GreenField Health Matters February 2022
Regeneron on Hold:
- With the drastic increase in the prevalence of the COVID omicron variant, the CDC and other large-scale national and international-level health organizations have been racing to study how the medical community can best respond. In the course of this study, we have found that Regeneron is very poorly effective against omicron. Because omicron now accounts for the majority of new cases diagnosed, the CDC has put the use of outpatient Regeneron on indefinite hold. This means GreenField will not be able to continue offering Regeneron for our patients until further notice. We will continue to keep our member community updated on this important matter
Changes to Annual Wellness Visits:
- Starting in the 2022 calendar year, insurance-mandated changes require that all annual wellness visits will be preventative only going forward. This means that while you may have new concerns or updates on chronic issues to discuss at annual wellness visits, separate appointments will need to be scheduled for those concerns. Do not hesitate to bring your concerns up to your provider, though - even if those require an additional visit, we will ensure that these are addressed in a timely and thorough manner
GreenField On Call for You 24/7
- The clinical team at GreenField is on call for all of our patients 24 hours a day, 7 days a week. That means that if you have any pressing need, question, or concern regarding your health, you can call on us at any time, and a clinician will be available to respond. Call support is available for patients of all ages. This is a benefit that we take pride in offering all GreenField members, and is one way we keep our commitment to reliably serving you. It is also one way we can help limit sometimes unnecessary/expensive/unpleasant trips to urgent care or the ER. Please do not hesitate to call us after/off hours when you need us!
Sleeping Well in the New Year
You may have heard that people require at least 8 hours of sleep per night for good health. Is this accurate? Are there other elements of sleep that matter, such as continuous versus broken sleep? When it comes to sleep and health, there are understandably a lot of questions to consider.
The evidence demonstrates that sleep need varies somewhat based upon age and individual - that is there is a range of ideal sleep volume that varies per person and per age category. At the high end of sleep need are infants, who require a total of 14-16 hours per 24-hour day. At the lower end are adults over 18 years old, for whom 7-9 hours per 24 hour cycle are necessary for optimal health.
So, if you are over 18 years old, ideally you want to get 7-9 hours of sleep total every calendar day. That does not mean, though, that all of those hours need to be contiguous for everyone. It is possible to have partially broken sleep and still get adequate sleep, provided that there is at least one uninterrupted 4-hour block of rest in there somewhere. This is because it takes roughly 4 hours to complete the 4-stage sleep cycle, and the final stage of that cycle is the most important for long-term brain health. That’s the stage that involves brain-specialty immune cells like microglia and others performing essential synapse strengthening, synapse pruning, and debris clean-up functions.
It is important to note that sleep patterns do naturally change over time. As we get older, we tend to fall asleep less easily and rouse from sleep more easily. This means more sleep disruption generally. And other obstacles can get in the way of healthy sleep patterns, too. For some folks, this disruption can increase the risks for mood disorders such as major depression, cardiovascular disease, cognitive decline, increased risk of infection, and so on. A night of disrupted sleep here and there is not enough to increase these risks substantially; the brain and body can accommodate to some degree, though focus and response time can suffer. The chronic risks really only rise in a meaningful way when the issue is chronic.
All of that said, it is very important to stress as little as possible about sleep. Many common sleep problems are contributed to or caused by anxiety about sleep, and sometimes not at all the lack of sleep itself. This can lead to a negative feedback loop – a bit of bad sleep leads to anxiety about sleeping which leads to poor sleep and more anxiety… you probably get the picture. It can become a vicious cycle.
There is a lot that can be done to optimize sleep, from sleep hygiene and lifestyle shifts to behavioral therapy, medications, and supplements. There are also a lot of purported therapies out there that are not beneficial, and still others can be outright harmful; for example, hypnotic medications such as Ambien and Lunesta are strongly linked to increased risks of death from all causes, as well as parasomnias. Additionally, those medications can contribute to cognitive decline themselves.
The bottom line is that we all need adequate sleep, but there are nuances. Some of us need more and some of us need less, though there are general guidelines worth following. You should not trouble yourself if you need more than 9 hours of sleep from time to time, nor is an occasional night of disrupted sleep worth stressing over too much. If sleep issues do become chronic, please discuss with the GreenField team. It would be our pleasure to support your sleep health this new year.
Collective New Year’s Resolution: Interpersonal Connectivity
And this leads us into our last topic for this month, which is staying social and connected.
Being connected can mean different things to different people. It can be as simple as calling or emailing a friend or loved one. It can also look more involved, like putting together a COVID-aware gathering or coordinating delivery of a care package to someone in need.
No matter how you feel comfortable connecting, it is key to recognize that as social animals, human nervous systems require positive interfacing with others on a regular basis in order to thrive and flourish. When this is absent or deficient, significant harm can occur; for example, when the use of social media supplants actual contact, or when someone is physically isolated, or when someone is repeatedly bullied, whether in person or online. In contrast, when adequate connectivity is present, health outcomes improve dramatically: the incidence of depression and anxiety are lower, cardiovascular disease outcomes improve, health behaviors shift to favor more wellness, and so on.
And meeting this need can be phenomenally simple. In fact, data demonstrate that the most impactful interactions that people have throughout their day are often the ones they have with others they know the least - including complete strangers! The recommendations from those in this field of study include starting a simple, kind exchange with someone on the street, on the trails of Forest Park, or in the store. Compliment their dog or their shoes, ask them how their day is going, wish them well, or flash a sincere smile (eyes can smile, too!). Let your GreenField team be a part of developing this new (or continuing this existing) habit. And the next time someone does you this service, thank them and notice how your day changes in response. You might find it has more impact than you think.
Your GreenField Integrative Physician, Dr. Matt Van Auken
And the entire team at GreenField Health