Sleep, Stress, and Burnout: Dr. Parsley Breaks It Down on the Synergee Podcast

Podcast Transcript

Lori Esarey  0:05 

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

Kelly Engelmann    0:38

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

Dr. Kirk Parsley  1:09 

Well,I guess I’ll, I’ll start, you know, I, I joined the military right out of high school. You know, I was a terrible student my whole life. I started getting D’s and F in like, third grade after four years of high school as a sophomore. So I dropped out of high school and joined the Navy. And I’d heard about this Navy SEAL training supposed to be like the toughest training in the world. I didn’t know what a Navy SEAL was, but I wanted to do the toughest training in the world, so I went and signed up for that. Made it through that, and then I did about six I did six years, a little over six years in the Navy. And then I got out and was, you know, being a high school dropout, kind of had some ambitions around, kind of maybe an athletic trainer, like a, you know, athletic trainer ish kind of thing, strength and conditioning coach, maybe. But like, stretch goal, maybe a PT. And so I started volunteering at San Diego Sports Medicine Center to get my volunteer hours, because you need 2000 volunteer hours to apply to PT school, which is craziest thing I’ve ever heard of. And then they hired me pretty quickly. And after about six months there, like they hired me as a PT assistant or PC aid, and after about six months there, decided I didn’t really want to be a PT. And I worked with a bunch of this was like a healthcare method, had every kind of every kind of healthcare professional you could think of. And I worked with a bunch of doctors who were about about my age because I’d been in the military, so they’re maybe two or three years older than me. And they were like, oh, you should go to medical school. Yeah, we’re like, pump the brakes there. Sparky, you know, I didn’t even graduate high school, like, I’m in junior college, right? And long story around that. But eventually they kind of talked me into thinking that was possible, and so I tried to get into medical school. And when I took the MCATs and had all my coursework done, you know, before the internet was a big thing, I had to go down the bookstore and pull out the Kaplan review book, right? Well, I’m competitive for and that’s when I found out that the military had their own medical school. And I was like, wow. Like, I I had no idea, and I was already married, I already had a kid. I had another kid on the way, so it’s kind of a no brainer, you know, they’re gonna pay you to go to medical school instead of the other way around. And and I figured I’d get back to the SEAL teams and be able to give back to that community, which, you know, was instrumental in shaping me as a man and as an adult. And you know, you know, my only experience with medicine was as an athlete or a seal, and so it was all pretty much orthopedics, like sports medicine, injuries, right? And so that’s really all I thought medicine was. And so when I went to medical school, I thought I was going to be an orthopedic surgeon or maybe a sports medicine doctor. I don’t know something like that. And you know, when medical schools, you know, shaped everything I did my rotations. Really liked ortho and shaping everything towards that. But the way the military works is, you do your first year of residency, and then they make you go out and to the fleet and be a general practitioner for a couple of years, and then you can come back and finish. I guess you know, partially to test, you know, your commitment to that, right, but also so that they have general practitioners or everyone would just specialize and stay in the hospitals. So, so I did that, and went, went back to the SEAL teams. And, you know, I worked at San Diego Sports Medicine Center the whole time I was in college, you know, which was six years, because I had to do two years of junior college just to qualify for college. And then, and then, of course, I, you know, like I said, I really shaped all my medical school training towards, or. So, and I get to the SEAL teams, and, you know, it’s a bureaucratic funding organization, right? So it takes about 10 years to get the money for a project that they approve. And so they had just gotten the money to build the very first sports medicine facility the SEAL teams had ever had. And, like, like, coincidentally, the exact same month that I train

Kelly Engelmann    5:20 

Wow. Talk about timing, right?

Dr. Kirk Parsley  5:24 

And they’re like, well, you’re perfect. You should supervise the build out of this clinic. I’m like, Yeah, I’m perfect for this. This would be great. And then, of course, I Yeah, we had to, like, we hired our first physical therapist and our first trainer and strength and conditioning coaches and nutritionist and all this. And we and, you know, supervised the build out, like the physical build out and equipment purchase. And I, you know, helped hire all these professionals. And we got, we had great people. I mean, we had people from professional sports teams, from the Olympic Training Center, from d1 colleges, you know, we creme de la creme. And then I worked with a Navy hospital to, you know, to bring rounds through. So I had, like, pain rounds coming through, Northrop rounds coming through. We had a chiropractor coming through. We had acupuncture coming through. So then I was the dumbest guy around right now, this guy with one year of residency training and, and I’m supposed to be, you know, running this facility. And so when you’re and so when you’re and when you’re in the military, and you’re the dumbest guy around, they put you in charge. And so you Well, you’re a leader now, yeah, so like, you supervise all these people. And I’m like, Okay, I don’t really know what that means, but like, everybody there knew their job way better than I did, so I’m like, Okay, I’ll so I had an office inside this center, but I didn’t truly have a job, and seals. Seals are a lot like professional athletes, and that the worst, the worst possible outcome they can think of is for you to put them on the bench, them out of their job, is the worst thing that can happen to them. And so they usually don’t tell their doctors anything. You know. They lie about everything they you know, there’s mandatory, you know, checkups and physicals, and they just go in there, everything’s great, man, not a single problem, right? And then they spend money out of their pocket and they’ll go find a doctor in town to treat whatever problem they’re actually having. And so, because I’d been a seal, and I’d been a seal recently enough to where there are a lot of seals there that I trained with and deployed with, and obviously had a good enough reputation where the guys trusted me. And so guy started coming in my office and closing the door behind him and say, Hey, let me. Let me tell you what’s really going on with me. And you know it, I can elaborate for guidance if you want. But for y’all, I know you’ll you’ll understand it. They looked like 55 to 65 year old men with, uh, with metabolic syndrome.

Kelly Engelmann    7:49 

Right. But they were, what? How old were?

Dr. Kirk Parsley  7:53 

Their labs look like, and they were 28 to 36. They had six pack abs, and they’re ripped. But you look at their labs, every marker and you know, because I had no idea, like they came in and they said, you know, my motivation sucks, my sex drive sucks, my concentration sucks, my mood control sucks. I’m getting fatter, I’m getting weaker, I’m doing everything the nutritionist says, I’m doing everything the strength and conditioning coach says. And I’m getting fatter, I’m getting weaker, I’m getting slower. My I can’t remember things. I can’t concentrate. You know, interestingly, they never complain about sleep, because part of SEAL training is a week without sleep, right? So our community, our community is like, ah, sleep’s luxury, right? But I would get a list of their medications, and I’m, I’m embarrassed to say how long it took, I don’t remember exactly, but it was a lot of guys had come in my office and told me the same story, right? Because once one guy came in and told me a story that was therapeutic for him, and he thought I was going to help him, and I was like, I don’t. And I was honestly like, I have no idea. Like, I don’t have a clue, but we’ll figure it out. So I just tested everything I knew how to test. I’m just like, 98 lab markers. Just go do this, go to the hospital and get all this. And I just, I look, and, of course, everything anabolic was low, everything catabolic was high, inflammation was high, oxidation was high, insulin sensitivity sucks, you know? I just, and I and I still didn’t really have a solution. I was thinking, you know, I’d heard about this, uh, adrenal fatigue thing, right? Because I, you know, this is eight years of combat for these guys. I’m like, Well, maybe it’s like that shell shock thing or combat fatigue you’ve heard about from other wars. And it seemed like people were kind of blaming that on adrenal fatigue now. So I started looking into that and trying to do, you know, whatever, whatever that combination tended to be, essentially what quartet tapers and IV Myers, cocktails and, you know, things like that. You know, of course, there was a little response, but it wasn’t, it wasn’t anything to write home about. So,

Kelly Engelmann    9:53 

Doc, can you time out for a minute? Because I just want to highlight what you said those list of symptoms, because Lori and I are seeing this in our practices, right and left. So young guys, 20 years ago, we didn’t see this. 15 years ago, we didn’t see this. Even 10 years ago, we didn’t see this. But we’ve got young, healthy guys. They look like they just stepped out of the magazine. They’re fatigued. Their labs, they have low sex drive. They’re not performing the way that they want to perform. They’re frustrated, and their lives are a mess. And so this has not just happened to people that have over trained, right, like in the Navy, Navy SEAL world, I would think, and a lot of that was over training, right? But this is happening in just mainstream day to day, people that are just not able to compensate anymore, right.

Lori Esarey  10:40 

Post COVID, we’re seeing more and more business owners that are this way too. So this common denominator of these overachievers, high performance, yeah.

Dr. Kirk Parsley  10:51 

I mean, my private clients now are, you know, run all over the spectrum. Most, most of them are entrepreneurs and C suite kind of guys. You know, I still treat a lot of seals. I still work with seals when they’re getting out of the military to kind of help them recover from their career out of a lack of imagination. I called it the SEAL syndrome. It’s it’s been it was then taken over by some researchers in San Diego and and study, they studied all the findings that I was claiming, which the military was laughing me out of the room when I was telling them that I thought these problems had to do with sleep and lifestyle issues. But some researchers got in there and they validated all this, and they’ve dubbed it the operator syndrome now, and they apply it to a broader audience, obviously. And, you know, there’s books on it now and journal articles. And it’s, a thing. Now, you know, it’s a thing, but, yeah, but it’s, it’s basically premature aging, right? It’s premature age, poor aging, so premature, like metabolic syndrome kind of things. And, like I said, embarrassed to admit how long it took me to catch on that seemed like a lot of people told me they were taking Ambien when I was getting their drug list, you know, and when I went to medical school, you know, I didn’t have any classes on sleep. I had pharmacology. I knew it. I knew Ambien was a GABA analog. I didn’t really know what l that meant, but I knew, you know, bound to a GABA receptor. I didn’t know how that affected sleep or anything. So I had to learn a lot about sleep. But once I figured out you know, because, of course, ya’ll know this. But for anyone, your audience, doesn’t know this, when the FDA applies for a patent, they do the research, they own the research, and they get or when the pharmaceutical applies to the FDA, I should say they they do the research, they own the research, and they give the FDA what they want to give them, and they don’t give them what they don’t want to give them, unless they get sued, right? And then when they get sued, they have to show everything. And so they had been, they had been sued. The Z drug companies were getting sued, and, you know, then I got, I got to see what the real research was on it, so that that was beneficial, because that happened the year before this started. So, so I so once I learned enough about sleep, and learned enough about Ambien and the seals were also drinking alcohol before bed, like is a sleep aid, very common, doing those two together. And then once I started learning about, well, you know, the different stages of sleep and what happens during the different stages of sleep, I was like every single symptom they’re telling me about could be explained by this, right? Because Ambien, Ambien destroys REM sleep, right? 80% of REM sleeps gone with Ambien. 20% of deep sleep. Alcohol does the opposite. So when you take Ambien with alcohol, you get no sleep and and in fact, that’s what I saw when I sent the seals in to get sleep studies. And again, they weren’t complaining about sleep, like this was just life. It’s like, Hey, I can’t I wake up at four. I can’t go back to sleep. I just come in and work and work out and try to get tired that day and go home and go to sleep earlier that night. And they’ve been doing it for five years. Hasn’t worked yet, but their seals, they’re going to keep putting their head down and running harder and figuring out how to do it better. And so, you know, I, I said, Well, you know, every single symptom like I didn’t think every single symptom would resolve, but I thought every single symptom they have could be correlated to this poor sleep thing. I’d have them do. I’d have them do sleep studies. Their sleep studies came back 99.9% stage two sleep. So no deep sleep, no REM sleep. Now, y’all, y’all have been practiced long enough to know how much BS there is in the medical literature. But, you know, academics would tell you that those guys would die, right? They can’t, you can’t survive, that you can’t survive that way. Yes, they’ve been doing it for, you know, 510, years. So it’s like you can survive, I don’t know how, but you can. And so, you know, I finally, you know, I talked a bunch. I mean, by the time I kind of figured out what, what I thought was going on, I probably already had 100 150 guys depending on me to help them. And so I said, Well, I really think the sleep is good. Be a big component of it, right? And there’s a ton of resistance to that, you know, because sleep is for the week. Sleep, you sleep when you’re

Kelly Engelmann    15:08 

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

Dr. Kirk Parsley  15:16 

Right, something like that, right? And, yeah, and so I talked them into trying, and of course, I couldn’t just, you know, take their ambient away and say, suck it up, you know, I had to give them something else. And so I went to, like, very traditional things, like Cochrane Database, you know, PubMed stuff, and it was like, what, what supplements have been proven to help with sleep? And then I was learning a lot about sleep and what happens when you sleep. So I could figure out why you’re why those supplements work, it makes sense. And so I just, I had the combination of supplements that I wanted to put, like, I didn’t do anything herbal or botanical, because I don’t know, I don’t know anything about that, like, I can’t evaluate that stuff. So, you know, there’s no, you know, lemon grass, or, you know, whatever the, you know, the things, kava root, those types that I didn’t so it’s just, you know, things that are ordinarily in your body, like, what, what? What can we do with those? And so with the help of the seals, I just said, Hey, we’re going to try all these, like, six ingredients, like, we’re just going to try to figure out how much of each of this to take. And we figured it out. And then that was their they call it doc. So in the military, anybody who has any medical training, like two weeks of corpsman school, up to 16 years as a neurosurgeon, you’re just doc, everybody’s doc, you’re on par. So, so they call it doc parsley sleep remedy, or sleep sleep cocktail, is what they called it. And I gave them, you know, that was their handout, and they would just go buy it all. And, you know, quit taking the Ambien. Some guys were super, super addicted to it, so I would have, I’d have their Ambien converted to a serum, and then so I could titrate it down, you know, one milligram a week, essentially. But I got all these guys off of Ambien, and I was giving them, like some, you know, pregnenolone and in DHEA just kind of, you know, support for the daytime. And I was giving them zinc citrate as as a mild aromatase inhibitor, but the primary thing I was doing was getting them to sleep better. And I’m not exaggerating these guys, you know, total and free testosterone were tripling and quadrupling because I had, I had 28 year old guys in great shape come in my office with a total testosterone of 252, and 253, and endocrinology is like, you’re good, like 250 is a cut off, so you’re good, right? Yeah. And, and so, you know, once I got him to sleep, it worked way, way better than I thought it would. I mean, I thought I was going to get like a 30% solution, but it’s probably like an 80% solution for 80% of the guys. And of course, you know, once their anabolic markers went up, and catabolic markers went down, and oxidation went down, and inflammation went down, and insulin sensitivity, like, increased, like, like, you know, I had 45 year old seals, you know, setting records and things they’ve been doing their whole lives. And they’re like, it’s not a record for my 40s as a record for my life, you know, it’s the fastest I’ve ever run that, or fastest I’ve ever done this optical course, or the most weight I’ve ever lifted and all this other stuff. So I was I was sold, and then I had to convince the leadership that this was a problem. And like I said,

Lori Esarey  18:18 

Can I say something real quickly, some of the things that you did… we need this in medicine. You were a listener, you know, you admitted to facts you didn’t know. But you heard them. You offered them hope. You gave them a solution. You used intuition, smarts, just common sense, applying that to numbers. And said, This doesn’t make sense. Try this, and we just traditional medicine lacks all of that. Yeah, you know, the insurance-based model sees, you know, they’re seeing patients every five to eight minutes. They can’t listen to them. It’s algorithmic medicine.

Dr. Kirk Parsley  18:58 

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

Lori Esarey  19:27 

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

Dr. Kirk Parsley 19:35 

That started in in the summer of 2009

Lori Esarey  19:38 

Okay, okay, yeah, because when you know, my practice started just around that time, too, yeah,

Dr. Kirk Parsley  19:43 

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

Lori Esarey  22:20 

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

Dr. Kirk Parsley  23:15 

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

Kelly Engelmann    25:57 

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

Dr. Kirk Parsley  26:16 

You know, it is as long as you’re, you know, reasonably circadianly aligned. You know, you would go to bed in a stage one, which is sort of the pre sleep when you’re, you know, you can hear other stuff going on in other rooms. You can hear your neighbor, whatever, but it’s a little different. It’s almost like a dream. You’re kind of like, you know, you’re processing it slightly differently. What? For sure, all that one of the questions I ask at my lectures, just because I find it entertaining, as I say, you know, who in the audience here can define sleep for me, right? And never, I’ve been, I mean, I’ve been given this I’ve been lecturing for 15 years. I’ve never had anyone do it and and, you know, I find that fascinating, right? I really do, you know. And I couldn’t have defined it, you know, before I really dove into this myself, right? And I was just like, something every person on the planet does every day, and nobody can define it. That’s, that’s kind of ironic, right, right? So anyway, the point of saying that is like the truest definition of being asleep is lack of being awake, right? Rhetorical, but that’s really what it is. And it’s basically like it’s an equal. It’s equally as important as your waking hours. And the best way to define it is this, like, kind of the opposite of being awake, because it’s hard to define something you don’t really have a subjective experience of, right? And even if you could define it, well, who could validate it? Because you don’t really have a subjective experience of it. So what it really is is, like all, all of your interaction with the world, right? Your your cerebral cortex, that you know that that part of our brain that makes us so smart, like all of our motor function, all of our sensory and you know that all kind of gets turned off. It still works, but we just it gets quietened down, and we don’t pay attention to it. And that allows the brain to do other things, because it’s not involved with processing our environment. So the first, so the first thing that happens is you you start processing your environment slightly less. So, you know, the sounds, kind of the lights, and just, kind of just quit paying attention in the same way. Then you go into actual stage two sleep, where your sensory is really no longer active. You’re not processing sensory so to speak. Of course, you are at a small level, which is why somebody can make a loud noise and wake you up, or, you know, turn on the light and wake you up, or shake and wake you up. So it’s still working. It’s just, you know, you lower, you lower the resting potential of those cells, and it makes it that much harder for them to fire. And then that allows your brain to start doing other things. And it’s, you know, we we now know, we didn’t know about this when I started, but we now know about the glymphatic system. So you’re flushing out waste, and then you’re, you’re, you’re recalibrating neurotransmitters for the brain itself. And then you’re, you know, your your brain is starting to do all kinds of amazing things. So when you go into stage two, that, that stuff, you know, the the chemical, the biochemical, changes in order for all those processes to have happen, starts, and then you drop down into deep sleep. And deep sleep is where your your thalamus and hypothalamus are processing what’s in your blood and trying to figure out, what do we need more of, what do we need less of? And then your pituitary is reacting to all of that. And so you’re you’re recalibrating all your hormones, and then you’re secreting luteinizing hormone and FSH, and, you know, HC, th, if you needed that, which would be, you know, very rare, of course, but you know, thyroid function, everything is being adjusted and measured. Like I said, the glymphatics is flushing out waste products, and then these hormone changes are. Allowing the neurotransmitters in your brain to do different things, which is primarily restoring and regenerating themselves, right to to put to get rid of the waste products, but also to put the proper neurotransmitters where they need to be, improved concentrations of things, flush out adenosine, obviously, you know, dentistine is the the kind of the byproduct of ATP consumption. So you build that adenosine back up into ATP, and you’re re energizing the brain. You’re getting the brain ready for tomorrow, really. So the whole point of going to sleep tonight is to repair essentially, from today, right? So, like, I’m depleting things. I’m kind of damaging things. If I’ve worked out of a run, like, I’ve tweaked muscles and tendons and like. So my brain and body are like when I go to sleep, they’re repairing, and then it’s preparing for tomorrow, right? Because I’m using today as the template for what I did to anticipate what I’m going to do tomorrow, right? And so if I ran today and I hurt, you know, I hurt my muscle and my muscles, you know, exhausted at this phase. Well, when my brain and body start repairing that it’s going to repair it in a way that tomorrow I can run as far as I did today. Was a little less damage, right? That’s the whole idea. And if we could do that perfectly, right? If we could, if we could go to bed every night and repair and prepare, recover 100% we would never age. By definition. We’d wake up exactly the same every day. And obviously, when we’re young, we do right? When we’re kids, wake up better, amazing, smarter, and, you know, right? And then 20 to 25 ish, kind of, that all kind of plateaus. And then you start going the other direction. And you, you know, you’re repairing 99.99999% or something. But that’s that’s given eight hours. And this is the interesting thing, I find, it takes eight hours to recover from being awake 16 hours period. It just does. You can wish that away all you want to, but and so when you take, when you take, when you when you deliberately by choice, and we’re the only animal on this planet that deliberately sleep deprives itself. But when you by choice, say, I’m gonna sleep six hours instead of eight hours, you’re choosing to age 25% faster, that’s just all there’s to it. No getting around that. So anyway, I’ll get back to the stage, just so you go into deep sleep. A lot of hormonal regulation. I like to point out that fight or flight is the maximum, maximum adrenalized hormones, right? Maximum sympathetic tone, cortisol, epinephrine, norepinephrine, right? All that’s maximized during stress hyper, hyper stress situations. The absolute minimum stress hormones you will ever have is during deep sleep, slow wave, sleep cycles, okay, stress hormones are catabolic, and testosterone, growth hormone, DHEA, like all these things, DHT, all these are anabolic. So the most anabolic period of any 24 hours is deep sleep, because you have to have the lowest amount of stress hormones, as well as having the highest amount of anabolic hormones, which are all being produced while you’re in deep sleep. And so then you travel across time in deep sleep, you kind of stair step back from four to three to two, transition up and go into REM, which is actually going past wakefulness. And then you do a little bit of REM, and that would complete one sleep cycle. And a sleep cycle is 90 to 120 minutes. And then the next sleep cycle, well, the first sleep cycle is like 80 to 90% deep sleep. And then the next sleep cycle is less deep, more REM, less deep, more REM throughout the night to all your last sleep cycle before you wake up, it’s like 80% REM, and very little deep. And in REM, you’re rehearsing everything you’ve heard, everything you’ve thought of, everything you’ve learned, conversations you’ve had. You’re rehearsing that, and you’re figuring out. Your brain’s figuring out if you need it or not, or if you want to hold on to it, and if it does want to hold on to it, then it it forms connections to other pieces of information, different regions of the brain that would be similarly affected by that thought. And you form these connections. The more connections you form, the more durable that information becomes. And then, when you can think of it from lots of different angles. You actually know it right? So you’ve memorized everything until you go to sleep, and then once you go to sleep, you can actually work with it, and you can actually know it. And then the more times you rehearse that, the more times your brain confirms you need it, the more durable kind of becomes, this durable super highway. And then you think that way all the time. And then when you get older and you lose neuroplasticity, you always think that way to make you grumpy old person, because this is the way, that’s the way we know that’s the way, yeah, might be different. And and then the other thing that happens during REM sleep, and we think this is one of the, one of the reasons for the symptomatology of PTSD, is during REM sleep, you emotionally categorize so if you have a conversation, they say, like, you have a fight with your spouse about dirty dishes in the sink or something, you know, but now, like that well, that you know that should be over as soon as the conversation’s over, right? Like you shouldn’t really have that, but if you don’t sleep, well, there’s a chance you miscategorize That, right? And that’s. In like this, you know, this highly contentious situation, and then routinely due to that, and you can have these situations where dirty dishes in the sink trigger you to where you’re thinking about divorce, and you’re yelling and screaming, right? And that’s extreme example, but that’s, that’s one of the things we think.

Kelly Engelmann    35:20 

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

Dr. Kirk Parsley  35:26 

Sleep is the most productive time in your life. And I’ve been, I’ve been as guilty as everybody. Like I said, I was a seal. I went a week without sleep to prove it. You don’t really need it, right? You don’t actually have to have it, and it’s luxury. And then when I was in college, you know, I was working full time, and I was going to college full time, and I had a wife, and I had kids, and, man, I slept like five hours a night and pulled all nighters all the time. And then medical school, I had a family, so I did the same thing. I got up at 330 in the morning so that I could go work out, go to school, come home at 430 spend time with my family, you know, try to go to the bed by 11 o’clock or something, and then get up at 330 the next day, you know, or get up at three and leave at 330 so I’m as guilty of it as anybody else. And what, the younger we are there, you know, the more you know, the more resilient we are. And we can, we can handle that. But youth is wasted on the young, right? If I knew how, I wouldn’t have done that, you know, but that’s, that’s how I chose to do it.

Lori Esarey  36:27 

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

Dr. Kirk Parsley  36:42 

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

Kelly Engelmann    39:11 

Do you recommend any wearables for tracking sleep? Are there? Do you have a favorite wearable that you recommend?

Dr. Kirk Parsley  39:18 

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

Kelly Engelmann    40:20 

You’re not supposed to.

Dr. Kirk Parsley  40:23 

Might not be right for your well, your perfect night’s sleep might be an 80, right and right. And you could even have a worse night’s sleep this may be a 90. So it’s a useful tool, as long as you’re not using it as the

Kelly Engelmann  40:38 

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

Dr. Kirk Parsley  40:39 

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

Kelly Engelmann    41:01 

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

Dr. Kirk Parsley  41:07 

Sure. Well, so for me, performance encapsulates everything, right? So we all have, like, we all have a vision of what our ideal life would be, right? Like if you gave me a magic wand, where would I What would things look like today? What would things look like a year from now, five years from now, 10 years from now? So if I want to move in a meaningful way towards the the life that I feel like would bring me the most fulfillment and happiness anything, anything that I can do that moves me towards that is performance, right? So if you want to, you know, if say, like a lot of my clients, are entrepreneurs, right? And they built and sold a big business, they want to build another business. So anything that helps them build another business, anything that helps them in the boardroom, helps their decision making, helps their problem solving, helps their planning, yeah, any of that, that’s our performance, performance, right? Being being able to have enough energy to get out of the bed and go to work and do the things you need to do and not be miserably dragging yourself along through the day. That’s performance. And then, of course, there’s athletic stuff, you know? There’s guys that want to be stronger. They have very specific goals. They’re athletes. They want to reach things as people want to be more enduring, you know, I have ultra marathoners, you know, and anything that you want to get better at being a better communicator. That’s a performance goal that requires cognition that primarily prefrontal cortex. The most impacted region of your brain is the prefrontal cortex. When you don’t get enough sleep, your body compensates by releasing stress hormones, because stress hormones keep you alert in proportion to your environment. You’re depressed like your physiology is depressed, the stress hormones ramp you up in a catabolic way. So it’s costly to do this, but it ramps you up. Unfortunately, anybody who’s been in fight or flight knows you don’t you don’t think when you’re in fight or flight, it’s 100% reactive. And so the closer you get to fight or flight, the less you think. And so you impair the prefrontal cortex just your ability to, you know the obviously, the purpose of that is like the simulator. We can think about things we want to do and plan and figure out if that’s a good idea or not. We can change our ideas. We can solve high level problems. We can put things together in a unique way. But more importantly, we communicate with our prefrontal cortex. And so what you think, what you think my expression means, might be different than what you think my words mean, and that is incredibly impaired with just a little bit of sleep deprivation, one night of short sleep, and you, you take a couple and you, you give one of them one night of short sleep, the other one sleeps eight hours. One sleeps six hours, one of them sleeps eight hours. And then you ask them at the end of the day, how did they think their partner was They both think that the other one was off because the sleep deprived one thinks that the other one’s off because they’re sleep deprived, and then sleep deprived one is actually off. So the person who’s not sleep deprived thinks they’re wrong.

Kelly Engelmann    43:59 

So, discord, discord.

Dr. Kirk Parsley  44:03 

Right, and you know that emotional categorization and things and so it’s a huge issue, you know where? And I tell people, you know, there’s activity which is just like the baseline of being human, right? You the more activity you do, the less exercise you need to do, unless you have a performance goal, right? So for millennia, people and people didn’t get up and say, I’m going to go run 20 miles, right? They they got up and they walked to where they’re going. They foraged, they hunted, they sprinted to catch things or not, to get killed. They jumped on things. They carried things like, that’s That’s enough, if you’re doing enough of that. We don’t live in a world where that’s realistic, but we can get there, like, mow your own lawn, wash your own car, clean your own house, take the stairs, park at the back of the parking lot, all those simple things, right? That’s activity. You should always do activity. If you’re sleep deprived. That’s all you should do is activity. You shouldn’t exercise. So as I, as I said earlier, like if I go into the gym today and I work out. For an hour, and if I do anything worth doing, I’m I’m weaker when I leave the gym than I was when I walked into the gym. Yes, when I go to sleep tonight, my brain and body work together to repair that muscle to say, well, we want to be able to do that tomorrow without damaging the muscle so much, so I’m going to build it back in a little stronger way. And so that’s how I progressively get stronger. Well, if I don’t recover 100% why? Why am I going to go to the gym and damage myself even more? Because now I have two nights worth of work to do in one night, and that’s not going to work. And you string a bunch of those if you did that intermittently, no big deal. Like once or twice a month. You don’t get enough sleeping. Still go to the gym, fine. But if you’re somebody who’s sleeping six hours a night, four to six hours a night on average, like every night, you should not be exercising because you’re not going to recover. You should be active because that obviously, there’s all sorts of physiologic benefits we need to express glut for, you know, you know, AMPK, like all mTOR, all that needs to be activated by activity, just contractions of muscles, and it doesn’t have to be intense, doesn’t have to be goal oriented, but just doing activity, and then we can, you know, obviously, we can maintain health and body composition as long as we’re eating a nutritionally reasonable amount of calories, and, you know, nutritionally dense foods, and controlling your stress hormones and all that other stuff. So, but, you know, I say exercises, exercises activity with a goal, right? So it’s like, I’m, I’m going to ride this bike really fast, or I’m going to run, or I’m going to lift these weights, because I have a goal of getting stronger or more enduring or faster, or whatever. And that, then that becomes a performance tool. So exercise performance tool, activities is a longevity and life tool, and help just generalized health tool. My performance is whatever you’re aiming for.

Kelly Engelmann    46:48 

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

Dr. Kirk Parsley  47:10 

There’s so much there. That’s, that’s one of the most fascinating things. It really is. It really, really is. There’s some really fascinating things going on in medicine right now, in our world that’s kind of outside of there’s a lot of fascinating peptides. Hyperbarics is a really fascinating tool, sure. Psychedelics, nothing touches it.

Kelly Engelmann    47:29 

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

Dr. Kirk Parsley  48:01 

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

Kelly Engelmann    48:23 

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

Dr. Kirk Parsley  48:35 

We didn’t really get into it. But I always tell people the the number one factor in getting adequate sleep is believing that you need to sleep. And most people don’t. And most people, after they listen to this, they’ll be like, ehhh, you know, kind of maybe, kind of change their mind. So I have a couple of these, a couple of pieces of advice on that. So the first thing is, go into something credible. Ish, who knows what’s credible anymore? Google Scholar, PubMed or something, and put in sleep and anything else you care about, parenting, concentration exercise, strength, endurance, what? I don’t care whatever sleep and that anything you care about and read until your until you’re petrified, like sleep. Sleep is not contentious, like nutritional medicine. It’s

Kelly Engelmann  49:34 

Yeah. Everybody needs it.

Dr. Kirk Parsley  49:37 

All the research says the same thing, like, you’re going to die sooner, and you’re going to be weaker and worse while you’re alive, like that’s all there’s to it. And so once you convince yourself of that, now you’re going to be stressed out. And then and the number one reason, apart from not believing that you need sleep, the number one reason that people who actually are trying to sleep more can. Sleep is because they have too much stress Yeah, and their stress hormones are too high. And as I told you, deep sleep is the lowest stress hormones you ever have in any 24-hour period. So about 30 to 45 minutes after you go to sleep, you need to have the lowest stress hormones you’ve had in 24 hours if you’re stressed out. It doesn’t work that way, right? And so, I have – it would take me probably 30 to 45 minutes to explain it, but I have a worksheet on that that I know my team sent you guys a link to that you can, people can go to that, and it’s like a three page worksheet that tells you how to get stress out of your sleep. There’s some behavioral psych mixed into some sleep hygiene, you know, like there. It’s just kind of a, it’s, it’s laughable. Of all the things that I do, all the tools that I have, this is the most powerful thing I have on I’m working and it’s

Kelly Engelmann    50:56 

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

Dr. Kirk Parsley  51:12 

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

Lori Esarey  51:58 

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

Dr. Kirk Parsley  52:00 

It does have to become a non-negotiable, of course, you know?

Lori Esarey  52:03 

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

Dr. Kirk Parsley  52:49 

Yeah, we gotta, we all gotta stick together, because we’re not with the system rewards, that’s for sure, right? We’re what the patient needs, but not what the system wants. Yes, yeah, absolutely.

Lori Esarey  53:00 

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

Dr. Kirk Parsley  53:09 

Okay, no problem, we’ll do it. Thank you.

Lori Esarey  53:12 

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