Recharge is different from other areas of self-care in the Circle of Health. Sometimes, rather than requiring that a person “do something,” enhancing health may involve not doing something. How might stillness–or taking a pause–fit in? Recharge can involve taking a break, or a vacation. In addition, a major focus for Recharge in many Integrative Health plans is sleep, which is essential to good health. This overview builds on the material in Chapter 9 of the Passport to Whole Health, specifically focusing on how sleep is influenced by all of the areas of the Circle of Health.

Key Points

• Good sleep has a multitude of health benefits; conversely, insomnia can be quite harmful to health and can contribute to decreased lifespan and risk of multiple chronic diseases.
• As you work with people to help them improve their sleep, there are many options available. Goals related to self-care, such as dietary changes or creating activity plans can help, as can working with stress using various mind-body tools, including those offered by Cognitive Behavioral Therapy for Insomnia (CBT-I).
• Professional care can also play an important role when it comes to Recharge. Dietary supplements (several are discussed), acupuncture, and pharmacotherapy all have their place, as do a number of other approaches.

Meet the Patient

Carl, a 62-year-old retired pilot, presents with complaints of poor sleep. His symptoms began when he started to fly on international routes and had to repeatedly deal with jet lag. He describes difficulty falling asleep and staying asleep. He occasionally has disturbing dreams relating to his service as an Air Force pilot Operation Desert Storm in his 20s. He has had a sleep study in the past, and it demonstrated mild obstructive sleep apnea, but he declined treatment with continuous positive airway pressure (CPAP).

Carl reports difficulty falling asleep unless he takes medication. He has tried multiple over-the-counter agents but feels groggy in the morning whenever he takes them. About three years ago, he was prescribed zolpidem 10 milligrams and initially found it to be effective. However, he has been using it essentially continuously for at least 18 months, and lately he has found it to be less effective. As a result, he has increased his dose to two tablets. His primary care physician has become concerned about the increased dose, and the pharmacist has expressed concerns about continued usage at this dose. Carl recently experienced a fall during a sleep-walking incident.