Sleep: the Modern Hack to Better Health

Guest: Kirk Parsley

The purpose of this presentation is to convey
information. It is not intended to diagnose, treat, or cure
your condition or to be a substitute for advice from your
physician or other healthcare professional.
Dr. Aconfora: Hey, everybody. Welcome back to The
Longevity & the Anti-Aging Project. I'm your co-host
today, Dr. Mike Aconfora. And today I have with me Dr. Kirk Parsley. Doc, how
are you today?
Dr. Parsley: I'm well. How are you, Mike?
Dr. Aconfora: I'm fantastic. Thank you.
I'm going to read Doc's bio. And we're going to get right into it because I've got
a bunch of questions to ask. And I'm ready to start writing.
Dr. Kirk Parsley served as an undersea medical officer at the Naval Special
Warfare Group 1 from June 2009 to January 2013. While there, he led the
development and supervised the group's first sports medicine rehabilitation
center.
He's a former Navy SEAL and received his medical degree from Bethesda
Uniformed Services University of Health Sciences (USUHS) in 2004. He
interned in obstetrics and gynecology at Balboa Naval Hospital in San Diego in
2005, and subsequently completed a Navy residency in hyperbarics and diving
medicine in 2006.
Dr. Parsley has been a member of the American Academy of Sleep Medicine
since 2006 and served as Naval Special Warfare expert on medicine. In
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addition, he is certified in hormonal regulation that's age management

medicine.
After leaving the Navy, he went into concierge medicine and consulting. He
continues to consult for multiple corporations, and professional athletes and
teams. Dr. Parsley lectures worldwide on sleep wellness and hormonal
optimization and is currently completing a book on sleep and health
optimization.
His philosophy for wellness is simple: in order to optimize our health and get
the most out of our bodies and minds, we must live more closely to the way we
evolved as a species. He believes that many diseases and disorders that we
accept as inevitable in our modest society are unnecessary and complications
of poor sleep habits, living in a toxic environment, eating foods we are not
designed to digest, and allowing stress to overwhelm us.
His passion is to help his patients and clients achieve the highest quality of
life possible and realize their health performance and longevity goals. Dr.
Parsley spends as much of his spare time as possible with his wife Cindy and
his three beautiful children, Hayden, Cole, and Harper. He's been a
competitive athlete his entire life and enjoys nearly all outdoor activities and
sports.
Dr. Parsley, welcome to the program.
Dr. Parsley: Thank you.
Dr. Aconfora: That is a heck of an introduction.
Dr. Parsley: It certainly is. It's a mouthful.
Dr. Aconfora: It is. It's a neat life that you've led. Can you tell people a little
bit of your backstory and a little bit about your journey?
Dr. Parsley: Sure. As you and I had talked about a little earlier, I grew up in
Katy, Texas, which was a small town outside of Houston at that time. I was a
competitive athlete my whole life. I started playing football in kindergarten.
And I played every year through my senior high school.
Got into power lifting and weight lifting during high school football. Competed
in track and field as part of football-enhancing activities. I did some martial
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arts, boxing, and some other things like that. I've just kind of always really
been into that.
I literally started lifting weights at 8 years old. I started reading nutritional
books, exercise physiology books at a really young age, probably around
middle school. I started getting really into those types of things. And so I've
just always had a really deep interest in health, primarily around optimizing
my own health and optimizing my own performance.
I was really into athletics. I was really into girls. I was really into cars. I wasn't
so much into academics. And so I actually was a pretty pitiful high school
student. I ended up dropping out of high school. It went for four years, but
then graduated. And then I went to the Military to become a SEAL. I wanted to
challenge myself towards the most challenging physical training there was.
I made it into the SEAL teams. Towards the end of that six-year term, I met a
girl, as the saying goes. I realized that being a SEAL is sort of a young single
man's job, and I was becoming neither. So I decided I'm going to get out and
pursue other interests. And the girl I was dating at that time was a physical
therapist, and so I thought I would become a physical therapist. I was taking
her textbooks in deployment with me and reading all of her grad school
textbooks.
It takes about 2,000 hours of volunteer work to even apply to a PT school, so I
started volunteering at San Diego Sports Medicine Center when I started
college, and that pretty quickly turned into a job as a physical therapy aide
and then eventually a physical therapy assistant. But I quickly decided that
physical therapy wasn't quite the real field for me.
I worked with a lot of doctors. They encouraged me to apply to medical school.
And you could imagine, given my high school performance, I cautioned around
trying to get into medical school. But obviously I succeeded and managed to
get into medical school and get through medical school. And you pretty much
covered the rest of that in the bio.
I went back to the SEAL teams as their doctor. I got there at a really
opportune time when they were building their first sports medicine clinic. And
of course, having worked in a sports medicine center for six years during
college, it's a pretty easy fit for me. And so I designed that center and we hired
the first exercise physiologist, our first strength and conditioning coach, our
first nutritionist, and all the things you would assume that in a lead
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organization like the SEALs would have had for decades.

Then I was the dumbest sports medicine guy around because I've hired all
these experts who have been working in sports medicine for 20 years. And so
then, they put me in charge of it and manage it. That's what you do when
you're the least qualified. You manage.
So the SEALs would come in my office not to talk to me about their
musculoskeletal injuries, but to talk to me about these other sorts of
symptoms that we're sort of nebulous. None of them fit disease. But it was
just sort of suboptimal performance, and a lot of it had to do with mood and
emotion, and just physiological shifts/changes in body composition and
energy, and sleep patterns and stuff like that.
I actually had no idea how to solve it. I hadn't learned anything in medical
school about suboptimal performance. Medical school is very much a disease
recognition and treatment algorithm sort of learning program. So if you don't
have disease, you pretty much send them home with a slap on the butt and
say, "Walk it off."
These guys definitely did not have disease. But they just werent performing as
they should, and that just led me to exploring lots of other avenues. Some
people would call it alternative medicine. I don't think there's necessarily
anything alternative about it. It's just non-disease carried medicine, and a
greater function of medicine, sort of all those types of things.
I was initially really interested in all the hormone dysregulation to all the
SEALs, but the Military being a really conservative organization, I realized the
military leadership wasn't about to let me get up in front of thousands of
SEALs and start talking about hormone dysregulation. Because then all the
SEALs would want hormones, and they weren't going to let me put SEALs on
hormones because then there would be an admiral on CNN explaining why all
SEALs are taking steroids or whatever this then would be.
So I was in a great position during this self-education phase where SEALs
received a lot of notoriety already from the war because this was 2009. So lots
of their high-profile missions had already been out there. So they had this
quasi-celebrity status. And I could call world-renowned experts in any field
that I was interested in and say, "Hey, my name is Dr. Parsley. I work with the
SEALs. And we're having this problem. I read your book or read your blog. I've
listened to your podcast or seen your video. And I was wondering if I could
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consult with you or train with you or whatever." People were always more than
willing to help.
So it allowed me ramp-up pretty quickly. I started talking about sleep as a
sleight of hand because I could talk about hormone replenishment and
hormone production during sleep, and it sort of motivated the SEALs around
the anabolic nature of sleep. I was kind of half bought into the idea that sleep
was the major problem. I definitely thought it was a contributing factor. But it
was a politically and socially acceptable way for me to talk about these things.
And then through years of continued researchand I don't mean I'm doing
clinical research, but researching, reading literature and consulting with the
professionalsI'm now convinced. I've been drinking my otherwise Kool-aid.
I'm now convinced that there probably isn't anything more important than
sleep for health. I actually take the word 'probably' out of there -- I'm
convinced there's nothing more important than sleep. And probably by orders
of magnitude, sleep is the most important aspect of, not only health, but
definitely health optimization.
Dr. Aconfora: You are really the only person that I know ofAnd looking at
the truly remarkable work that people are doing, everybody touches on this
sleep issue. You're the only who staked their flag in the ground and said,
"Sleep is the issue." And I'm telling you, I have to agree with you.
We can get all our ducks in a row in terms of our nutrition, our exercise, and
a positive mindset, and if we're not sleeping, the picture that you've painted
for me is that none of that stuff matters if we're not getting to sleep.
Dr. Parsley: Right. You can kind of dissect it systematically, sort of debunk
the other pillars of health as being the most important. What I mean by that
is, say if you're taking nutrition. Nutrition is important. When I work with
groups or individuals, I work on all four pillars. Don't get me wrong. I don't
think you can just throw any of them out the window.
Let's say you're really focused on nutrition. We know there's all sorts of
bickering between the zealots on either end of the nutritional spectrum. But
we know, there's no question that most of the nutrition issues revolve around
insulin sensitivity. Lots of people think of insulin as the way the regulation of
blood glucose. And that's true. But it does a lot more than just regulation of
blood glucose.
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It's really the master hormone that's dictating what we call "fuel partitioning."
What are you going to do with all of the calories that you eat. And how, in
what order, and in which preference are you going to use these various
nutrients to produce energy. And which energy system is your body going to
preferentially use during the day and during exercise, and so on and so forth?
That's real partitioning. It's all based on insulin sensitivity.
So we know that decreasing the amount of sleep that you get by two hours per
night -- and so sleeping eight hours at night to sleeping six hours a night -over the course of about four days, we've proven that young, healthy, athletic,
fit, completely disease-free college students will decrease their insulin
sensitivity by about 30 percent just from that short little intervention.
So now you take somebody who's going to be 40 and doesn't have great
insulin sensitivity than 20-year-old athletic people. They're 40-year-old largely
sedentary office worker and so forth. So they're probably sort of the borderline
insulin sensitivity already. They short-sleep by two hours a night. They're
prediabetic, if not diabetic within a couple of days. That's a major issue, right.
So you can be eating a great diet, but if you're prediabetic or if you're
peridiabetic, you're really setting yourself up for failure. That's kind of the
beginning of the end for everybody as it comes to nutrition. Of course, there's
lots of other hormones that are involved in that, and leptin being a fatsignaling thing, which is also affected by sleep. Ghrelin, which is an appetitestimulating hormone form the stomach also affected by sleep.
So you can see that your nutrition is not going to really pay the bills if you
aren't sleeping because everything that you're trying to do by eating well is
going to be undone just by simply not sleeping enough.
Take the same thing about exercise. The whole idea of exercise is to increase
insulin sensitivity really. That's the primary mechanism of which exercise is
benefitting people when you talk about moderate exercise for health. When
you're talking about elite performance and competing, there's other aspects of
it. But those other aspects, again, requires sleep.
So if you're training to be an endurance athlete, you're going to over-train your
muscles. You're going to work your muscles over a long duration that's going
to deplete the glycogen storage and cause them to resort to other fuel-burning
mechanism. Again, insulin sensitivity is playing a big role in that.
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But whether you are exercising your muscle cells through low-intensity, longduration exercises, like training for a triathlon, or if you're trying to become an
Olympic lifter or power lifter and you're looking at very short-hour bursts of
moving more weight than those muscle cells are actually capable of moving,
what you're doing is you're overloading that system.
And by overloading that system, you're actually breaking down. You're
damaging all of the tissues -- connective tissues, muscular tissues. You're
stressing not only the fuel utilization and production of the cells, but also the
ability to clear toxins and your lactic acid being an obvious one. But there's
lots of other things that are building up that need to be cleared.
It's actually when you repair that that you become stronger or you become
more enduring. If you don't ever sleep, then you don't ever repair. If you sleep
poorly, you repair at a much slower rate. Most people who train for sports,
taking the guidance of coaches and health experts in the field that they're
trying to perform in.
And all of that advice is based on people who are metabolically and
physiologically sound. So if they say, "Do X number of repetitions or x miles
for your training," that's based on you being physiologically intact. And in
order to prevent over-training, you need to be physiologically intact for that
volume to be appropriate.
And if you're not sleeping well, then you're not physiologically intact. And you
probably need twice as much recuperation time. And so you need to cut that
training volume or the progression towards higher training volume in half. You
need to make thatIt's going to take you a lot longer to get better in any type
of activity. So you can kind of get rid of exercise as being the most important
because sleep really controls how effective exercise is.
And then the other pillar that I work with when I'm working with clients,
groups or individuals, is stress control, stress mitigation. That's really just
kind of turning down what we call your autonomic nervous system. And you
can just think of that as your autonomic nervous system. So it's controlling
your respiratory rate, your heart rate, and blood pressure and all sorts of
visceral organ production and neuro attention and all sorts of things
throughout your body that you just don't think about.
That's broken into two categories. One is sympathetic. One is
parasympathetic. The parasympathetic is like the calm side of the autonomic
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nervous system or the automatic nervous system. For simplicity's sake, we

call that the rest and digest pathway, kind of self-explanatory. And then the
other side of the spectrum would be the sympathetic nervous system, which
we sometimes call the fight or flight nervous system.
Fight or flight, as most people know, is like the extreme of stress. It's like the
highest level of stress you can possibly be. You hit this threshold and
essentially your brain shuts off and you redistribute your energy sources
across your body to be able to fight or flee really well.
And when you do that, you rub other aspects of your body from what the
parasympathetic system would have you do. Things like digestion, repair and
immune function, repairing damaged tissues, fighting out disease, parasites,
viral infections, all those types of things.
It's something really interesting which makes sense, from an evolutionary
standpoint. If you think about what fight or flight is really designed to do, it's
really designed to get us out of a very bad situation as quickly as possible and
then return to homeostasis, return to natural baseline as soon as that threat
is gone.
Well, we have hundreds of thousands of years of genetic training so to speak,
genetic predisposition towards how we handle certain stressors. Our ancestors
learned to recognize and assess threat. And the ones that we really get to
fighting and fleeing became our ancestors. And the ones that weren't aren't
our ancestors because they became some other animal's dinner or something
like that.
So if you want to have a really well-functioning fight or flight system, the
interesting thing is you actually disengage that prefrontal cortex that I was
talking about, that executive functioning and emotionality because you want
to be super impulsive. You don't want to sit there and think about tactically
how you're going to get away from this threat. You just want to move. You
want to get away from the threat as fast as you possibly can.
And then actually thinking, what slow that process will make you less likely to
succeed. So we know that when people sleep-deprive themselves, they have
excessive sympathetic tone. Now, interestingly, in today's society, we have
excessive sympathetic tone all the time anyway because we have so many
stimuli coming in.
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And even though they aren't necessarily stressful in and of themselves, like a
phone a call isn't necessarily stressful, but when you have 12 phone calls
coming in and you're 36 emails behind, and you're running late for an
appointment, and youve got to pick a kid from school, and the bills need to be
paid -- all these little things that just we didn't evolve to have.
We are essentially stressing ourselves out more and more and so we have this
higher and higher sympathetic tone. And as I described, when you're in fight
or flight, your body is marshalling its resources to be able to fight or flee. It's
not marshalling its resources to repair damage, to fight off infections, to
increase fertility, all of the types of things that you would be doing during your
rest and digest.
So actually, the exact opposite of fight or flight is deep sleep, what we call
slow-wave sleep cycles. And during slow-wave sleep cycles you have almost no
adrenal function. You're like 99 percent in the parasympathetic neuro system.
And being in there is like the most anabolic you can be. You're repairing all of
your tissues. Your brain is opened up, all these little channels to be able to
flush out neurotoxins and replenish neuropeptides an neurotransmitters.
Your brain is repairing. Your body is repairing. Youre taking things that were
in your working memory and short-term memory, converting those into longterm memory. You're categorizing emotional events into their appropriate
intensity and appropriate place, and sort of your emotional stratification.
All these things are dealing with your ability to recognize and feel what is a
high-stress level. And then if you want to sort of implement stress reduction
techniques, things like box breathing or if you want to use your biofeedback
device or heart rate variability device, or you wanted to use some meditation
or yoga or any of those other types of things, that requires some selfawareness, and it requires the motivation to actually take a break from what
you're doing and do that.
And that motivation might be called will power, self-discipline. I just told you,
when your sympathetic system is running wild, you lose executive
functioning, and that executive functioning is where your willpower comes
from. So now you're much less likely to engage in the stress reduction
techniques. Even if you know them and you practice them and you value
them, they're just not going to seem as important or available to you because
you're going to be focusing on the stresses of your life.
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That to me debunks the whole argument of the four pillars of health: sleep,
nutrition, exercise, and stress mitigation. All of these pillars are heavily
influenced by sleep. Now, sleep is also affected by all of those other pillars.
But my argument is that if you're sleeping well, you set yourself up for
success across all these pillars, all the other pillars. If you're not sleeping well,
you set yourself up for failure across the other three pillars. So you can have
great sleep and crappy nutrition, and probably be okay. You can have great
sleep and moderately good nutrition and not really exercise much, and you'll
probably be okay.
That's just kind of my anecdotal and professional experience with all these
stuff. So that's why ultimately I ended up being the sleep guy. I've never really
started out to be the sleep guy. Just the more I learn about it, I'm just like,
"This really is the most important thing. And I'm more convinced about it
every day.
Dr. Aconfora: And I would go as far to say, let's look at life as building a
mansion. And if our foundation is not a solid foundation for this mansion,
we're setting ourselves up for having to pay in one form or another. And that
mansion is going to collapse. And that's us. And that's what we see in society
today.
Dr. Parsley: Yeah, I agree.
Dr. Aconfora: So let's talk about a couple of different things here. Number
one, what does the World Health Organization say about shift work? Because
modern society, everybody is doing shift work today, it's not back in an
agricultural society where sun up, sunrise. Everybody is working shift work.
So what does the World Health Organization say about it?
Dr. Parsley: The World Health Organization classifies [shift] work as a type
2a carcinogenic. What that categorization means is that a significant increase
in your risk of all cancers. However, the reason that's a 2a is because we're
never going to study it. We're not going to subject people to sleep work and see
if they get cancer. Of course, that's an unethical trial. So it's always going to
be a type 2a.
So that's sort of the one really big bad aspect. People are really afraid of
cancer. And so I guess that's a good motivator. I always remind people that if
you're a man, you're still eight times more likely to die of a heart attack. And if
you're a female, you're still six times more likely to die of a heart attack. But
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10

cancer gets a lot of publicity right now. And so people are really worried about
cancer.
There's several proposed mechanisms. But at the end of the day, we know the
facts of insulin sensitivity. And we know that almost all cancers thrive off of
glucose. If you have elevated blood glucose and you develop cancer, it's much
more likely to become aggressive at a higher rate and grow more quickly, so
on, and so forth. We know that it affects your ability to repair damage.
But what's really going on with shift work is what most people think about
when they think of circadian rhythms is they're thinking about-- I guess the
people who have actually considered this and read a little bit about it -they're all thinking about the exposure to sunlight or light saturation and our
bodies desire for times to be asleep, which is true. That is a part of circadian
rhythm.
However, what most people don't think about is that circadian rhythm is also
controlling the epigenetic expression of multiple genes throughout the day -protein synthesis, fuel utilization, you're toxicity clearance. All of those things
are happening in a rhythm, and every single cell in your body has a biological
clock that's in tuning, that's trying to entrain himself with the environment.
Now, the sleep-wake cycles are part of that, but you can completely change
your sleep-wake cycles and you're not going to change the biological clock of
your liver or your kidneys or your bones and your muscles. Any of these other
cells that are using their biological clock, they're still going to be going on their
own pre-set circadian rhythm. And they might actually be varying and
dancing all over the place. And it just might be a complete of lack of
synchronicity.
And in doing that, you're just essentially metabolically breaking yourself.
You're setting yourself up for failure because although we break the body
down into systems as a way to study them, it's a purely academic exercise.
There is no such thing as the nervous system, the immune system,
musculoskeletal system, and the cardiovascular system. We can describe
what these means, but all of those are completely intertwined. There's no way
of separating that.
Your heart is controlled by neurological things that's controlled by hormones
being produced by your liver, hormones produced by your kidneys. Your
muscle lactic acid threshold is driving hormone production in your liver,
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11

which is then affecting your brain, which is then affecting your heart.
Everything is completely intertwined. So it's way too complex to say, "Well,
this is why sleep deprivation is dangerous."
Sleep deprivation is dangerous for every reason imaginable. That's whether
you're talking about cancer, whether youre talking about health and fitness,
wellness, stress control, emotional control. It doesn't matter. Everything is so
inextricably linked that you really can't break it out and say, "Well, this is the
important mechanism"
Which is where science tries to get to. By and large, science is a reductionist
belief system. We just think, "Well, if we can find the receptor or the gene
expression that's causing all these, then we'll be able to fix that and target
that. And then all these will go away."
Well, it hasn't worked for anything. Hundred years of pharma, that just really
hasn't worked. Apart from vaccine and antibiotics, that's really what's worked
in pharma. And that's about it. Everything else has, I would say, comparable
risks to benefits. There's very few pharmaceuticals out there that have an
exponentially more benefits than risks, and they're usually just slightly edging
out the risks. That would be my take on shift work.
Dr. Aconfora: We also know that the lack of sleep chronically elevates
cortisol. Why is that a bad thing?
Dr. Parsley: When you're talking about fight or flight, the fight or flight
mechanism primarily comes from the adrenal hormones. So you have an area
in your brain called the amygdala which is like the alarm system for your
body. It recognizes a threat and sets out this cascade of events to say, "Hey,
there's an orange-white-block striped pattern that we know to be associated
with a tiger that's very dangerous," or "That guy is pointing a gun at me and
that's very dangerous," or a truck nearly hit you, whatever.
You pick up on this alert. This alarm system picks up on something, and your
body then changes everything. One of the major things that happens is you
get a huge influx of adrenal hormones. And the adrenal hormones are cortisol,
epinephrine, and norepinephrine which are adrenaline, aldosterone which
controls your blood pressure, and then DHEA which has fuel production
pathways. But its primary function is to be converted into sex hormones and
anabolic intermediates on the way to sex hormones, which there's multiple or
dozens of those that are probably beneficial towards this process.
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12

But as I told you, when you are on fight or flight, your body's one and only
goal is to get you out of that bad situation. So if you're trying to get out of that
bad situation, does your body care if you can reproduce? So all of that
pathway is being diminished because you're using that fuel for other things.
Does your body care if it can fight off a virus? Or does it care if it can fight off
bacterial infection or a parasite? No, it doesn't matter. If you don't get away
from the tiger, none of that matters. Does it matter to your body if you can
repair the tendon damage, cartilage damage or ligament damage or muscle
damage that you've incurred in today's activities or the previous day's activity?
No, it doesn't matter. Does it matter if you can digest the food in your
stomach? Absolutely not. Does it matter if your liver can produce hormones
and antioxidants and cholesterol? No. All of that essentially gets shut down.
But that's our maintenance system and repair system. So when you have
chronically elevated cortisol, you're chronically impairing all of those activities.
Without being able to repair, you just essentially progressively breaking
yourself down more and more over time. That's the biggest mechanism
involved. There's lots of little nuances of that concept. That's the really basic
way to phrase that.
Dr. Aconfora: Absolutely. So we know that lack of sleep decreases
testosterone. It decreases growth hormone. It decreases insulin sensitivity and
thyroid function. Can you talk a little bit about that and how it affects
obviously the aging process?
Dr. Parsley: Most people have probably heard of growth hormone as like the
anti-aging drug. There's lots of well, I won't call them snake oil salesman, but
along that continuum, there are thoughts of physicians out there that will just
pump you for all the growth hormone you want, and then that will make you
feel better. The argument is, "Well, they look and feel better." I'm like, "Well, if
I gave them cocaine every day, they'd feel better, too. But that doesn't make
that a good idea."
So probably an excess of growth hormone pass some deleterious effects. But
when you talk about the actual phenotypic-- what people see the phenotypic
aspect of aging, so like thinning skin, wrinkles, gray hair, and all stuff -- that
stuff is by and large being controlled by anabolic activity and primarily growth
hormone.
When you don't get enough slow-wave sleep cycles or deep sleep cycles, that's
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13

when you're producing about 99 percent of the growth hormone that you're
going to produce during the day. So if you don't have that, now you have a
growth hormone deficiency. Also, the vast majority of your testosterone is
produced while you're asleep.
Testosterone isn't a male hormone. People think of it as the dominant sex
hormone for men. It's the dominant sex hormone for men and women. Women
actually have 10 times more testosterone than they do estrogen, but men have
10 times more testosterone than women do and 1/10 of the estrogen that
women have. So that's where, I think, that misnomer came from.
But testosterone is a very anabolic hormone. Thyroid is actually is a very
anabolic hormone. But when we're talking about chronically elevated cortisol,
one of the things that chronically elevated cortisol does is it interferes with
thyroid function. Your thyroid actually produces and secretes a hormone
called T4, which means it has four iodine molecules on it. And it has to be
converted into T3 to become biologically active. And there's an enzyme that
does that. And it's called an deiodinase enzyme, for anybody who wants to
geek out on that.
But that enzyme is actually impaired by excessive cortisol levels, and then
what we get is a lot of what we call reverse T3, which is not biologically active.
So now you've interfered with your primary growth hormone, your primary
anabolic hormone, and your secondary anabolic hormone]. And really, what
aging is, as we talk about exercise breaking down cells, all cells in our body
have a finite life period. Probably most of your audiences have heard of
apoptosis. It's just like programmed cell death.
All of your cells are dying and replenishing. The rate at which that happens is
largely determined by your physiological state. So people can actually
physiologically age faster than the years would predict. And that is primarily
caused by a lack of all these hormones that we're talking about. When you
don't have these hormones, you don't have the ability to repair these cells, to
repair the little machineries inside the cells, what we call the organelles.
And the fuel utilization and what we call antioxidants, a lot of our fuel
production for energy leads to these free radicals, these oxygen molecules that
can damage cells and damage tissue .And we produce natural antioxidants to
kind of counter-produce or counteract those. But those proteins and
antioxidants are seriously decreased if you don't have enough anabolic
pathways.
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So when you decrease collagen production, say, which is a well-known side

effect of having low growth hormone, that results in what we call facial sagging
and facial wrinkles and also thinning of the skin because collagen makes up a
significant amount of the skin thickness.
What also happens with a decrease of anabolic hormones is that you actually
lose musculature. So your muscle start wasting because of the fuel
partitioning issue. You're actually using your muscle cells as amino acids
since you're breaking down muscle cells and you're losing muscle cells. The
reason elderly people's face looks a lot like their skull is because they've lost
the muscle that was sort of padding that skull to make it look more round and
robust. So that's an obvious facial aspect of aging.
If you look at other aspects, I guess we should first clear what is aging. In my
opinion, aging is really becoming fatter, dumber, slower, and colder. We lose
cognitive functioning from sleep deprivation, so that makes us dumber. We
lose thyroid function through sleep deprivation. That makes us colder. We lose
insulin sensitivity, leptin sensitivity, ghrelin sensitivity, orexin sensitivity -- all
sorts of things that are controlling our appetite and fuel partitioning when
we're sleep-deprived, which makes us fatter.
Slower comes from aches and pains, from cognitive slowing down, from pure
muscle strength, pure energy, and all that stuff again are all affected by this.
If you have a chronically elevated cortisol and by chronic I mean more than a
couple of days, definitely more than a couple of weeks of elevated cortisol, we
know that leads to chronic inflammation.
And we can measure this in your serum. We can find all these little
inflammatory markers that tell us your body is having this hyper immune
response to nothing specific. And these inflammatory markers are causing
pain, stiffness, and edema or swelling. They're causing joint pains. They're
causing you to feel old and move slowly.
So again, sleep really touches on all of those things. The reverse of all of those
things are true. If you sleep really well relative to other peopleAnd again
aging is a relative concept. We're all basically comparing ourselves to people
about our age and how we look, feel, and perform compared to those people.
If you're sleeping really well, you're going to be more advanced in these areas,
which means you're going to maintain collagen longer. You're going to
maintain skin turgor longer. You're going to maintain skin thickness. You're
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going to maintain musculature. You're going to maintain body composition,

body warmth, and mobility, and decrease aches and pains and all that other
stuff, which is going to make you more active. You're going to maintain
cognitive function more.
We know for a fact that sleep deprivation leads to death of brain cells and if
you chronically sleep-deprive yourself, a lot of that is irreversible. One of the
major reasons that you lose these brain cells is an area in the brain calls the
locus coeruleus. And it's one of the primary alertness pathways that the brain
comes from, and not only just cognitive alertness, but like physical initiation
of movement and so forth. Essentially it's secreting adrenalin-like hormones
that are affecting your brain, which are affecting your motor cortex as well as
your cognitive abilities.
Dr. Aconfora: You have painted, I would say like Rembrandt, a brilliant
picture of what happens when we don't get any sleep. It's just remarkable.
Now, could you be like Leonardo Da Vinci and tell us what we could do to get
better sleep?
Dr. Parsley: Sure. The first step in getting good sleep is realizing that we need
sleep -- realizing that sleep isn't a luxury. There's a little bit of the reversal of
social training. The social training is that sleep is a luxury. If you're going to
be really successful and a really valuable person to society, you're going to get
up early and you're going to work hard and go to bed late. That's just all part
of the self-discipline of being a professional and being high-achiever. Nothing
could be further from the truth.
Every hour that you deprive yourself of sleep, you lose in that hour in
productivity, somewhere between 15 and 30 minutes. So if you sleep one hour
less than you need, you're going to decrease your overall efficiency for that day
and your productivity for that day by about 15 to 30 minutes. So it's negative.
So you're essentially losing 15 to 30 minutes of work by getting to work an
hour earlier if you're sleep-depriving yourself to get there.
So for people who really recognize that, "Hey, this is probably the most
important thing that I can do for anything -- for my personal health, my
professional performance, my ability to see my grandchildren grow and enjoy
that aspect, and my ability to travel after my kids have left home, all the stuff
that people look forward to towards the later stages in life, you're robbing
yourself of all that stuff. But you're also robbing yourself of your current
performance.
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In my opinion, the most important thing is that you're robbing yourself of the
enjoyment of what's currently going on in your life. We didn't touch on that
much. But really your ability to enjoy what's going on, your emotional
stability, your outlook on life like whether you're looking at the world as the
glass half empty and the glass half full, it's largely controlled by how well
you're sleeping.
If you're chronically sleep-deprived, you are definitely interfering and affecting
your emotional cascades. You're making yourself much more of a pessimist.
You're making yourself a much more stressed out reactionary person. I'll quit
beating that drum, but that's the number one, I have to say. Sleep is really
valuable. I'm 100 percent committed to it.
If really nothing elseand I've written a blog about this in the pastone of the
things that we used to say in the cell teams is when they would give you a
test, they just seemed absolutely impossible. One of the little clich sayings
when people would bicker about whether or not that was a realistic test, they
would always say, "If I gave you a million dollars to" And this was back in
the '80s when a million dollars was worth something.
"If I gave you a million dollars, would you be able to do this? Would you be
able to figure out what to do with this?" The answer is almost always yes. And
then I say, "Well, then, you can do it without the million dollars." The million
dollars is just a luxury. If you can do it with a million dollars, you can do it
without a million dollars. So figure out a way to do it.
So if you were really like, "This is my number one priority," you don't need me
or anybody else. As long as you have a computer, a network, and you can get
on Google and you can search to your heart's content. But in order to give
your audience a little more simplistic path, I'll give a few tips on that. But the
point is, there are just an unaccountable, innumerable number of tactics and
strategies that you can employ to improve your sleep. But it basically boils
down to two things.
There are two things that allow you to go to sleep. One of those things is a
change in your brain's neurochemistry, which is primarily controlled by the
amount of light entering your eyes. The other thing is the stimulation to your
neocortex. And the neocortex is really that big wrinkly mass of brain that we
all think of when we think of the human brain.
Sort of buried within the bottom part of that is what we call the lizard brain or
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the primordial brain. That's where all the autonomics is occurring, but that's
also where the neurotransmitter changes are occurring, which are then later
affecting the neocortex, but they're affecting your body and also some other
things.
And so the slowing down of the neocortex is necessary for us to go to sleep.
And what that means is that anybody who's ever had the experience of getting
a poor nights sleep, getting up and going to work, just being miserably tired
all day and then saying, "As soon as work is over, I'm going home and Im
getting in bed, and I'm going to sleep like 12 hours tonight and I'm going to be
way better tomorrow, and then something happens, one of your friends talks
you into going to a bar or go to happy hour, or going to the gym, which is
maybe a little more understandable.
But if you think about happy hour, you're going to down to a bar. You're going
to drink what is essentially a CNS depressant which should be making you
more tired. But yet you're going to wake up and then you start feeling more
alert, and you go, "I don't need to go home and go to sleep," and then you're
going to make some more bad decisions. And then you're going to get another
bad night of sleep. And the cycle is going to perpetuate.
But what's allowing you to be awake, even though you're drinking a CNS
depressant where it should be making you more tired is that you're
stimulating your neocortex. You're stimulating it with light. You're stimulating
it with movement. You're stimulating it with conversation. You're stimulating
it with your attraction to the hot girl or the hot guy next to you or whatever.
Whatever it is that's going on that stimulates you, that's going to keep you
awake.
The same thing is true if you're at home. So if you were watching television
right up until the moment you go to sleep, you're stimulating your brain.
You're actually doing both. You're putting the light into your eyes and you're
stimulating your neocortex. If you're trying to work on your computer right up
until the moment you go to sleep, your brain is racing. Your brain is not ready
to go to sleep.
I always give the metaphor it's the same as if you're trying to work until 9:59
and get in bed at 10 o'clock, and expect to be able to go to sleep is no more
realistic than waking up, getting out of bed, and having big weights right next
to your bed and trying to do the one rep max dead lift or something the second
you wake up. Who would do that, right? You're just not physiologically ready
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to do that. It's going to be a terrible idea. It's the same thing with going to bed.
I tell people really the key to getting enough sleep is slowing down the
neocortex and decrease the amount of light going into your eyes. It's really
that simple. You can decrease the amount of light going into your eyes by
dimming the lights in your house.
Philips makes light bulbs that have no blue light. We didn't really get into
that, but blue light is what really stimulates the brain to be awake. You can
wear gaming glasses or shooting glasses that essentially blocks the blue light,
decreasing the amount of blue light going into your eyes which will allow these
cascades to go on.
If you're working on a computer or a smart phone, there's apps. One is called
F.Lux. I have nothing to do with these corporation or company. I get no money
from referring those guys. But what that program does is you can program in
where you live. And at sundown, it will take the blue light out of your
computer screen or out of your smartphone screen. And then when the sun
comes up, it will put it all back in there. You'll notice your computer getting
significantly dimmer. Those are all techniques for decreasing the amount of
light going into your eyes. That's light saturation.
The other thing I do is I tell people, "You need to slow your brain down before
you get into bed." So at least an hour before you go to bed, you need to shut
down. You have to shut down your work. You have to shut down your worries.
You have to shut down your conversations about everything important. This
should be self-evident to anybody who's ever had a kid or been a kid. You
don't take a kid who's bouncing off the walls and just go stick them in bed.
You have like this protracted bedtime ritual to get them ready for bed.
Adults need that same ritual. There's no difference. I usually recommend to
people that you set an alarm to tell yourself it's time to get ready to go to bed.
So an hour before your bedtime an alarm goes off. And you take that alarm
just as seriously as you take the alarm that wakes you up in the morning to
go to work. And once that alarm goes off, it's time to start decreasing the
stimulation to your brain. Then you're definitely dimming down the lights. You
can do some very low-intensity stretching, low-intensity yoga, low-intensity
tai-chi -- any time of movement that makes you feel good and great.
You can read a book and sort of lower level is great. You can meditate. You
can do some breathing exercises. You can simply sit on your couch and
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daydream and have a can of milk tea or something like that, but just start
decreasing your activity in your brain, decreasing the stimulation in your
brain, and your brain will slow down and be much more ready to go to sleep.
And if you've done the light saturation stuff earlier, which needs to start
happening about three hours before bed, then your brain will be really ready
to go to sleep when you get to bed.
Another thing that will help that process, something that's called sleep
pressure, which is basically our drive to go to sleep which is what makes us
feel like you're just completely zonking out when we hit the pillow is a peptide
called adenosine. And adenosine is a breakdown of ATP which most people
have heard of as sort of our cellular energy or fuel source. ATP breaks down to
ADP and then AMP, and then eventually it's just adenosine. And adenosine
causes sleep pressure.
So the more you exercise, the more ADP, the more adenosine you build up,
the more sleep pressure you'll have. Also, just using your brain extensively, so
if you're really concentrating and working hard all day, you're not only
stimulating brain, you'll build up adenosine and actually it will be in your
brain, which again will increase sleep pressure.
So all of those things will help you drive yourself to sleep. Now staying asleep
is a different issue. And actually staying asleep and falling asleep can be
interwoven slightly in this topic I'm about to discuss.
But one of the things that keeps people from falling asleep is stress and worry,
and one of the things that wakes people up prematurely is stress and worry.
So what I always tell people to do is to take a piece of paper and draw a line
down the middle line. And this is really much more effective if you'd do this on
paper as opposed to doing it on a computer or something.
On the left-hand size, you write your to-do list, everything that you know you
need to do tomorrow. On the right-hand side of your paper, you write down
your to worry list. And the difference between the to-do list and to-worry list is
that the to-worry list is that the to-worry list is primarily made up of stuff you
don't have any control over. But you don't want to forget to worry about it.
So you put all these on the right-hand side of the paper. You put all your todos on the left-hand side of the paper. And then you look at that piece of
paper and you say, "This is a lot of stuff to do," and maybe that's causing you
anxiety. You say, But the most capable Im going to be in handling this list is
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after I've gotten a good night of sleep. So I'm going to get a good nights sleep.
And while you're wide awake and your brain is functioning well, youre going
to pick out what time you need to wake up in the morning and you're going to
set an alarm clock. And you're going to put that alarm clock somewhere where
you can't see it, in a drawer, cover it with a towel, whatever it takes, to where
you can't see that clock anymore. But you know you'll still be able to hear it
and it's going to wake you up.
And then you make yourself a pact. If I'm most capable of handling this list
after a good night sleep, why would I think about anything on this list before
I've gotten a good night sleep? You're actually much more likely to make a
mistake or make some poor choices around that list.
So now you put that list on your table. And you know it's there in the morning
and you say, "I'm going to turn all of that off. I'm going to get a good night's
sleep." And the way I'm going to initiate sleep is when I lay here and I'm going
to relax. I'm going to allow myself to fall asleep whenever it happens
And you lay there. And you fall asleep by doing breathing exercises, by doing
progressive muscle relaxation, by meditating, by closing your eyes and trying
to hallucinate colors, by thinking of pleasant environments -- whatever it is
that takes your mind off of that list. And then you just allow yourself to fall
asleep whenever you fall asleep, and don't make a big deal when you fall
asleep. You're not going to look at that clock again. That's the number one
thing to think about. You're not going to look at that clock again.
You're going to lay in bed and relax. And at some point, you're going to sleep
and at some point you're going to wake up, and you're not going to make a big
deal out of when either one of those things happen.
Now, eventually you'll fall asleep. If you're somebody who falls asleep really
easily or even if takes you a while to go to sleep, you might wake up later. If
you wake up in the middle of the night, you're not going to know what time it
is because you're not going to look at your clock. If you look at your clock,
you're immediately going to start doing all these mental calculations about
how much more sleep you can get and what sort of things you can shift
around in your day to be able to handle your list and all these other things
you get going on in your brain.
But if you dont look at your clock, you can say, "Oh, I've woken up. Whatever.
That's a part of life. I'm going to lay here and relax again. I'm going to lay here
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and do my breathing again, or my progressive relaxation, or my meditation" -whatever your thing is. "I'm going to lay here and do that until my alarm clock
goes off."
And if your alarm clock goes off 15 minutes later, great. You got 15 minutes of
meditation or relaxation. You're going to be a little better off than if you
haven't got those 15 minutes. If your alarm clock is going to go off for four
hours, you're going to fall back asleep.
Those very simple rules are really all it takes. Everything else we talked about
around sleep hygiene is just a more sophisticated or more verbose way of
saying those same things. All the techniques around sleep hygiene are all
based around those two concepts. It's slowing down the neocortex, not
stimulating the neocortex, and decreasing the light saturation in your eyes.
That's really all there is to it. That simple.
Dr. Aconfora: That actually is really simple and one of the things that helps
me do a breathing exercise before I sleep. I also give gratitude. And it just
makes my life much more fuller and richer and allows me to put my head on
the pillow and I can fall immediately to sleep.
Dr. Parsley: Giving gratitude is a great stress-reducing technique because
you're realizing that there's lots of things in your life that are more important
than what you're feeling or worried about right now. Gratitude is just like this
global view of the world as opposed to the intricacies or the tasks of the next
day or the next week, or kind of whatever your stresses are. That should be
pretty minor.
Dr. Aconfora: What I really like, what you said, Doc, was putting pen to
paper in the to-do list and to-worry list. There's something magical about
putting pen to paper, engaging the neocortex when we do that. I think that's a
great, great practice for people to start doing.
So let me ask the really final question is where can people find you in the
world?
Dr. Parsley: If they want to see me personally, they're going to need to find
me in one of the many states of the country. I don't know -- I travel a lot. But
seriously, my site is active and has been up for a couple of years. And that's
docparsley.com. Within the next, hopefully, four weeks or so, we're
relaunching that site to a much more professional and robust source of
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information. I've written and contributed way more content. I know what's
actually on my site.
You can just put my name on Google and you could find -- I think there's over
a hundred podcasts now, and there's probably 40 or 50 videos there, and my
TED talk is there, my Dr. Oz stuff is there. Kind of all the personal and
commercial media stuff I've done are also available.
You can learn more about my sleep product off of my site under the SHOP, or
you can go to or click to that site, to sleepcocktails.com, and I actually cover a
lot of what we talked about. There's the normal physiological things that
should happen in order for your brain to start changing the
neurotransmitters. I go into more detail on that site about what we just talked
about and that takes to a higher level of scientific rigor, I guess.
Dr. Aconfora: And just so people know I'm being completely transparent, I
refer my patients and clients to Sleep Cocktail, because it's a wonderful
product. It really does help with sleep hygiene, and we've gotten some really,
REALLY good results with people who have had chronic sleep deprivation
problems.
Like yourself, Doc, my dad was a police officer working with the police
community. We've actually started to make some headway in getting better
sleep in doing all of these sleep hygiene things. You nailed it and your product
is definitely part of that.
Dr. Parsley: Thank you.
Dr. Aconfora: Thank you. Well, everybody, thanks so much, Doc, for being
on the show. I hope you guys enjoyed this and we will see you next time.
Thanks everybody. Ciao!

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