunar cycle. Also, it has been documented that animal behavior can be affected by the moon. For example, births in cattle are more frequent during a full moon phase but this is an evolutionary tool to minimize loss of calves by predators.

The best explanation, simply, is human nature. Most people will remember and note a full moon because the appearance is so striking. They will then recall EMS runs and certain things that are associated with a full moon. Most people do not even notice the other lunar phases (e.g., new moon, crescent moon, gibbous moon) and do not tend to associate EMS calls with these lunar phases.

Storytelling is common in EMS and medicine and there are no better stories than full moon stories. But, although great to recount for the rookie EMT, they are nothing but another EMS myth.

1. Alves DW, Allegra JR, Cochrane DG, et al. Effect of lunar cycle on temporal variation in cardiopulmonary arrest in seven emergency departments during 11 years. Eur J Emerg Med. 2003;10(3):225—228.

2. Eisenburger P, Schreiber W, Vergeiner G, et al. Lunar phases are not related to the occurrence of acute myocardial infarction and sudden cardiac death. Resuscitation. 2003;56(2):187—189.

3. Bunevicius A, Gendvilaite A, Deltuva VP, et al. The association between lunar phase and intracranial aneurysm rupture: Myth or reality? Own data and systematic review. BMC Neurol. 2017;17(1):99.

4. Wamp MA, Dibue M, Slotty P Jr, et al. Impact of the moon on cerebral aneurysm rupture. Acta Neurochir (Wien). 2013;155(8):1525—1530.

5. Banfield JC, Abdoleel M, Shankar JS. Secular pattern of aneurismal rupture with the lunar cycle and season. Interv Neuroradiol . 2017;23(1):60—63.

6. Arampatzis S, Thalmann GN, Zimmermann H, et al. Lunar tractive forces and renal stone incidence. Emerg Med Int. 2011;2011:813460.

7. Yang AW, Johnson JD, Fronczak CM, et al. Lunar phases and emergency department visits for renal colic due to ureteral calculus. PLoS One. 2016;11:e0157589.

8. Francis OJ, Kopke BJ, Affatato AJ, et al. Psychiatric presentations during all 4 phases of the lunar cycle. Adv Mind Body Med. 2017;31(3):4—7.

9. Kung S, Mrazek DA. Psychiatric emergency department visits on full-moon nights. Psychiatr Serv. 2005;56(2):221—222.

10. Arampatzis S, Thalmann GN, Zimmermann H, et al. Lunar tractive forces and renal stone incidence. Emerg Med Int. 2011;2011:813460.

11. Biermann T, Estel D, Sperling W, et al. Influence of lunar phases on suicide: the end of a myth? A population-based study. Chronobiol Int. 2005;22(6):1137—1143.

12. Ong S, Wingfield M, McQuillan K. Labour ward activity and the lunar cycle. J Obstet Gynaecol. 1998;18(6):538—539.

13. Ochiai AM, Gonçalves FL, Ambrizzi T, et al. Atmospheric conditions, lunar phases, and childbirth: A multivariate analysis. Int J Biometeorol. 2012;56(4):661—667.

14. Margot JL. No evidence of purported lunar effect on hospital admission rates or birth rates. Nurs Res. 2015;64(3):168—173; discussion 173—175.

15. Arliss JM, Kaplan EN, Galvin SL. The effect of the lunar cycle on frequency of births and birth complications. Am J Obstet Gynecol. 2005;192(5):1462—1464.

16. Thompson DA, Adams SL. The full moon and ED patient volumes: Unearthing a myth. Am J Emerg Med. 1996;14(2):161—164.

17. Schuld J, Slotta JE, Schuld S, et al. Popular belief meets surgical reality: Impact of lunar phases, Friday the 13th and zodiac signs on emergency operations and intraoperative blood loss. World J Surg. 2011;35(9):1945—1949.

18. Chapman S, Morrell S. Barking mad? Another lunatic hypothesis bites the dust. BMJ . 2000;321(7726):1561—1563.

19. Redelmeier DA, Shafir E. The full moon and motorcycle related mortality: Population based double control study. BMJ. 2017;359:j5367.

20. Coates W, Jehle D, Cottington E. Trauma and the full moon: A waning theory. Ann Emerg Med . 1989;18(7):763—765.

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• United Kingdom

Even Doctors Believe The Moon Brings Chaos

Even doctors & nurses believe the full moon brings chaos, more from spirit, r29 original series.

Lunar phase cycle and psychiatric hospital emergency visits, inpatient admissions and aggressive behavior

Affiliation.

• 1 Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
• PMID: 23050914
• DOI: 10.1016/j.ajp.2010.12.002

Introduction: We examined the correlation between lunar cycles and the number of psychiatric emergency visits, patients' gender, aggressive behavior, need for inpatient admission, legal referral and need for involuntary chemical restraint in a period of one calendar year.

Method: Charts of all psychiatric emergency room patients were reviewed retrospectively. Arabic calendar lunar months were divided based on three different models: Two 15 days sections, three 10 days, and six 5 days parts in the third model.

Results: 5431 patients were seen in the psychiatric emergency service (PES) during a one year period. We did not find a relationship between the visit time (day or night), gender, and legal referral in relation to moon cycles. A higher number of visits during full moon period which was not statistically significant (P>0.05) was found. Highest frequency of inpatient admissions was discovered in the first and last parts of the three part model and in the first and last segments of the six part model followed by second and fifth parts (P-values: 0.000).

Conclusion: This study revealed a slight increase in number of visits to psychiatric emergency room during full moon periods. In addition a highly significant increase in the severity of illness and aggressive behaviors and agitation in the beginning and end of the moon cycles were noticed. Some of the underlying possible causes such as changes in intra/extracellular fluids, neural and endocrine cell functions, hemodynamic and biological responses and changes in social dynamics and support are discussed.

Copyright © 2011 Elsevier B.V. All rights reserved.

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What May's full moon in Sagittarius means for you

The full moon in May is nicknamed the Flower Moon because of — you guessed it — the flowers the bloom in spring.

This month's lunation falls in the sign of Sagittarius, aiming to heighten our wanderlust and autonomous spirit. It’s a moment in which we will be able to assert our visions into the world and make them a reality.

The Flower Moon is the last Full Moon of spring and urges us to wrap up matters to begin new ones. Lean into the abundance and growth that we’ll all experience. Most importantly, use the positive energy to have fun and expand our knowledge. 

How can you see May 2024’s full moon?

May's full moon rises on May 23 at 9:53 a.m. and will appear full for about three days.

What is the astrological meaning of May 2024’s full moon?

Powerful Pluto, who’s retrograde in Aquarius gives us the drive to take action. With Venus entering Gemini later in the day, we’ll be in good condition to start manifesting our dreams.

Heather Roan Robbins, astrologer and author of Starcodes: Navigate Your Chart with Choice-Based Astrology , says this full moon “can also bring a bittersweet end to one chapter and help us seed a new one, so roll with it if it’s time to say goodbye to a limited mindset or shallow way of seeing the world.”

"Think locally but act globally; world events can open our hearts and affect us locally. Explore food from another culture, be drawn to foreign accents, connect the natural world, and consider dancing the night away," she recommends.

How the May 2024 moon may affect your sign

Your impulse to fight for what you want is high, urging you to step back and decipher if you will take a grandstand. Understand that people may not defend you as much as you account for them, so you should ensure they’re fully invested in the relationship before taking action.

Consolidate your financial matters and come up with a constructive way to solve what's giving you anxiety. You’ll be able to come up with the best answers to your financial struggles.

Focus on how you can improve relationships during this lunation. You may discover parts of yourself or a partner that allow you to connect on a deeper level. Not only that, but you’ll want to hash out past issues to create a harmonious partnership that has the capacity to grow.

You are extremely busy with work, errands, and tasks — so much so that you’re beginning to feel burnt out. Give yourself time to relax and pause from all of the projects and social affairs that are going on. Revive your spirit with a beneficial self-care activity to recenter your energy.

Don’t hold yourself back! Take more risks in the work you do and let your talents shine. Be willing to share what you create, and let your peers acknowledge your amazingness which will lead to your success.

Since you’re constantly extending your energy to helping others, it’s time to focus on doing what makes you happy and fills your heart with joy. Extend your heart to helping yourself because you’re the most important person in your life.

Although it’ll be tempting to get involved in petty gossip, it might create significant problems for yourself because you’ll be perpetuating the rumor, which can put you in trouble. Try to steer clear of false information and keep your head out of drama.

Your confidence is booming now, allowing you to speak your mind with ease. When you let your feelings be known, you’re able to deepen and ignite the bond that you have with others that can last a lifetime.

Sagittarius

Don’t use your energy to fight the same dragons twice. Learn from your past mistakes and focus on the future. As long as you put the energy into manifesting something for yourself, it will feel like the stars are pushing you toward greatness.

Take a break from the social scene. Try to restore your senses and have peace of mind because you’ve been working hard and burning the midnight oil.

Aligning with the cause that helps people flourish and evolve will bring you a sense of pride and joy. Invest your time and energy into a humanitarian cause that speaks to your heart. Invite friends to participate and allow you to let your visions be known to get more participants.

If you’ve been planting the seeds for a promotion, now is the time to strike. Management is willing to grant you a higher-yielding position because you’ve earned it. Not only that, but they’ll applaud you for a job well done because you put in the effort, and they’ve seen it.

Lisa Stardust is a New York City-based astrologer. Stardust is the resident astrologer for Oprah Magazine, Teen Vogue and The Hoodwitch. She has two upcoming books: “Saturn Return Survival Guide: Navigating this cosmic rite of passage” is due out this May from Hardie Grant Books and “The Cosmic Deck” from Chronicle Books is due out in November. Follow Lisa on Instagram for her daily horoscopes @lisastardustastro.

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Aries June 2024 Horoscope: Read Your Monthly Predictions

By Sophie Saint Thomas

Read your sign's 2024 horoscope to see what's in store for you this year, or check out the   Aries personality profile .

Happy June, Aries . During May , despite some potential hiccups within your friend group, the stars brought opportunities for professional growth as well as time to rest. Now, this month is rich with changes for clear communication, self-care, and even spiritual introspection. Perhaps it's time to give tarot a whirl to help you connect with the divine, especially when Saturn goes retrograde at the end of the month.

But first, the cosmos advises you to tap into your signature assertive nature. Monday, June 3 sees chatty Mercury entering Gemini, its home sign, enhancing your ability to express yourself effectively. This transit is perfect for promoting your business or projects as your confidence and authenticity shine, making it an excellent period for marketing. It's also advantageous for expressing your needs in relationships. In particular, the inky new moon , a time for fresh starts, in Gemini on Thursday, June 6 marks an ideal day for initiating important conversations, whether they're about new creative ventures or defining relationships. If you're looking for an astro-approved day to talk about relationship statuses or launch a project on social media, this is it.

If that all sounds a bit exhausting, don't worry. June is absolutely not all about the hustle. On Saturday, June 8, Mars, your ruling planet, moves into luxurious Taurus. Even the warrior planet likes to lounge sometimes. This transit invites you to indulge in life’s finer things—think comfy bedding , relaxing in front of the TV, or getting cozy with your pet and a good book. It’s a reminder that enjoying downtime and treating yourself isn’t just okay. It’s necessary. Rest is a crucial investment into long-term productivity. Just think about how hard it is to get anything done when you're feeling anxious.

Try to integrate that leisurely vibe into your whole routine. A potentially tense aspect arises on Tuesday, June 11 as your ruler Mars squares (a stressful aspect) Pluto, the planet of death and rebirth. You may feel you have to fight to maintain your individuality and core values. Perhaps a family member is asking you to come visit and when you explain that it's just plain impossible with your schedule, they try to guilt-trip you. Or you may feel like you're losing yourself in a corporate environment. Prioritize self-care as suggested earlier to navigate this challenging period without feeling like you're sacrificing your agency.

Shortly after, on Sunday, June 16 , loving Venus glides into Cancer, putting you in a domestic mood. This date also happens to be Father’s Day . While for some Aries this is a super fun day with dad, for others with more complicated family situations, it's a reminder to reach out to friends. Such traditional holidays can be emotionally taxing and not just for you. It's more than okay to lean heavily on your chosen family around this time.

Earlier this month, around the new moon, was a pretty calm time ideal for promoting a business online. However, try not to spend more time on social media than you need to. When messenger Mercury moves out of its home sign of Gemini and into cozy Cancer on Monday, June 17 , the stars are encouraging you to take a break from the digital world. From influencers fear-mongering about the faux dangers of sunscreen to comparing your face to celebrities who have millions to spend on plastic surgery, it can be hard to feel good while staring at your screen. Mercury in Cancer is all about analog communication, so use this time to focus on IRL hangs.

Speaking of IRL hangs: If you're dating, hooking up with someone, or are just really into your sex toys , expect to feel like a sex goddess on and around Wednesday, June 19 when Vesta, the asteroid of sacred sexuality, moves into proud Leo. If you're more in the mood for a sweet, rather than spicy, spiritual celebration, know that when Cancer season begins on Thursday, June 20 , it also marks the magical holiday of Litha. According to legend, this is when the fairies like to come play on the human plane. Celebrate the longest day of the year with whimsical activities like wearing a flower crown or indulging in fairy-approved makeup .

While June is largely about taking it easy, be on the lookout for welcome professional news on Friday, June 21 , which features a full moon in ambitious Capricorn. Then, the lovely month starts to come to a close with Capricorn's ruling planet, Saturn, going retrograde in Pisces on Saturday, June 29 , which, as you may recall, is a time for reevaluating your spiritual practice and connecting with the divine. Enjoy the major month, and we'll see you in July.

Monday, June 3: Mercury enters Gemini Thursday, June 6: New moon in Gemini Saturday, June 8: Mars enters Taurus Sunday, June 16: Venus enters Cancer Monday, June 17: Mercury enters Cancer Wednesday, June 19: Vesta enters Leo Thursday, June 20: Sun enters Cancer Friday, June 21: Full moon in Capricorn Saturday, June 29: Saturn goes retrograde

To see monthly predictions for another zodiac sign, check out our full list of June 2024 horoscopes .

Read up on astrological events:

What's in store for your sign this year? Read our 2024 horoscope predictions to find out.

What is a twin flame, and how is it different from a soul mate?

Discover the 12 zodiac signs & their personality traits

A guide to angel numbers and what they mean

The ultimate Mercury retrograde survival guide

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Tonight's 'Flower Moon' will rise close to a red supergiant star

May 2024's full moon, also known as the Flower Moon and the Planting Moon, will be at its fullest on Thursday, May 23. It will also appear bright and full on Friday.

May's full moon, known as the Flower Moon, will be at its fullest tonight (Thursday, May 23), and shine close to the bright star Antares. The moon will also appear bright and full on Friday.

May's full moon is called the Flower Moon, after the plentiful flowers that bloom during this month in the Northern Hemisphere, according to Timeanddate.com . Other names for May's full moon include the Milk Moon, Mothers' Moon, Bright Moon, Hare Moon and Grass Moon. Many Anishinaabe, or Ojibwe, Indigenous people of the Great Lakes region know it as Nimebine Giizis, or Sucker Moon, according to the Center for Native American Studies .

Since the moon turns full at 9:53 a.m. EDT on May 23, there is no ideal time this month to watch the full moon rise in a twilight sky. 

Related: What would happen if the moon disappeared tomorrow?

Check the moonrise and moonset times for your location and find a place to observe from with a low view of the eastern horizon. 

— See a SpaceX rocket photobomb the moon in incredible award-winning shot

— See photos of NASA's suitcase-sized rovers that will soon map the moon's surface

— Defying the odds, Japan's SLIM lander survives 2nd night on the moon

However, tonight you will be able to view it alongside the bright star Antares — the brightest star in the constellation Scorpius, the scorpion. Antares, a red supergiant star, will be visible to the lower left of the full moon as it rises. It has an unmistakable red tint, particularly through a pair of stargazing binoculars or a good small telescope . It's one of the few very bright stars the moon appears close to during its orbit. 

The next full moon will be the Strawberry Moon on Friday, June 21. This is the first full moon of summer in the Northern Hemisphere and winter in the Southern Hemisphere, and will occur just a day after the 2024 summer solstice . 

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Jamie Carter is a freelance journalist and regular Live Science contributor based in Cardiff, U.K. He is the author of A Stargazing Program For Beginners and lectures on astronomy and the natural world. Jamie regularly writes for Space.com, TechRadar.com, Forbes Science, BBC Wildlife magazine and Scientific American, and many others. He edits WhenIsTheNextEclipse.com .

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Legalized Weed Is Landing More Seniors in the E.R.

In Canada, cannabis poisonings rose sharply among people 65 and older after the country legalized the drug, a new study found.

By Matt Richtel

As more places legalize marijuana, policymakers and health officials have worried about the health risks that the drug may pose to adolescents. But a new study suggests that an additional demographic is at risk: seniors.

The study, published Monday in JAMA Internal Medicine , found that after Canada legalized marijuana, the number of emergency room visits for cannabis poisoning rose sharply among people ages 65 and older. Poisonings doubled after Canada legalized sale of the cannabis flower, and then tripled just 15 months later, when Canada legalized the sale of edibles.

“It’s often a baked good, a chocolate or a gummy,” said Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital and researcher at Women’s College Hospital in Toronto, and lead author on the study. Dr. Stall noted that researchers and emergency room doctors were finding that seniors used drugs intentionally but also sometimes by accident, when edibles were mistaken for regular food or snacks.

Symptoms of cannabis poisoning can include dizziness, confusion, nausea, loss of coordination and balance, drowsiness and hallucinations.

The findings were consistent with other research published in the United States, Dr. Stall said, and showed that more attention needed to be paid to drug use by seniors , and to the health effects.

“It’s somewhat in the shadows, and there is some ageism and bias in thinking that older adults aren’t using drugs,” Dr. Stall said.

The study looked at 2,322 emergency room visits for cannabis poisoning among people 65 and older in Ontario. The visits spanned 2015 through 2022, allowing researchers to see what happened before and after October 2018, when Canada legalized the sale of dried cannabis, and January 2020, when the sale of edibles was legalized.

In 2015, there were 55 emergency room visits caused by cannabis poisoning. That figure rose steadily to 462 by 2021, and then fell off slightly to 404 in 2022.

Dr. Stall said he was motivated to undertake the study after being called into the emergency room to consult on an octogenarian who was experiencing severe confusion. The patient was barely conscious and showed strokelike symptoms. Multiple tests revealed no clear cause, until Dr. Stall ordered a toxicology test and found cannabis in the patient’s urine.

When Dr. Stall disclosed the finding, he said, a family member of the patient who was present at the bedside “went beet red and realized that the older adult had got into their edible cannabis product and mistaken it for food .”

Dr. Stall said that the patient was hospitalized and given supportive care, and that there was not a specific treatment or antidote for such poisonings.

Why the Increase?

The study did not look at why seniors overdosed, but Dr. Stall said that he and other doctors were seeing poisonings caused by accidental ingestion as well as intentional use of edibles for recreation or medicinal reasons.

There are several reasons seniors might be prone to overdose, Dr. Stall said. Many cannabis strains are far more potent than in past decades, and seniors who used the drug earlier in life may underestimate the concentrations of THC they are inhaling or ingesting. Particularly with edibles, Dr. Stall said, the high can take about three hours to unfold, which might prompt users to ingest too much in the buildup.

Older adults also metabolize cannabis differently from younger people, Dr. Stall said, and their bodies eliminate the drug more slowly. Seniors also are more likely than younger people to take other medications, including psychoactive drugs for sleep, that can have problematic interactions with cannabis. And, Dr. Stall said, some seniors might already be prone to confusion or falling, which the use of cannabis could worsen.

“The question is What do we do about it?” Dr. Stall said.

What Can Be Done

Dr. Stall noted the importance of ensuring edibles were kept in locked locations and in clearly identified packaging, to prevent unintentional exposure.

Also, he said, policymakers should encourage senior-specific dosing information for cannabis, along with public-education campaigns about the kinds of conditions and circumstances that put older adults at risk when using the drug. He added that seniors who are experimenting with cannabis for the first time might want to draw from a mantra used in geriatric medicine: “Start low and go slow.”

“That would mean starting lower and going slower than a younger population who is trying cannabis for a first time,” Dr. Stall said.

Matt Richtel is a health and science reporter for The Times, based in Boulder, Colo. More about Matt Richtel