Sleep, Stress & Peak Performance: Dr. Kirk Parsley on Healing the High-Achiever

On this episode of the Synergy Podcast, we're joined by Dr. Kirk Arsley, affectionately known as Doc, a former Navy SEAL who turned his focus to medicine and the science of sleep. After a decade of peak performance in one of the world's most elite forces, Doc realized the transformative power of quality sleep. As an undersea medical officer for the SEALs, he witnessed the devastating effects of sleep deprivation and developed the groundbreaking sleep remedy to help optimize recovery and performance. Tune in as Doc shares his journey and the critical role sleep plays in achieving peak mental and physical health.

Welcome back, Synergy listeners. Lori and I are so excited to have Kirk Parsley, Dr. Kirk Parsley, with us today, affectionately known as Doc Parsley, joining us. And I want to really let him dig into his story because I think his story is pretty fascinating. Lori and I are both recovered marathon runners, so we've been into the fitness world and kind of extreme things, so. And so he takes that to a whole new level, and I want to hear him tell his story.

Well, I guess I'll start. You know, I joined the military right out of high school. You know, I was a terrorist, terrible student my whole life. I started getting D's and F's in like, third grade. After four years of high school, I was a sophomore, so I dropped out of high school and joined the Navy. And I'd heard about this Navy SEAL training, supposed to be like the toughest training in the world. I didn't know what a Navy SEAL was, but I wanted to do the toughest training the world. So I went and signed up for that, made it through that. And then I, I did about six, I did six years, a little over six years in the Navy. And then I got out and was, you know, being a high school dropout, kind of had some ambitions around kind of maybe an athletic trainer. Like a, you know, athletic trainer is kind of thing, strength and conditioning coach maybe, but like stretch goal, maybe a pt. And so I started volunteering at San Diego Sports Medicine center to get my volunteer hours, because you need 2, 000 volunteer hours to apply to PT School, which is craziest thing I've ever heard of. And then they hired me pretty quickly. And after about six months there, like, they hired me as a PT assistant or PC aide. And after about six months there, I decided I didn't really want to be a pt. And I worked with a bunch of. This was like a healthcare mecca. It had every kind of, every kind of healthc care professional you could think of. And I worked with a bunch of doctors who are about, about my age because I'd been in the military. So they're maybe two or three years older than me and they're like, oh, you should you go to medical school? And yeah, we're like, pump the brakes there, Sparky. Yeah, I, I didn't even graduate high school. Like I'm in junior college. Right. And you know, long story around that, but eventually they kind of talked me into thinking that was possible. And so I tried to get into medical school and when I took the MCATs and had all my coursework done, you know, before the Internet was a big thing, I had to go down the bookstore and pull out the Kaplan review book.

Right.

Well, I'm competitive for. And that's when I found out that the military had their own medical school. And I was like, wow, like I.

I didn't know idea.

And I was already married, I already had a kid, I had another kid on the way. So it's kind of a no brainer, you know, they're going to pay, you go to medical school instead of the other way around. And, and I, I figured I'd get back to the SEAL teams and be able to give back to that community, which, you know, was instrumental in shaping me as a man and as an adult. And you know, you know, my only experience with medicine was as, was an, was as an athlete or a seal. And so it was all pretty much orthopedic, like sports medicine, injuries. Right. And so that's really all I thought medicine was. And so when I went to medical school, I thought I was going to be an orthopedic surgeon or maybe a sports medicine doctor, I don't know, something like that. And you know, when medical schools, you know, shaped everything, you know, did my rotations, really liked ortho, I was shaping everything towards that. But the way the military works is you do your first year of residency and then they make you go out into the fleet and be a general practitioner for a couple of years and then you can come back and finish, I guess, you know, partially to test, you know, your commitment to that.

Right.

But also so that they have general practitioners or everyone would just specialize and stay in the hospitals. So, so I did that and went, went back to the SEAL teams and, you know, I worked at San Diego Sports Medicine center the whole time I was in college, you know, which was six years because I had to do two years of junior college just to qualify for college. And then, and then, of course I, you know, like I said, I really shaped all my Medical school training towards ortho. And I get to the SEAL teams and, you know, it's. It's a bureaucratic funding organization, right? So it takes about 10 years to get the money for a project that they approve. And so they just gotten the money to build the very first sports medicine facility the SEAL teams had ever had. And I, like, like, coincidentally, the exact same month that I transferred.

Timing, right?

I was like. And. And they're like, well, you're perfect. You should supervise the build out of this clinic. I'm like, yeah, I am perfect for this. This would be great. And then, of course, I, you know, we had to. Hi. Like, we hired our first physical therapist and our first trainer and strength and conditioning coaches and nutritionist and all this. And we, and I, you know, supervised the build out, like the physical build out and equipment purchase. And I, you know, helped hire all these professionals. And we had. We had great people. I mean, we had people from professional sports teams from the Olympic Training center, from D1 Colleges. You know, we. Creme de la creme. And then I worked with a Navy hospital to, you know, to bring rounds through. So I had, like, pain rounds coming through and ortho rounds coming through. We had a chiropractor coming through. We had acupuncture coming through. So then I was the dumbest guy around, right? I have this guy with one year of residency training and. And I'm supposed to be, you know, running this facility. And so when you're. And when you're in the military and you're the dumbest guy around, they put you in charge and say, you, well, you're a leader now. Yeah. Like, you supervise all these people. And I'm like, okay. I don't really know what that means. But, like, everybody there knew their job way better than I did. So I'm like, okay, I'll. So I had an office inside this center, but I didn't truly have a job. And seals. Seals are a lot like professional athletes. And that the. The worst. The worst possible outcome they can think of is for you to put them on the bench. Them out of their job is the worst thing that can happen to them. And so they usually don't tell their doctors anything. You know, they lie about everything. They, you know, there's mandatory, you know, checkups and physicals, and they just go in there and everything's great, man. Not a single problem, right? And then they spend money out of their pocket and they'll go find a doctor in town to treat whatever problem they're actually having. And so because I'd been a SEAL and, and I'd been a SEAL recently enough to where there are a lot of seals there that I trained with and deployed with and obviously had a good enough reputation where the guys trusted me. And so guys started coming in my office and closing the door behind him and say, hey, let me, let me tell you what's really going on with me. And you know, it. I can elaborate for your audience if you want, but for y', all, I know you'll, you'll understand it. They look like 55 to 65 year old men with, with metabolic syndrome, right?

But they were, what, how old were they?

Their labs look like. And they were 28 to. Yeah, they had six pack abs and they're ripped. But you look at their labs, every marker and you know, because I, I had no idea, idea. Like they came in and they said, you know, my motivation sucks, my sex drive sucks, my concentration sucks, my mood control sucks, I'm getting fatter, I'm getting weaker, I'm doing everything the nutritionist says, I'm doing everything the strength and conditioning coaches says, and I'm getting fatter, I'm getting weaker, I'm getting slower. My, I can't remember things, I can't concentrate. You know, interestingly, they never complained about sleep because part of SEAL training is a week without sleep, right? So our community, our community is like, ah, sleep's a luxury, right? But I would get a list of their medications and I'm, I'm embarrassed to say how long it took. I don't remember exactly. But it was. A lot of guys had come in my office and told me the same story, right? Because once one guy came in and told me a story that was therapeutic for him and he thought I was going to help him. And I was like, I don't. And I was honest, like, I have no idea. Like I don't have a clue. But we'll figure it out. So I just tested everything I knew how to test. I'm just like 98 lab markers. Just go do this, go to the hospital and get all this. And I just, I'd look and of course, everything anabolic was low, everything catabolic was high, inflammation was high, oxidation was high, insulin sensitivity sucked. You know, I just, and I, and I still didn't really have a solution. I was thinking, you know, I'd heard about this adrenal fatigue thing, right? Because I was, you know, this is eight years of combat for these guys. I'm like, well, maybe it's like that Shell shock thing or combat fatigue you've heard about from other wars. And it seemed like people are kind of blaming that on adrenal fatigue now. So I started looking into that and trying to do, you know, whatever, whatever that combination tended to be essentially what quartet, tapers and iv Myers cocktails and you know, things like that. You know, of course there was a little response, but it wasn't, it wasn't anything to write home about.

So doc, can you time out for a minute because I just want to highlight what you said, those list of symptoms because Lori and I are seeing this in our practices. Right and left. So young guys, 20 years ago we didn't see this. Fifteen years ago we didn't see THIS. Even 10 years ago we didn't see this. But we've got young, healthy guys. They look like they just stepped out of a magazine. They're fatigued, their labs, they have low sex drive, they're not performing the way that they want to perform. They're frustrated and their labs are a mess. And so this has not just happened to people that have over trained. Right. Like in the Navy SEAL world, I would think a lot of that was over training. Right. But this is happening in just mainstream day to day people that are just not able to compensate anymore.

Right.

Post Covid, we're seeing more and more business owners that are this way too. So this common denominator of these overachievers, High performance.

Yeah, I mean my private clients now are, you know, run all over the spectrum. Most, most of them are entrepreneurs and C suite kind of guys. You know, I still treat a lot of seals. I still work with seals when they're getting out of the military to kind of help them recover from their career out of a lack of imagination. I called it the SEAL syndrome. It's, it's been, it was then taken over by some researchers in San Diego and, and study. They studied all the findings that I was claiming, which the military was laughing me out of the room when I was telling them that I thought these problems had to do with sleep and, and lifestyle issues. But some researchers got in there and they validated all this and they've dubbed it the operator syndrome now and they apply it, you know, to broader audience. Obvious, obviously. And you know, there's books on it now and journal articles and it's, it's a thing now. You know, it's a thing. But yeah, but it's, it's basically premature aging. Right? It's premature age, poor aging. So premature, like metabolic syndrome kind of things. And Like I said, embarrassed to admit how long it took me to catch on that it seemed like a lot of people told me they were taking Ambien when I was getting a drug list, you know, and when I went to medical school, you know, I didn't have any classes on sleep. I had pharmacology. I knew it. I knew Ambien was a GABA analog. I didn't really know what the hell that meant, but I knew, you know, bound to a GABA receptor. I didn't know how that affected sleep or anything. So I had to learn a lot about sleep. But once I figured out, you know, because of course, you all know this, but for anyone in your audience doesn't know this, when the FDA applies for a patent, they do the research, they own the research, and they get. Or when the pharmaceutical applies to the fda, I should say, they. They do the research, they own the research, and they give the FDA what they want to give them, and they don't give them what they don't want to give them unless they get sued, right? And then when they get sued, they have to show everything. And so they had been. They had been sued. The Z. Drug companies were getting sued. And, you know, then I got. I got to see what the real research was on it. So that. That was beneficial because that happened the year before this started. So, so I. So once I learned enough about sleep and learned enough about Ambien, and the seals were also drinking alcohol before bed. Like, is a sleep aid, very common, doing those two together. And then once I started learning about, well, you know, the different stages of sleep and what happens during the different stages of sleep, I was like, every single symptom they're telling me about could be explained by this, right? Because Ambien. Ambien destroys REM sleep, right? 80% of REM sleep's gone with Ambien, 20% of deep sleep. Alcohol does the opposite. So when you take ambient with alcohol, you get no sleep. And. And in fact, that's what I saw when I sent the seals in to get sleep studies. And again, they weren't complaining about sleep. Like, this was just life. It's like, hey, I can't. I wake up at 4. I can't go back to sleep. I just come in and work and work out and try to get tired that day and go home and go to sleep earlier that night. And they've been doing it for five years. Hasn't worked yet. But their seals, they're going to keep putting their head down, running harder and figuring out how to do it better. And so, you know, I. I said, well, you know, every single symptom. Like, I didn't think every single symptom would resolve, but I thought every single symptom they have could be correlated to this poor slee thing I'd have them do. I'd have them do sleep studies. Their sleep studies came back 99.9% stage two sleep. So no deep sleep, no rim sleep. Now, y'. All. Y' all have been practiced long enough to know how much BS there is in the medical literature. But, you know, academics would tell you that those guys would die, right? They. They can't. You can't survive that.

You can't survive that way. Yes.

They've been doing it for, you know, five, 10 years. So it's like, you can survive. I don't know how, but you can. And so, you know, I finally, you know, I talked to a bunch. I mean, by the time I kind of figured out what. What I thought was going on, I'd. I probably already had 100, 150 guys depending on me to help them. And so I said, well, I really think this sleep is going to be a big component of it. Right? And, yeah, there's a ton of resistance to that, you know, because sleepers for the week sleep. You sleep when you're dead like that.

It's kind of like trying to tell a runner not to run.

Right? Something like that. Right. And, yeah, and so I. I talked them into trying, and of course, I couldn't just, you know, take their Ambien away and say, suck it up. You know, I had to give them something else. And so I went to, like, very traditional things, like Cochrane database, you know, PubMed stuff. And I was like, what, what supplements have been proven to help with sleep? And then I was learning a lot about sleep and what happens when you sleep. So I could figure out why you're. Why those supplements work. It makes sense. And so I just. I had the combination of supplements that I wanted to put. Like, I didn't do anything herbal or botanical because I don't know. I don't know anything about that. Like, I can't evaluate that stuff. So, you know, there's no, you know, lemongrass or, you know, whatever the, you know, the. The things. Kava root, those types that I didn't. So it's just, you know, things that are ordinarily in your body, like, what. What. What can we do with those? And so with the help of the seals, I just said, hey, we're gonna try all these like six ingredients. Like we're just gonna try to figure out how much of each of this to take. And we figured it out and then that was their. They, they call it Doc. So in the, in the military, anybody who has any medical training, like two weeks of corpsman school, up to, you know, 16 years as a neurosurgeon, you're just Doc. Everybody's docked, you're on par. So, so they call it Doc Parsley sleep remedy or sleep sleep cocktail is what they called it. And I gave them, you know, that was their handout and they would just go buy it all and, you know, quit taking the Ambien. Some guys were super, super addicted to it. So I would have, I'd have their Ambien converted to a serum and then so I could titrate it down, you know, one milligram a week essentially. But I got all these guys off of Ambien and I was giving them like some, you know, pregnenolone and dhea, just kind of a, you know, support for the daytime. And I was giving them zinc citrate as, as a mild aromatase inhibitor. But the primary thing I was doing was getting them to sleep better. And I'm not exaggerating. These guys, you know, total and free testosterone were tripling and quadrupling because I had, I had 28 year old guys in great shape come in my office with a, you know, total testosterone of 252 and 253. Endocrinology is like, you're good, like 250 is a cutoff. So you're good, right?

Yeah.

And, and, and, and so, you know, once I got him to sleep, it worked way, way better than I thought it would. I mean I, I thought I was going to get like a 30 solution, but it's probably like an 80% solution for 80% of the guys. And of course, you know, once their anabolic markers went up and catabolic markers went down and oxidation went down and inflammation went down and insulin sensitivity, like increase like every, like, you know, I had 45 year old seals, you know, setting records and things they've been doing their whole lives and they're like, it's not a record for my 40s, it's a record for my life. You know, it's the fastest I've ever run that or fastest I've ever done this optical course or the most weight I've ever lifted and all this other stuff. So yeah, so I, I was, I was sold. And then I had to convince the leadership that this was a problem. And like I said.

Can I say something real quickly? Some of the things that you did, I. We need this in medicine. You were a listener. You know, you admitted fact, you didn't know, but you heard them. You offered him hope, you gave him a solution. You used intuition, smarts, just common sense. Applying that to numbers and said, this doesn't make sense. Try this. And we just. Traditional medicine lacks all of that.

Yeah.

You know, the insurance based model sees, you know, they're seeing patients every five to eight minutes. They can't listen to them. It's algorithmic medicine. It's here's a pill for.

It's worse than that. Right. Because the insurance companies should only be involved in paying, but they're actually managing care. Right. They're managing care by default by saying, well, you can't prescribe that, you can't get paid for that study and you only have eight minutes. You know, like that's, you're, you're practicing medicine essentially at that point. Yeah, right. Yeah. And, and I told those guys, I was like, hey, I'm a western trained physician. I know how to recognize and treat diseases. And you don't have any diseases. You just, you know, you aren't doing as well as you would like.

You have dysfunction, not disease. Right. You know, but at the time that you did this, when was all of this?

I just, that started in the summer of 2009.

Okay. Okay.

Yeah.

Because when, you know, my practice started just around that time too.

Yeah. And, and so, you know, what I had going for me was that the seals had already done a, they've been covered in the media a lot. And they, they developed kind of this national image, you know, near almost a celebrity, a minor celebrity kind of fault, you know, whatever moniker. And so I like, if I read somebody's book or saw somebody's TED Talk or heard him lecture, I just call them and say, hey, I'm the doctor for the west coast seals. Could I, you know, consult with you? Could I train with you, can ask you some questions? And every single person was so generous and very helpful. And I just got to learn a ton. And it completely changed, completely changed what I did with my career. I had no interest in going back into a hospital and, you know, managing sick people who are just going to keep getting sicker. Like, it just, it just, I'm like, there's no reward to that when you compare it to this. And you know, the other thing that, you know, probably helped me over most people is, you know, I wasn't I'm not the guy who's supposed to be in that job. You know, when the Navy puts a guy in that job, it's a. It's a GP who's just gonna, you know, prescribe anti inflammatories and, you know, do like, whatever. Like just general practice, low intensity, low consequence kind of medicine. Right. And. And that's. And that's what was expected of me. And they were very upset that I wasn't doing that, because what I was doing was voodoo. And they kept shutting me down and telling me I couldn't do this and couldn't do that. They did official inquiries into me, suspended me for a while to see if I was like you, practicing outside of my scope and doing things dangerous and. But these are my brothers, man. I was like, I'm here for them. I don't care what you think. Like, I really. I. I shouldn't say that, I'm sure. But I just said it. I don't. I don't care. Like, I'm going to keep doing what these guys need because that's. That's my job. Right. My job is to help the patient is not to satisfy Bureau of Medicine or Navy Medicine or the local hospital internist, you know, like some. Some local hospital Internet. The Navy hospital internist just went crazy calling everybody in the. In the military leadership about how I needed to be fired and, you know, officially charged and all this because I was giving. I was giving a man a cancer drug, and I was like a cancer. A remedex. Right. Okay, that's. Yeah, all right, I see what you're.

Thinking there, but mechanism of action.

I was like, well, all right.

Yeah.

Yeah, I guess. Yeah.

Yeah. And you know, what? You. What you did took grit, perseverance. I could name a ton of things. And. And I can really relate to that. Kelly can, too, for the degree of pushback. I live in a. I would say a good old boy network area. Yeah. You know, and I can't say that it was well accepted to be talking about nutrition, you know, in a family. This. To be talking about lack of blood sugar control and blood sugar dysregulation, which was my story. I developed diabetes. I didn't look like a diabetic. I was a marathon runner, for crying out loud. But I had blood sugar dysregulation, which landed to other things. And it's like, but you're not eating sugar. But guess what? There's other things. So we've. We've all had to develop that grit and be different and Be willing to take those risks, because, you know, at the. Of the day, what you said, we're there for the patients that we serve and the people that serve. You know, how did you.

Ultimately.

The insurance companies. Yeah. And the administrators and all that stuff. And. And. And so, you know, I. I had. I had a lot of success with that. And. And one of the things that the SEAL community does is before. Before a team deploys, and when a team comes back from a deployment, they would take them out to this, like, weekend retreat at a local resort, and they would talk to them about, you know, the. The family strain they're going to, you know, deal with and, you know, just kind of the. The complexities and complications of. Of this phase of their life and marriage and this. And say, bring them out in their families and, you know, give them resources, you know, places for the wife to go and talk to people to talk to and. And all that type of things while the guys are gone and, you know, things the guys can do while they're gone. And we would bring in. We'd bring in kind of ringers that people were interested in. Right. So, like, I don't know if y' all are familiar with Rob Wolf, but he kind of the initiator of the Paleo diet, and he had, like, one of the first health podcasts was his, and so brought guys like him in, and they'd bring in two or three speakers. And because I was free, I. I was always on the speaking docket, too. And then it's like, go up there and tell them what you know about this. And so, you know, they're SEALs, and I motivated them by talking about testosterone and growth hormone. Right, Right. That's what they needed. Inflammation and pains. Like, this is what they care about. They know what these do. So I explained to them how testosterone and growth hormone is secreted at night, and if they're not sleeping. And I was the only person talking about sleep at that point. And so all these, you know, Rob Wolf and Chris Kresser, Mark Sisson, like, all these. All those guys have kind of the original health podcast and. And books and all that stuff they kept. They started inviting me to their. To go on their podcast and to do different lectures with them and all that. And then I just got dubbed the sleep guy, you know, and then. And so. So now, like, I, you know, I do lifestyle medicine, and sleep's a big component of that. Right. But I, you know, I counsel and sleep and exercise and nutrition and stress mitigation. And then, you know, I do Hormones and peptides and all that stuff on top of that, and hyperbarics, I have a lot of training. Hyperbarics and even psychedelics. I don't prescribe them or so to say, but I don't administer them. But I have, I have resources that I send guys to. So I kind of like, I, I do, I kind of do everything to kind of keep people healthy. Healthy lifestyle and optimizing health and performance is what I do. But what I'm best known for is sleep. So, yes, that's how. That's how it all panned out.

So let. For our listeners, let's talk about sleep and sleep stages. And you mentioned earlier kind of the consequences of not having deep and REM sleep. But let's dig into that a little bit more. What, what should we expect from our sleep architecture at night? What's an ideal sleep pattern?

You know, it is as long as you're, you know, reasonably circadianly aligned. You know, you would, you would go to bed in a stage one, which is sor. The pre. Sleep. When you're, you know, you can hear other stuff going on in other rooms. You can hear your neighbor, whatever, but it's, it's a little different. It's almost like a dream. You're kind of like, you know, you're processing it slightly differently. What. Before I start all that, one of the questions I ask at my lectures, just because I find it entertaining, is as I say, you know, who in the audience here can define sleep for me? Right. And never. I've been. I mean, I've been given this. I've been lecturing for 15 years. I've never had anyone do it. And, and, you know, I find that fascinating. Like, I really do, you know, and, and I, I couldn't have defined it, you know, before I really dove into this myself. Right. And. And I was just like something every person on the planet does every day, and nobody can define it. That's. That's kind of ironic. Right?

Right.

So anyway, the, the point of saying that is like the, the truest definition of, of being asleep is lack of being awake.

Right, Right.

Rhetorical. But that's, that's really what it is. And it's, it's basically like it's, it's an equal. It's equally as important as your waking hours. And the best way to define it is just like kind of the opposite of being awake because it's hard to define something you don't really have a subjective experience of. Right. And even if you could define it, well, who could validate it because you don't really have a subjective experience of it really is, is like all, all of your interaction with the world. Right. Your, your cerebral cortex that, you know, that, that part of our brain that makes us so smart, like all of our motor function, all of our sensory and, you know, that all kind of gets turned off. It still works, but we just. It gets quiet down and we don't pay attention to it. And that allows the brain to do other things because it's not involved with processing our environment. So the first, so the first thing that happens is you, you start processing your environment slightly less so, you know, the sounds, kind of the lights. Yeah. You know, just kind of quit paying attention. In the same way, then you go into actual stage 2 sleep where your sensory is really no longer active. You're not processing sensory, so to speak. Of course, you are at a small level, which is why somebody can make a loud noise and wake you up or, you know, turn on the light and wake you up or shake you and wake you up. So it's still working. It's just, you know, you, you lower, you, you lower the resting of those cells, and it makes it that much harder for them to fire. And then that allows your brain to start doing other things. And it's. You know, we, we now know. We didn't know about this when I started, but we now know about the glymphatic system. So you're flushing out waste and then, yeah, you're re, you're, you're recalibrating neurotransmitters for the brain itself. And then you're, you know, your, your brain is starting to do all kinds of amazing things. So when you go into stage two, that, that stuff, you know, the, the chemical, the, the biochemical changes in order for all these processes to have happen, starts. And then you drop down into deep sleep. And deep sleep is where, you know, your, your thalamus and hypothalamus are, are processing what's in your blood and trying to figure out what do we need more of, what do we need less of. And then your pituitary is reacting to all of that. And so you're, you're recalibrating all your hormones, and then you're secreting luteinizing hormone and fsh, and, you know, hcth, if you needed that, which would be, you know, very rare, of course, but, you know, thyroid function, everything is being adjusted and measured. Like I said, the glymphatics is flushing out waste products. And then these hormone changes are allowing the neurotransmitters in your brain to do different things, which is primarily restoring and regenerating themselves. Right. To, to put, to get rid of the waste products, but also to put the proper neurotransmitters where they need to be improve concentrations of things. Flush out adenosine. Obviously, you know, adenosine is the, the kind of the byproduct of ATP consumption. So you build that adenosine back up into ATP and you're re energizing the brain. You're getting the brain ready for tomorrow really. So the whole point of going to sleep tonight is to repair essentially from today, right. So like I'm depleting things, I'm kind of damaging things if I've worked out of a run, like I've tweaked muscles and tendons and ligament. So my brain and body are like, when I go to sleep, they're repairing and then it's preparing for tomorrow. Right. Because I'm using today as the template for what I did to anticipate what I'm going to do tomorrow. Right. And so if I ran today and I hurt, you know, I hurt my muscle or my muscles, you know, exhausted at this phase. Well, when my brain and body start repairing that, it's going to repair it in a way that tomorrow I can run as far as I did today with a little less damage. Right. That's the whole idea. And if we could do that perfectly, right. If we could, if we could go to bed every night and repair and prepare, recover 100, we would never age by definition. We'd wake up exactly the same every day. And obviously when we're young, we do, right. When we're, we're kids, wake up better, amazing, harder and you know, right. And then 20 to 25ish, kind of that all kind of plateaus and then you start going the other direction and, and you, you know, you're repairing 99.9999% or something. But that's, that's given eight hours. And, and this is the interesting thing, I find it takes eight hours to recover from being awake 16 hours period. It just does. You can wish that away all you want to, but. And so when you take, when you take, when you, when you deliberately by choice, and we're the only animal on this planet that deliberately sleep deprives itself. But when you by choice say I'm going to sleep six hours instead of eight hours, you're choosing to age 25% faster. That's just all there is to it. There's no getting around that. So anyway, I'll get back to the stages. So you go into deep sleep, a lot of hormonal regulation. I like to point out that fight or flight is the maxim. Maximum adrenalized hormones, right? Maximal sympathetic tone, cortisol, epinephrine, norepinephrine. Right. All that's maximized during stress, hyper, hyper stress situations. The absolute minimum stress hormones you will ever have is during deep sleep, slow wave sleep cycles. Okay. Stress hormones are catabolic and testosterone, growth hormone, dhea, like all these things, dht, all these are anabolic. So the most anabolic period of any 24 hours is deep sleep because you have to have the lowest amount of stress hormones as well as having the highest amount of anabolic hormones, which are all being produced while you're in deep sleep. And so then you travel across time in deep sleep. You kind of stair step back from four to three to two, transition up and go into rem, which is actually going past wakefulness. And then you do a little bit of rem and that would complete one sleep cycle. And a sleep cycle is 90 to 120 minutes. And then the next sleep cycle, well, the first sleep cycle is like 80 to 90% deep sleep. And then the next sleep cycle is less deep, more rem, less deep, more REM throughout the night to all your last sleep cycle before you wake up, it's like 80% REM and very little deep. And in REM, you're rehearsing everything you've heard, everything you've thought of, everything you've learned, conversations you've had, you're rehearsing that and you're figuring out, your brain's figuring out if you need it or not, or if you want to hold on to it. And if it does want to hold on to it, then it, it forms connections to other pieces of information, different regions of the brain that would be similarly affected by that thought. And you form these connections. The more connections you form, the more durable that information becomes. And then when you can think of it from lots of different angles, you actually know it, right? So you've memorized everything until you go to sleep. And then once you go to sleep, you can actually work with it and you can actually know it. And then the more times you rehearse that, the more times your brain confirms you need it, the more durable kind of becomes this durable super highway. And then you think that way all the time. And then when you get older and you lose neuroplasticity, you always think that Way to make you grumpy old person. Because this is the way. That's the way. We know that's the way. Yeah, it might be different. And, and then the other thing that happens during REM sleep, and we think this is one of the re. One of the reasons for the symptomatology of PTSD is during REM sleep you emotionally categorize. So if you have a conversation, say like you have a fight with your spouse about dirty dishes in the sink or something, you know, banal like that, well, that, you know, that should be over as soon as the conversation's over. Right. Like you shouldn't really have that. But if you don't sleep well, there's a chance you miscategorize that. Right. And that stays in like this, you know, this highly contentious situation and then routinely do that. And you can have these situations where dirty dishes in the sink trigger you to where you're thinking about divorce and you're yelling and screaming. Right. And that's extreme example. But that's, that's one of the things we think happening. Yeah. And that's, that's pretty, that's pretty much so.

Would you, Would you. Is it safe to say that sleep is not a waste of time?

Sleep is, Sleep is the most productive time in your life. And I've been, I've been as guilty as everybody. Like I said I was, I was a seal. I went a week without sleep to prove that you don't really need it. Right. You don't actually have to have it. It's.

Right.

It's luxury. And then when I was in college, you know, I was working full time and I was going to college full time and I had a wife and I had kids and man, I slept like five hours a night and pulled all nighters all the time. And then medical school, I had a family, so I did the same. I got up at 3:30 in the morning so that I could go work out, go to school, come home at 4:30, spend time with my family, you know, try to go to bed by 11 o' clock or something and then get up at 3:30 the next day, you know, or get up at 3 and leave at 3:30. So I'm as guilty of it as anybody else. And what. The younger we are, you know, the more, you know, the more resilient we are. And we can, we can handle that. But youth is wasted on the young. Right? If I knew how, then I wouldn't have done that, you know, but that's, that's how I chose to do it.

So. Because some people listening are like, that's me. Like I've been doing for all of these years. So, I mean, yes, that is, is the detriment just done? Like, is, is the damage done or is there repair? Like, can we make.

Yeah, I mean, think of it like any other kind of progressive disease, right? Like if you have type. Dude, if you have type 2 diabetes and you reverse it, is it all fixed? It's like, well, how long did you have it? How much did you write? So I, I give a, I give a common, I give a kind of a simplistic metaphor is if you break your leg, you know, if I do a tib fib fracture all the way through and I just say I don't have time to deal with it. I'm just going to limp around until it's, you know, until it's better. A year from now, I'm probably limping, I'm probably in pain, you know, like, you probably didn't heal all that great. And if one of us were to look at it and look at an X ray and feel it would be like, yeah, you, you, this is a messed up bone. But if, you know the other side of it, you break your, you break your leg and you get it set immediately and maybe put a bone stimulator on there and you wear a cast and you, you know, do everything right that you can and, and you, and you heal quicker. A year from now, you probably won't realize that you broke your leg. But we could still tell, couldn't we? Right? We could still look at an X ray and go, ah, yeah, there, yeah, there's a little callus there. We know, we know that you broke it, but it looks great, right? Sleep's kind of the same way. It's like if it, if you, if you. So you know, beta amyloid plaque is building up right now, even like this, this late in the day and it's building up and if I go to sleep, you know, at eight hours, at 16 hours of being awake and I sleep my eight hours, I'll, I will flush out almost all of that, right? But if I decide I'm going to pull an all nighter and then I'm going to go to sleep tomorrow night, I'm not, I'm not going to get rid of all of it, right? But some of the other, like, yeah, there's so many things going wrong, right? So like that's the measurable. But I'm doing so many things wrong and I'm damaging so many systems like one short, short night of sleep we define as two hours or two hours less than you need or more so six hours instead of eight hours. One night decreases, decreases testosterone 30%. One night decreases insulin sensitivity by 30%. You know, one night increases stress hormones by percent. And, and all. Obviously all of that's damaging. Right? That's all. And so the more of those you string together, the worse it is. And, and you know, I work, I've done a little work with law enforcement and you know, guys work night shift their entire life, their entire career. They work night shift and guess What? They die 14 to 16 years earlier, depending on whose research you read.

Do you recommend any wearables for tracking sleep?

Are there.

Do you have a favorite wearable that you recommend?

I was really excited about the wearables when they came out. I'm not, I'm not as excited about them now. Not because I don't think they're useful, but they're not super useful to me as your doctor. Right. They're, they're more useful to the individual. So you definitely have to track anything. You have to track and measure anything you want to change. Right. So there has to be some way of doing it. I have 75 year old patients who don't have any interest in anything wearable or anything keyboard on it or anything like that. So they journal and it works. Right. What time did you go to sleep? What time do you wake up? Do you feel like you slept good? Did you wake up a lot? Did you get up and peel it? Like you just kind of do that. And then before you go to bed that night, how did you feel today? Were you tired? Did you feel your. And, and then you figure out kind of, you know, the, the pattern from there. Wearables are obviously more accurate, but wearables are not nearly as accurate as they portray themselves to be. Right. So because it's an algorithm, it's working off of an artificial ideal. And so people will come to me like, I can't get 100 on my sleep score.

Right.

You're not supposed to.

It might not be right for you. Well, your perfect night's sleep might be an 80. Right.

Right.

And, and you could even have a worse night's sleep. That's maybe a 90. So it's a useful tool as long as you're not using it as the end all be all right. As long as you're not saying.

As long as it's not stressing you out even more. Yeah.

Right. And a ton of people do like a ton of people. Like, I don't think I got enough deep sleep. Like, my REM sleep was this and my deep sleep, and it's like, I can't do anything about that. Neither can anybody else. Like, all we can do is improve your sleep to where you're getting the best sleep you can possibly get. And that ratio is going to be what it's going to be. There's nothing I can say or do that's going to me, oh, get more REM and do this. You'll get more deep. It doesn't work that way.

So what about the difference between fitness and performance? Can we dig into that a little bit?

Sure. Well, so for me, performance encapsulates everything, right? So we all have a. Like, we. We all have a vision of what our ideal life would be, right? Like, if you gave me a magic wand, where would I. What would things look like today? What would things look like a year from now, five years from now, ten years from now? So if I want to move in a meaningful way towards the. The life that I feel like would bring me the most fulfillment and happiness, anything, anything that I can do that moves me towards that is performance. Right? So if you want to, you know, if, say, like, a lot of my clients are entrepreneurs, right? And they built and sold a big business. They want to build another business. So anything that helps them build another business, anything that helps them in the boardroom helps their decision making, helps their problem solving, helps their planning. Yeah, any of that, that's a performance. That's performance, right? Being. Being able to have enough energy to get out of bed and go to work and do the things you need to do and not be miserably dragging yourself along through the day. That's performance. And then, of course, there's athletic stuff. You know, there's guys that want to be stronger. They have very specific goals. They're athletes. They want to reach things. There's people who want to be more enduring. You know, I. I have ultra marathoners. You know it. And anything that you want to get better at, but you being a better communicator, that's a performance goal that requires cognition. That primarily prefrontal cortex, the most impacted region of your brain is the prefrontal cortex. When you don't get enough sleep, your body compensates by releasing stress hormones because stress hormones keep you alert in proportion to your environment. You're depressed, like your physiology is depressed. The stress hormones ramp you up in a catabolic way. So it's costly to do this, but it ramps you Up. Unfortunately, anybody who's been in Fight or flight knows you don't, you don't think when you're in Fight or flight, it's 100 reactive. And so the closer you get to Fight or Flight, the less you think. And so you impair the prefrontal cortex, just your ability to, you know, the, obviously the purpose of that is like the simulator. We can think about things we want to do and plan and figure out if that's a good idea or not. We can change our ideas, we can solve high level problems, we can put things together in a unique way. But more importantly, we communicate with our prefrontal cortex. And so what you think, you know, what you think my expression means might be different than what you think my words mean. And that is incredibly impaired with just a little bit of sleep deprivation. One night of short sleep and you, you take a couple and you, you give one of them one night of short sleep, the other one sleeps eight hours, one sleep six hours, one of them sleeps eight hours. And then you ask them at the end of the day, how did they think their partner was? They both think that the other one was off because the sleep deprived one thinks that the other one's off because they're sleep deprived, and then the sleep deprived one is actually off. So the person who's not sleep deprived.

Thinks there are so discord. Discord, right?

And you know that emotional categorization and things. And so it, it's, it's a huge issue, you know, where, and, and I tell people, you know, there's activity, which is just like the baseline of being human, right? You, the more activity you do, the less exercise you need to do unless you have a performance goal, right? So for millennia, people, and people didn't get up and say, I'm gonna go run 20 miles, right? They, they got up and they walked to where they're going. They forged, they hunted, they sprinted to catch things or not to get killed. They jumped on things, they carried things like, that's, that's enough. If you're doing enough of that. We don't live in a world where that's realistic, but we can get there. Like mow your own lawn, wash your own car, clean your own house, take the stairs, park at the back of the parking lot, all those simple things, right? That's activity. You should always do activity. If you're sleep deprived, that's all you should do is activity. You shouldn't exercise. So as I, as I said earlier, like, if I go into the gym today and I work out for an hour. And if I do anything worth doing, I'm, I'm weaker when I leave the gym than I was when I walked into the gym.

Yes, this.

When I go to sleep tonight, my brain and body work together to repair that muscle to say, well, we want to be able to do that tomorrow without damaging the muscle so much. So I'm going to build it back in a little stronger way. And so that's how I progressively get stronger. Well, if I don't recover 100%, why, why am I going to go to the gym and damage myself even more? Because now I have two nights worth of work to do in one night and that's not going to work. And you string a bunch of those. If you did that intermittent admitt no big deal, like once or twice a month, you don't get enough sleep and you still go to the gym, fine. But if you're somebody who's sleeping six hours a night, four to six hours a night on average, like every night, you should not be exercising because you're not going to recover. You should be active because that obviously there's all sorts of physiologic benefits we need to express glut for, you know, you know, ampk like mtor all that needs to be activated by activity. You know, just contractions of muscles. Not, doesn't have to be intense, doesn't have to be goal oriented, but just doing activity and then we can, you know, obviously we can maintain health and body composition as long as we're eating a nutritionally reasonable amount of calories and den, you know, nutritionally dense foods and controlling your stress hormones and all that other stuff. So. But you know, I, I say exercise is, exercise is activity with a goal, right? So it's like I'm, I'm going to ride this bike really fast or I'm going to run or I'm going to lift these weights because I have a goal of getting stronger or more enduring or faster or whatever and that, and then that becomes a performance tool. So exercise performance tool activities is a longevity and life tool and health just generalized health tool.

I love it.

And then performance is whatever you're aiming for.

You know, we could spend all day talking about this because we've only just tipped the iceberg of sleep, right? And there's so many other components to health that make life worth living. I would absolutely love to have you back and talk about PTSD and psychedelics because I do think there's a lot to be talked about there and there aren't Many people talking about it.

There's so much there that, that, that's, that's, that's one of the most fascinating things.

It really is. It really, really is.

There's some really fascinating things going on in medicine right now in our world that's kind of outside of. There's a lot of fascinating peptides. Hyperbarics is a really fascinating tool.

Sure.

But psychedelics, nothing touches it.

I just think more people than we recognize. I mean we think about military. My husband's retired military. He, he struggled. We think about that category of people having ptsd. But I think more people have reactive patterns that are PTSD based than we ever knew. And I do think having more tools in our toolbox to help them settle that, be able to get out of fight or flight and repair their body is huge. And I do think psychedelics can play a part in that. I don't think it's the only thing, but I think it's a huge role and I think another conversation would be amazing.

Yeah, that's an area I'm very passionate about. And that started with the SEAL patient as well. Yeah, a couple of seal patients. And it was something that I, I completely poo pooed and it's like that's just people getting high, you know, and, but man, that, that is. There's some fascinating, fascinating truths about, about psychedelics. And I'd be happy to come back and talk about that anytime.

I love it. I love it. Is there anything you want to put out there? Is there anything coming out that you want our viewers to be aware of? Anything that you want to, you just put out?

We didn't really get into it, but you know, I, I always tell people the, the, the number one factor in getting adequate sleep is believing that you need to sleep. And most people don't. And most people after they listen to this, they'll be like, ah, you know, kind of, maybe kind of change their mind. So I have a couple of, couple of pieces of advice on that. So the, the first thing is go on to something credible. Ish. Who knows what's credible anymore. You know, Google Scholar, PubMed or something and put in sleep and anything else you care about. Parenting, concentration, exercise, strength, endurance, what I don't care. Whatever. Sleep. And that anything you care about and read until you're par, until you're petrified. Like sleep. Sleep is not contentious like nutritional medicine. It's like, yeah, no one, everybody agrees. All the research says the same thing. Like you're gonna die sooner and you're gonna be weaker. And worse while you're alive. Like that's all there's to it. And so once you convince yourself of that now you're going to be stressed out. And then. And the number one reason apart from not believing that you need sleep, the number one reason to. But people who actually are trying to sleep more can't sleep is because they have too much stress.

Yeah.

And their stress hormones are too high. And as I told you, deep sleep is the lowest stress hormones you will ever have in any 24 hour period. So about 30 to 45 minutes after you go to sleep, you need to have the lowest stress hormones you've had in 24 hours if you're stressed out. It doesn't work that way. Right. And so, so I have, I, I have, I have, I. It would take me probably 30 to 45 minutes to explain it, but I have a worksheet on that that, that I know my team sent you guys a link to.

Okay.

That you can, people can go to that. And it's like a three page worksheet that tells you how to get stress out of your sleep. There's some behavioral psych mixed into some sleep hygiene. You know, like there. It's just kind of a, it's, it's, it's laughable. Of all the things that I do, all the tools that I have, this is the most powerful thing I have when I'm working with it.

And it's pen and paper. It's not electronic, it's pen and paper. I printed it out myself and I've worked through it. So yeah, I would, we'll definitely put that in the show notes so that people have access to that. Because I think that's a really powerful tool if you've used it and you've had results with it. I think that's phenomenal.

Yeah, it is the most powerful thing I do. It's, it's kind of embarrassing that that's true, but it makes me think I need to step up my game in other areas. But I'm like this simple little worksheet. Like it's, this is the most powerful thing I have because, and, and the reason I say it's the most powerful because it, it won't just help you sleep now, but because of the understanding that you develop about why your, why stress is wrong and how to get rid of stress. Like once you understand that, you can't ever go back, you can't ever not understand that. And then it's just a choice. And as long as you want to sleep, you'll be able to sleep. As long as you. As long as you prioritize it, you'll be able to do it. But, you know, it takes. It takes, you know, three weeks to, like, really kind of get your mind shift in there. But once, once that clicks, you'll be like, oh, I got it. Like, never have a problem again.

What I hear you saying is that it has to become a non negotiable.

It does have to become a non negotiable. Of course. Yeah.

And I think that in the world in which we live in right now, I think that there are so many things that are distracting. Right? You got to get this. You got to do that. You know, you got to meet this deadline, you. And at the end of the day, for. For. For what? And so I can't wait to work through it. I can't wait to share it with clients and our viewers. And I just. I want to thank you. I think that you have really led the charge in a way, you know, just on so many fronts. You're brave. You're. You're brave. Courageous. We need more providers of care out there, just like we really do. And I just stay strong, you know, from one, you know, one set of providers. We get that right back. Right?

Yeah, we gotta. We all gotta stick together because we're not with the system rewards, that's for sure.

Right.

We're what the patient needs, but not what the system wants.

Yes.

Yeah, absolutely. Well, thank you so much for taking the time today. I would absolutely. Kelly and I would really love to have another conversation, so. So we'll be back in touch with you for sure.

Okay, no problem. We'll do it.

Thank you.

The Synergy podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice, and no doctor patient relationship is formed. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition condition they may have, and should seek the assistance of their healthcare professionals for any such conditions.