Kirk Parsley

7/26/2019 Kirk Parsley

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© Centre for E i enetic Ex ression. All ri hts reserved. 1

Sleep: the Modern Hack to Better Health

Guest: Kirk Parsley

The purpose of this presentation is to conveyinformation. It is not intended to diagnose, treat, or cureyour condition or to be a substitute for advice from your

physician or other healthcare professional !

Dr. Aconfora: Hey, everybody. Welcome back to TheLongevity & the Anti-Aging Project . I'm your co-host

today, Dr. Mike Aconfora. And today I have with me Dr. Kirk Parsley. Doc, howare 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 gota bunch of questions to ask. And I'm ready to start writing.

Dr. Kirk Parsley served as an undersea medical officer at the Naval SpecialWarfare Group 1 from June 2009 to January 2013. While there, he led thedevelopment and supervised the group's first sports medicine rehabilitationcenter.

He's a former Navy SEAL and received his medical degree from Bethesda

Uniformed Services University of Health Sciences (USUHS) in 2004. Heinterned in obstetrics and gynecology at Balboa Naval Hospital in San Diego in2005, and subsequently completed a Navy residency in hyperbarics and divingmedicine in 2006.

Dr. Parsley has been a member of the American Academy of Sleep Medicinesince 2006 and served as Naval Special Warfare expert on medicine. In




addition, he is certified in hormonal regulation that's age managementmedicine.

After leaving the Navy, he went into concierge medicine and consulting. Hecontinues to consult for multiple corporations, and professional athletes andteams. Dr. Parsley lectures worldwide on sleep wellness and hormonaloptimization and is currently completing a book on sleep and healthoptimization.

His philosophy for wellness is simple: in order to optimize our health and getthe most out of our bodies and minds, we must live more closely to the way weevolved as a species. He believes that many diseases and disorders that weaccept as inevitable in our modest society are unnecessary and complicationsof 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 oflife possible and realize their health performance and longevity goals. Dr.Parsley spends as much of his spare time as possible with his wife Cindy andhis three beautiful children, Hayden, Cole, and Harper. He's been acompetitive athlete his entire life and enjoys nearly all outdoor activities andsports.

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 littlebit 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 inKaty, Texas, which was a small town outside of Houston at that time. I was acompetitive 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




arts, boxing, and some other things like that. I've just kind of always reallybeen into that.

I literally started lifting weights at 8 years old. I started reading nutritionalbooks, exercise physiology books at a really young age, probably aroundmiddle 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 optimizingmy own health and optimizing my own performance.

I was really into athletics. I was really into girls. I was really into cars. I wasn'tso much into academics. And so I actually was a pretty pitiful high schoolstudent. I ended up dropping out of high school. It went for four years, butthen graduated. And then I went to the Military to become a SEAL. I wanted tochallenge 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 agirl, as the saying goes. I realized that being a SEAL is sort of a young singleman's job, and I was becoming neither. So I decided I'm going to get out andpursue other interests. And the girl I was dating at that time was a physicaltherapist, and so I thought I would become a physical therapist. I was takingher textbooks in deployment with me and reading all of her grad schooltextbooks.

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 startedcollege, and that pretty quickly turned into a job as a physical therapy aideand 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 aroundtrying to get into medical school. But obviously I succeeded and managed toget 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 reallyopportune time when they were building their first sports medicine clinic. Andof course, having worked in a sports medicine center for six years duringcollege, it's a pretty easy fit for me. And so I designed that center and we hiredthe first exercise physiologist, our first strength and conditioning coach, our

first nutritionist, and all the things you would assume that in a lead




organization like the SEALs would have had for decades.

Then I was the dumbest sports medicine guy around because I've hired allthese experts who have been working in sports medicine for 20 years. And sothen, 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 theirmusculoskeletal injuries, but to talk to me about these other sorts ofsymptoms 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 andemotion, and just physiological shifts/changes in body composition andenergy, 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 diseaserecognition and treatment algorithm sort of learning program. So if you don'thave disease, you pretty much send them home with a slap on the butt andsay, "Walk it off."

These guys definitely did not have disease. But they just weren’t performing asthey should, and that just led me to exploring lots of other avenues. Somepeople would call it alternative medicine. I don't think there's necessarilyanything 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 themilitary leadership wasn't about to let me get up in front of thousands ofSEALs and start talking about hormone dysregulation. Because then all theSEALs would want hormones, and they weren't going to let me put SEALs onhormones because then there would be an admiral on CNN explaining why allSEALs are taking steroids or whatever this then would be.

So I was in a great position during this self-education phase where SEALsreceived a lot of notoriety already from the war because this was 2009. So lotsof their high-profile missions had already been out there. So they had thisquasi-celebrity status. And I could call world-renowned experts in any fieldthat I was interested in and say, "Hey, my name is Dr. Parsley. I work with theSEALs. 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




consult with you or train with you or whatever." People were always more thanwilling to help.

So it allowed me ramp-up pretty quickly. I started talking about sleep as asleight of hand because I could talk about hormone replenishment andhormone production during sleep, and it sort of motivated the SEALs aroundthe anabolic nature of sleep. I was kind of half bought into the idea that sleepwas the major problem. I definitely thought it was a contributing factor. But itwas a politically and socially acceptable way for me to talk about these things.

And then through years of continued research—and I don't mean I'm doingclinical research, but researching, reading literature and consulting with theprofessionals—I'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 ordersof magnitude, sleep is the most important aspect of, not only health, butdefinitely health optimization.

Dr. Aconfora: You are really the only person that I know of…And looking atthe truly remarkable work that people are doing, everybody touches on thissleep 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, anda positive mindset, and if we're not sleeping, the picture that you've paintedfor 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 debunkthe other pillars of health as being the most important. What I mean by thatis, say if you're taking nutrition. Nutrition is important. When I work withgroups or individuals, I work on all four pillars. Don't get me wrong. I don'tthink 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 ofbickering between the zealots on either end of the nutritional spectrum. Butwe know, there's no question that most of the nutrition issues revolve aroundinsulin sensitivity. Lots of people think of insulin as the way the regulation ofblood glucose. And that's true. But it does a lot more than just regulation ofblood glucose.




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, inwhat order, and in which preference are you going to use these variousnutrients to produce energy. And which energy system is your body going topreferentially 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 pernight -- 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 insulinsensitivity 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 borderlineinsulin sensitivity already. They short-sleep by two hours a night. They'reprediabetic, 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'reperidiabetic, you're really setting yourself up for failure. That's kind of thebeginning of the end for everybody as it comes to nutrition. Of course, there'slots of other hormones that are involved in that, and leptin being a fat-signaling thing, which is also affected by sleep. Ghrelin, which is an appetite-

stimulating 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 isgoing to be undone just by simply not sleeping enough.

Take the same thing about exercise. The whole idea of exercise is to increaseinsulin sensitivity really. That's the primary mechanism of which exercise isbenefitting people when you talk about moderate exercise for health. When

you're talking about elite performance and competing, there's other aspects ofit. But those other aspects, again, requires sleep.

So if you're training to be an endurance athlete, you're going to over-train yourmuscles. You're going to work your muscles over a long duration that's goingto deplete the glycogen storage and cause them to resort to other fuel-burningmechanism. Again, insulin sensitivity is playing a big role in that.




But whether you are exercising your muscle cells through low-intensity, long-duration exercises, like training for a triathlon, or if you're trying to become anOlympic lifter or power lifter and you're looking at very short-hour bursts ofmoving 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'redamaging all of the tissues -- connective tissues, muscular tissues. You'restressing not only the fuel utilization and production of the cells, but also theability to clear toxins and your lactic acid being an obvious one. But there'slots 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 becomemore 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'retrying to perform in.

And all of that advice is based on people who are metabolically andphysiologically sound. So if they say, "Do X number of repetitions or x milesfor your training," that's based on you being physiologically intact. And inorder to prevent over-training, you need to be physiologically intact for thatvolume to be appropriate.

And if you're not sleeping well, then you're not physiologically intact. And youprobably need twice as much recuperation time. And so you need to cut thattraining volume or the progression towards higher training volume in half. You

need to make that…It's going to take you a lot longer to get better in any typeof activity. So you can kind of get rid of exercise as being the most importantbecause 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 youcan 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 ofvisceral organ production and neuro attention and all sorts of thingsthroughout 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




nervous system or the automatic nervous system. For simplicity's sake, wecall that the rest and digest pathway, kind of self-explanatory. And then theother side of the spectrum would be the sympathetic nervous system, whichwe sometimes call the fight or flight nervous system.

Fight or flight, as most people know, is like the extreme of stress. It's like thehighest level of stress you can possibly be. You hit this threshold andessentially your brain shuts off and you redistribute your energy sourcesacross 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 theparasympathetic system would have you do. Things like digestion, repair andimmune 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 evolutionarystandpoint. If you think about what fight or flight is really designed to do, it'sreally designed to get us out of a very bad situation as quickly as possible andthen return to homeostasis, return to natural baseline as soon as that threatis gone.

Well, we have hundreds of thousands of years of genetic training so to speak,genetic predisposition towards how we handle certain stressors. Our ancestorslearned 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'tour ancestors because they became some other animal's dinner or somethinglike that.

So if you want to have a really well-functioning fight or flight system, theinteresting thing is you actually disengage that prefrontal cortex that I wastalking about, that executive functioning and emotionality because you wantto be super impulsive. You don't want to sit there and think about tacticallyhow 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 tosucceed. So we know that when people sleep-deprive themselves, they haveexcessive sympathetic tone. Now, interestingly, in today's society, we haveexcessive sympathetic tone all the time anyway because we have so manystimuli coming in.




And even though they aren't necessarily stressful in and of themselves, like aphone a call isn't necessarily stressful, but when you have 12 phone callscoming in and you're 36 emails behind, and you're running late for anappointment, and you’ve got to pick a kid from school, and the bills need to bepaid -- 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 thishigher and higher sympathetic tone. And as I described, when you're in fightor flight, your body is marshalling its resources to be able to fight or flee. It'snot marshalling its resources to repair damage, to fight off infections, toincrease fertility, all of the types of things that you would be doing during yourrest 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 toflush out neurotoxins and replenish neuropeptides an neurotransmitters.Your brain is repairing. Your body is repairing. You’re taking things that werein your working memory and short-term memory, converting those into long-term memory. You're categorizing emotional events into their appropriateintensity and appropriate place, and sort of your emotional stratification.

All these things are dealing with your ability to recognize and feel what is ahigh-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 biofeedbackdevice or heart rate variability device, or you wanted to use some meditationor yoga or any of those other types of things, that requires some self-awareness, 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 executivefunctioning, and that executive functioning is where your willpower comesfrom. So now you're much less likely to engage in the stress reductiontechniques. Even if you know them and you practice them and you valuethem, 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.




That to me debunks the whole argument of the four pillars of health: sleep,nutrition, exercise, and stress mitigation. All of these pillars are heavilyinfluenced 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 forsuccess 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 havegreat sleep and crappy nutrition, and probably be okay. You can have greatsleep and moderately good nutrition and not really exercise much, and you'llprobably be okay.

That's just kind of my anecdotal and professional experience with all thesestuff. So that's why ultimately I ended up being the sleep guy. I've never reallystarted 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 amansion. 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 thatmansion is going to collapse. And that's us. And that's what we see in societytoday.

Dr. Parsley: Yeah, I agree.

Dr. Aconfora: So let's talk about a couple of different things here. Numberone, what does the World Health Organization say about shift work? Becausemodern 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 type2a carcinogenic. What that categorization means is that a significant increasein 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 seeif they get cancer. Of course, that's an unethical trial. So it's always going tobe a type 2a.

So that's sort of the one really big bad aspect. People are really afraid ofcancer. 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




cancer gets a lot of publicity right now. And so people are really worried aboutcancer.

There's several proposed mechanisms. But at the end of the day, we know thefacts of insulin sensitivity. And we know that almost all cancers thrive off ofglucose. If you have elevated blood glucose and you develop cancer, it's muchmore likely to become aggressive at a higher rate and grow more quickly, soon, 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 aboutwhen they think of circadian rhythms is they're thinking about-- I guess thepeople 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 ourbodies 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 alsocontrolling the epigenetic expression of multiple genes throughout the day --protein synthesis, fuel utilization, you're toxicity clearance. All of those thingsare happening in a rhythm, and every single cell in your body has a biologicalclock 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 othercells that are using their biological clock, they're still going to be going on theirown 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 ofsynchronicity.

And in doing that, you're just essentially metabolically breaking yourself.You're setting yourself up for failure because although we break the bodydown 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 describewhat these means, but all of those are completely intertwined. There's no wayof separating that.

Your heart is controlled by neurological things that's controlled by hormonesbeing produced by your liver, hormones produced by your kidneys. Your

muscle lactic acid threshold is driving hormone production in your liver,




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 you’re talking about health and fitness,wellness, stress control, emotional control. It doesn't matter. Everything is soinextricably linked that you really can't break it out and say, "Well, this is theimportant mechanism"

Which is where science tries to get to. By and large, science is a reductionistbelief system. We just think, "Well, if we can find the receptor or the geneexpression that's causing all these, then we'll be able to fix that and targetthat. And then all these will go away."

Well, it hasn't worked for anything. Hundred years of pharma, that just reallyhasn't worked. Apart from vaccine and antibiotics, that's really what's workedin pharma. And that's about it. Everything else has, I would say, comparablerisks to benefits. There's very few pharmaceuticals out there that have anexponentially more benefits than risks, and they're usually just slightly edgingout the risks. That would be my take on shift work.

Dr. Aconfora: We also know that the lack of sleep chronically elevatescortisol. Why is that a bad thing?

Dr. Parsley: When you're talking about fight or flight, the fight or flightmechanism primarily comes from the adrenal hormones. So you have an area

in your brain called the amygdala which is like the alarm system for yourbody. 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 associatedwith a tiger that's very dangerous," or "That guy is pointing a gun at me andthat's very dangerous," or a truck nearly hit you, whatever.

You pick up on this alert. This alarm system picks up on something, and yourbody then changes everything. One of the major things that happens is youget a huge influx of adrenal hormones. And the adrenal hormones are cortisol,epinephrine, and norepinephrine which are adrenaline, aldosterone whichcontrols your blood pressure, and then DHEA which has fuel productionpathways. But its primary function is to be converted into sex hormones andanabolic intermediates on the way to sex hormones, which there's multiple or

dozens of those that are probably beneficial towards this process.




But as I told you, when you are on fight or flight, your body's one and onlygoal is to get you out of that bad situation. So if you're trying to get out of thatbad situation, does your body care if you can reproduce? So all of thatpathway 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 offbacterial infection or a parasite? No, it doesn't matter. If you don't get awayfrom the tiger, none of that matters. Does it matter to your body if you canrepair the tendon damage, cartilage damage or ligament damage or muscledamage 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 yourstomach? Absolutely not. Does it matter if your liver can produce hormonesand 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 mechanisminvolved. There's lots of little nuances of that concept. That's the really basicway to phrase that.

Dr. Aconfora: Absolutely. So we know that lack of sleep decreasestestosterone. It decreases growth hormone. It decreases insulin sensitivity andthyroid 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, butalong that continuum, there are thoughts of physicians out there that will justpump you for all the growth hormone you want, and then that will make youfeel better. The argument is, "Well, they look and feel better." I'm like, "Well, ifI gave them cocaine every day, they'd feel better, too. But that doesn't makethat a good idea."

So probably an excess of growth hormone pass some deleterious effects. Butwhen you talk about the actual phenotypic-- what people see the phenotypicaspect of aging, so like thinning skin, wrinkles, gray hair, and all stuff -- thatstuff is by and large being controlled by anabolic activity and primarily growthhormone.

When you don't get enough slow-wave sleep cycles or deep sleep cycles, that's




when you're producing about 99 percent of the growth hormone that you'regoing to produce during the day. So if you don't have that, now you have agrowth hormone deficiency. Also, the vast majority of your testosterone isproduced while you're asleep.

Testosterone isn't a male hormone. People think of it as the dominant sexhormone for men. It's the dominant sex hormone for men and women. Womenactually have 10 times more testosterone than they do estrogen, but men have10 times more testosterone than women do and 1/10 of the estrogen thatwomen have. So that's where, I think, that misnomer came from.

But testosterone is a very anabolic hormone. Thyroid is actually is a veryanabolic 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 beconverted into T3 to become biologically active. And there's an enzyme thatdoes that. And it's called an deiodinase enzyme, for anybody who wants togeek out on that.

But that enzyme is actually impaired by excessive cortisol levels, and thenwhat 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 primaryanabolic hormone, and your secondary anabolic hormone]. And really, what

aging is, as we talk about exercise breaking down cells, all cells in our bodyhave a finite life period. Probably most of your audiences have heard ofapoptosis. It's just like programmed cell death.

All of your cells are dying and replenishing. The rate at which that happens islargely determined by your physiological state. So people can actuallyphysiologically age faster than the years would predict. And that is primarilycaused by a lack of all these hormones that we're talking about. When youdon'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 fuelproduction for energy leads to these free radicals, these oxygen molecules thatcan damage cells and damage tissue .And we produce natural antioxidants tokind of counter-produce or counteract those. But those proteins andantioxidants are seriously decreased if you don't have enough anabolic

pathways.




So when you decrease collagen production, say, which is a well-known sideeffect of having low growth hormone, that results in what we call facial saggingand facial wrinkles and also thinning of the skin because collagen makes up asignificant amount of the skin thickness.

What also happens with a decrease of anabolic hormones is that you actuallylose musculature. So your muscle start wasting because of the fuelpartitioning issue. You're actually using your muscle cells as amino acidssince you're breaking down muscle cells and you're losing muscle cells. Thereason elderly people's face looks a lot like their skull is because they've lostthe muscle that was sort of padding that skull to make it look more round androbust. 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. Welose thyroid function through sleep deprivation. That makes us colder. We loseinsulin sensitivity, leptin sensitivity, ghrelin sensitivity, orexin sensitivity -- allsorts of things that are controlling our appetite and fuel partitioning whenwe're sleep-deprived, which makes us fatter.

Slower comes from aches and pains, from cognitive slowing down, from puremuscle 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, weknow that leads to chronic inflammation.

And we can measure this in your serum. We can find all these littleinflammatory markers that tell us your body is having this hyper immuneresponse to nothing specific. And these inflammatory markers are causingpain, stiffness, and edema or swelling. They're causing joint pains. They'recausing you to feel old and move slowly.

So again, sleep really touches on all of those things. The reverse of all of thosethings are true. If you sleep really well relative to other people…And againaging is a relative concept. We're all basically comparing ourselves to peopleabout 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




going to maintain musculature. You're going to maintain body composition,body warmth, and mobility, and decrease aches and pains and all that otherstuff, which is going to make you more active. You're going to maintaincognitive 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 themajor reasons that you lose these brain cells is an area in the brain calls thelocus coeruleus. And it's one of the primary alertness pathways that the braincomes from, and not only just cognitive alertness, but like physical initiationof movement and so forth. Essentially it's secreting adrenalin-like hormonesthat 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 getbetter sleep?

Dr. Parsley: Sure. The first step in getting good sleep is realizing that we needsleep -- realizing that sleep isn't a luxury. There's a little bit of the reversal ofsocial training. The social training is that sleep is a luxury. If you're going tobe really successful and a really valuable person to society, you're going to getup 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. Nothingcould be further from the truth.

Every hour that you deprive yourself of sleep, you lose in that hour inproductivity, somewhere between 15 and 30 minutes. So if you sleep one hourless than you need, you're going to decrease your overall efficiency for that dayand 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 anhour earlier if you're sleep-depriving yourself to get there.

So for people who really recognize that, "Hey, this is probably the mostimportant thing that I can do for anything -- for my personal health, myprofessional performance, my ability to see my grandchildren grow and enjoythat aspect, and my ability to travel after my kids have left home,” all the stuffthat 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.




In my opinion, the most important thing is that you're robbing yourself of theenjoyment of what's currently going on in your life. We didn't touch on thatmuch. But really your ability to enjoy what's going on, your emotionalstability, your outlook on life like whether you're looking at the world as theglass 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 quitbeating that drum, but that's the number one, I have to say. Sleep is reallyvaluable. I'm 100 percent committed to it.

If really nothing else—and I've written a blog about this in the past—one 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 cliché sayingswhen people would bicker about whether or not that was a realistic test, theywould always say, "If I gave you a million dollars to…" And this was back inthe '80s when a million dollars was worth something.

"If I gave you a million dollars, would you be able to do this? Would you beable to figure out what to do with this?" The answer is almost always yes. Andthen I say, "Well, then, you can do it without the million dollars." The milliondollars 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 geton 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 thepoint is, there are just an unaccountable, innumerable number of tactics andstrategies that you can employ to improve your sleep. But it basically boilsdown to two things.

There are two things that allow you to go to sleep. One of those things is achange in your brain's neurochemistry, which is primarily controlled by theamount of light entering your eyes. The other thing is the stimulation to yourneocortex. And the neocortex is really that big wrinkly mass of brain that weall 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




the primordial brain. That's where all the autonomics is occurring, but that'salso where the neurotransmitter changes are occurring, which are then lateraffecting the neocortex, but they're affecting your body and also some otherthings.

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 gettinga poor night’s sleep, getting up and going to work, just being miserably tiredall day and then saying, "As soon as work is over, I'm going home and I’mgetting in bed, and I'm going to sleep like 12 hours tonight and I'm going to beway 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 ismaybe 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 youmore tired. But yet you're going to wake up and then you start feeling morealert, and you go, "I don't need to go home and go to sleep," and then you'regoing to make some more bad decisions. And then you're going to get anotherbad night of sleep. And the cycle is going to perpetuate.

But what's allowing you to be awake, even though you're drinking a CNSdepressant where it should be making you more tired is that you'restimulating your neocortex. You're stimulating it with light. You're stimulating

it with movement. You're stimulating it with conversation. You're stimulatingit 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 televisionright 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'restimulating 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 readyto go to sleep.

I always give the metaphor it's the same as if you're trying to work until 9:59and get in bed at 10 o'clock, and expect to be able to go to sleep is no morerealistic than waking up, getting out of bed, and having big weights right nextto 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




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 theneocortex and decrease the amount of light going into your eyes. It's reallythat simple. You can decrease the amount of light going into your eyes bydimming the lights in your house.

Philips makes light bulbs that have no blue light. We didn't really get intothat, but blue light is what really stimulates the brain to be awake. You canwear gaming glasses or shooting glasses that essentially blocks the blue light,decreasing the amount of blue light going into your eyes which will allow thesecascades 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 inwhere you live. And at sundown, it will take the blue light out of yourcomputer screen or out of your smartphone screen. And then when the suncomes up, it will put it all back in there. You'll notice your computer gettingsignificantly dimmer. Those are all techniques for decreasing the amount oflight 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. Thisshould 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 topeople 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 togo to work. And once that alarm goes off, it's time to start decreasing thestimulation to your brain. Then you're definitely dimming down the lights. Youcan do some very low-intensity stretching, low-intensity yoga, low-intensitytai-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




daydream and have a can of milk tea or something like that, but just startdecreasing your activity in your brain, decreasing the stimulation in yourbrain, 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 starthappening about three hours before bed, then your brain will be really readyto go to sleep when you get to bed.

Another thing that will help that process, something that's called sleeppressure, which is basically our drive to go to sleep which is what makes usfeel like you're just completely zonking out when we hit the pillow is a peptidecalled adenosine. And adenosine is a breakdown of ATP which most peoplehave heard of as sort of our cellular energy or fuel source. ATP breaks down toADP and then AMP, and then eventually it's just adenosine. And adenosinecauses 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, soif you're really concentrating and working hard all day, you're not onlystimulating brain, you'll build up adenosine and actually it will be in yourbrain, which again will increase sleep pressure.

So all of those things will help you drive yourself to sleep. Now staying asleepis a different issue. And actually staying asleep and falling asleep can beinterwoven 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 linedown the middle line. And this is really much more effective if you'd do this onpaper 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 youneed 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 isthat the to-worry list is that the to-worry list is primarily made up of stuff youdon'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 to-dos on the left-hand side of the paper. And then you look at that piece ofpaper and you say, "This is a lot of stuff to do," and maybe that's causing you

anxiety. You say, “But the most capable I’m going to be in handling this list is




after I've gotten a good night of sleep. So I'm going to get a good night’s sleep.”And while you're wide awake and your brain is functioning well, you’re goingto pick out what time you need to wake up in the morning and you're going toset 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 itand it's going to wake you up.

And then you make yourself a pact. “If I'm most capable of handling this listafter a good night sleep, why would I think about anything on this list beforeI've gotten a good night sleep?” You're actually much more likely to make amistake 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 goingto 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 doingprogressive muscle relaxation, by meditating, by closing your eyes and tryingto hallucinate colors, by thinking of pleasant environments -- whatever it isthat takes your mind off of that list. And then you just allow yourself to fallasleep whenever you fall asleep, and don't make a big deal when you fallasleep. 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 bigdeal out of when either one of those things happen.

Now, eventually you'll fall asleep. If you're somebody who falls asleep reallyeasily 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 abouthow much more sleep you can get and what sort of things you can shiftaround 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 don’t 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




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 clockgoes off."

And if your alarm clock goes off 15 minutes later, great. You got 15 minutes ofmeditation or relaxation. You're going to be a little better off than if youhaven't got those 15 minutes. If your alarm clock is going to go off for fourhours, you're going to fall back asleep.

Those very simple rules are really all it takes. Everything else we talked aboutaround sleep hygiene is just a more sophisticated or more verbose way ofsaying those same things. All the techniques around sleep hygiene are allbased around those two concepts. It's slowing down the neocortex, notstimulating 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 helpsme do a breathing exercise before I sleep. I also give gratitude. And it justmakes my life much more fuller and richer and allows me to put my head onthe 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 importantthan 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 nextday or the next week, or kind of whatever your stresses are. That should bepretty minor.

Dr. Aconfora: What I really like, what you said, Doc, was putting pen topaper in the to-do list and to-worry list. There's something magical aboutputting pen to paper, engaging the neocortex when we do that. I think that's agreat, great practice for people to start doing.

So let me ask the really final question is where can people find you in theworld?

Dr. Parsley: If they want to see me personally, they're going to need to findme in one of the many states of the country. I don't know -- I travel a lot. Butseriously, my site is active and has been up for a couple of years. And that'sdocparsley.com. Within the next, hopefully, four weeks or so, we're

relaunching that site to a much more professional and robust source of



information. I've written and contributed way more content. I know what'sactually on my site.

You can just put my name on Google and you could find -- I think there's overa 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 andcommercial 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 alot of what we talked about. There's the normal physiological things thatshould happen in order for your brain to start changing theneurotransmitters. I go into more detail on that site about what we just talkedabout and that takes to a higher level of scientific rigor, I guess.

Dr. Aconfora: And just so people know I'm being completely transparent, Irefer my patients and clients to Sleep Cocktail, because it's a wonderfulproduct. It really does help with sleep hygiene, and we've gotten some really,REALLY good results with people who have had chronic sleep deprivationproblems.

Like yourself, Doc, my dad was a police officer working with the policecommunity. We've actually started to make some headway in getting bettersleep 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 beingon the show. I hope you guys enjoyed this and we will see you next time. Thanks everybody. Ciao!

Kirk Parsley

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