4/15/16  

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WHOLE  HEALTH:      

Change  the  Conversa5on  

Recharge    

VETERANS  HEALTH  ADMINISTRATION  

Recharge

Sleep is the only medicine that gives ease.

-Sophocles

4/15/16  

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VETERANS  HEALTH  ADMINISTRATION  

Recharge – Health for Life Video Office of Patient Centered Care & Cultural Transformation

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VETERANS  HEALTH  ADMINISTRATION  

Recharge: Rest and Refresh CDC Data

•  42%  greater  chance  of  obesity  •  69%  more  hypertension  •  40%  more  diabetes  •  36%  increase  in  elevated  lipids  •  62%  greater  risk  of  stroke  •  152%  increase  in  MI’s  

 Altman  NG,  et  al.    Sleep  2011;34(abstract  suppl):A57.  

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Nationalgeographic.com

For those with <5 hours (versus >7 hours of sleep):

4/15/16  

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The  Importance  of  Light  

And  Dark  

4/15/16  

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VETERANS  HEALTH  ADMINISTRATION  

Circadian Rhythms and Health

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4/15/16  

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VETERANS  HEALTH  ADMINISTRATION  

CBT-I and Mindfulness for Insomnia: Both Work!

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VETERANS  HEALTH  ADMINISTRATION  

Mindfulness Sleep Induction

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4/15/16  

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VETERANS  HEALTH  ADMINISTRATION  

Raising Melatonin Levels

•  Good  Sleep-­‐Wake  cycle  –   (7-­‐8  hrs  of  uninterrupted  sleep  in  darkness)      

•  Remove  EMFs  around  bed    

•  Maintain  ideal  weight  (Û  BMI=ÜMelatonin)    

•  If  able,  remove  drugs  that  lower  melatonin  – Beta-­‐blockers,  C  channel  blockers,  an\psycho\cs,  an\-­‐depressants  and  an\-­‐convulsants.  

VETERANS  HEALTH  ADMINISTRATION  

Light Therapy Works - No Matter the Season

11 Lam,  et  al.  Efficacy  of  Bright  Light  Treatment,  Fluoxe\ne,  and  the  Combina\on  in  Pa\ents  With  Nonseasonal  Major  Depressive  Disorder.  A  Randomized  Clinical  Trial.  Jama  Psychiatry.  Nov.  2015  

4/15/16  

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Light  Therapy  for  Depression  

   

VETERANS  HEALTH  ADMINISTRATION  

Light Therapy Pearls

•  The  dose  is  2,500-­‐10,000  lux  of  light  for  20-­‐60  minutes,  2-­‐3  \mes  a  day.  Start  at  20  minutes  twice  a  day  (morning  and  early  adernoon).  

•  Morning  therapy  is  most  effec\ve.  

•  The  lightbox  should  be  within  three  feet  and  the  individual  should  not  look  directly  into  the  light.  

 

•  Encourage  exercise  outdoors  on  a    sunny  day.  

4/15/16  

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VETERANS  HEALTH  ADMINISTRATION  

Vacation: Refresh & Refuel

• How  do  you  feel  ader  coming  back  from  vaca\on?  

 

• How  can  you  perceive  work  in  a  similar  light?  

 

• What  refreshes  and  energizes  you?  

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