The Melanie Avalon Biohacking Podcast Episode #170 - Dr. Kirk Parsely

TRANSCRIPT

Melanie Avalon: Hi, friends, welcome back to the show. I am so incredibly excited about the conversation that I am about to have, although this is a little bit of a unique scenario on this show. I am back with a guest who-- This will be his fourth appearance on the show which is a record. What you're about to hear after what we talk about right now is actually part 2 of an episode that we recorded quite a while back, all about sleep Q&A. It was questions from you, guys. And so, it's been a long time coming. We're going to air that. But before that, since it has been about a year, we decided to do a quick little update in the beginning, especially since this guest, Dr. Kirk Parsley has something very exciting going on that I just wanted to share with you guys. So, yes, we're going to jump in. Kirk, thank you so much for being here.

Kirk Parsley: Melanie, thank you for having me.

Melanie Avalon: What are you doing right now that is super, super cool that might break a world record that has to do with your background as a SEAL, and also a doctor, and all the things, and it's very exciting?

Kirk Parsley: Well, I'm doing several really exciting things including being on this podcast right now. But I think what you're alluding to, I don't want to embellish it or overstate my importance in this. I'm not actually one of the world's record-breakers. I'm just going to be part of the team, the support team. It's called Triple 7 and it's an expedition with the intention of-- well, two intentions. One is to break a world record for skydiving on all seven continents. Hence, the one seven-- one of the sevens. We're attempting to do this in seven days, which would be the second seven, which would be the current record by 30-fold, I guess, because the current record is seven jump, seven continents in seven months. So, we're trying to do this in seven days. 

And then the third seven is, the entire purpose for doing this is that we're trying to raise money for the spouses and children of the fallen and special forces military service. So, there's about a dozen former spec ops guys, which means special forces guys, Special Operations. They're not all SEALs. Five or six are SEALs, around half are SEALs. It's going to be 12 guys including an older gentleman, who currently holds the world record for the seven jumps on seven continents in seven months. So, he will get to break his own world record of being part of this. But our intention is to raise $7 million for these families. This is more your world than mine. I don't really know these people, but the director of documentary is doing-- Dan Myrick who's famous, notorious, I don't know.

Melanie Avalon: He did Blair Witch Project, right?

Kirk Parsley: Who did The Blair Witch Project and lots of documentaries, docu-series, and some television shows, and then producer, guy named Kristian Krempel. He did a Navy SEAL movie and it's called Act of Valor which I guess the Navy SEAL attempt at being Top Gun, but it was nowhere near as cool as Top Gun I guess so, didn't get the attention. But he also did that movie the 300 Spartans, [unintelligible [00:03:25] gates of hell and held off a 10,000-man army with 300 guys for three or four days or something like that, I don't know. Anyway, it's an old ancient tale. He did that movie. So, this is going to be a docu-series. I'm going for a couple of reasons. One, I'm going to be the medical support just for day-to-day stuff. But then, of course, in the unfortunate situation, if someone were to get hurt or injured, I would be responding to that as well. But I'm also collecting data.

We have-- Whoop is one of the sponsors, the Whoop bands. They're going to be collecting all the data they can. I'm going to be collecting serum and salivary samples to look at people's anabolic, and stress hormones, and inflammatory markers, and some things like that. It's not truly a research project. It's really observational. But Men's Journal is a big sponsor of this. So, there'll be a big publication about it in Men's Journal after it's all done. The 12 guys jumping, they're all going to have their own preference. They're going to take whatever supplements and whatever they want to do to make themselves feel better during the jump. But we'll know what everybody's taking. And so, it's in your world a little bit of biohacking to see what people can take for compensatory efforts against the certain and unavoidable circadian disruption that we're all going to be dealing with, so that's a big project.

Melanie Avalon: Okay. So, I know you and I were talking before this about how I was just going to basically ask one question. But now, I have some follow-up questions. 

Kirk Parsley: As you do.

Melanie Avalon: Traveling is not my skill in life. The idea of even traveling one place in seven months is probably a lot for me, definitely one place in seven days. Seven places in seven days, seven countries in seven days and jumping out of planes, I can't even imagine that. I'm super curious. You're always talking about the importance of sleep and how important that is. What do you anticipate sleep wise? What sleep are you guys going to be getting and how do you think that will affect people's jumps from the beginning to the end? Is this dangerous? Is this okay for their health?

Kirk Parsley: This is dangerous in that the events themselves are dangerous. And then of course, the farther we get into this expedition, the more sleep-deprived people are going to be, the more metabolically disrupted they're going to be. And so, it will get progressively more dangerous obviously. And then there's always danger associated with the drop zone, where you're landing, who's dropping you, when, weather. There're a lot of unknowns in this. We basically have a 72-hour window for every DZ. So, it could take up to 21 days if we spent 72 hours on each DZ before we actually got our jump. We don't know exactly how long it's going to take. 

Yeah, if you remember, I don't know, if we've talked about it on the podcast, but surely in the many conversations you and I have had probably discussed my guiding principle, the Pareto distribution that guides everything else in nature. And so, the whole idea of this is to make these guys as completely as resilient as they possibly can be before we start this. The whole idea behind the Pareto distribution is the 80/20 rule that people talk about. You do everything right 80% of the time essentially right and 20% of the time, you can't do what you should be doing. But if you're metabolically flexible enough, if you're resilient enough, then you can handle that bit. And that's always what I've had to deal with special forces guys. Obviously, they don't get to choose when they go to work, they don't get to plan around game day, there're no rules involved, they don't know where they're going to be, how much sleep they're going to get, all this stuff. And so, you do everything you can to make people as hard to kill as possible before you do something like this. 

We did our first training in the States. The guys just working on jumping together. They're all very experienced jumpers, obviously. But everybody working together and developing what we call SOPs, standard operating procedures for each jump. We started that training. We did that the first week of this month and then we're working to do a follow-up training in December, and then we're leaving at the very end of December to start this. And so, during those couple of months, I'm doing everything I can to work with everyone individually to get their sleep as good as it can be, and get their supplement schedule, and their hormones, and everything that I can do to optimize them in the world of Doc Parsley, that's what I do for a living is optimize people's health. So, I'm going to do the best I can to make these guys as resilient as possible because that's going to be absolutely disruptive and chaotic. And there's going to be canceled flights, and delayed flights, and rain, and clouds, and upset politicians, and who knows what else. There're problems getting through customs, who knows? There's going to be all sorts of trouble. Yeah, we just got to make everybody as resilient as they can possibly be before they start.

Melanie Avalon: I have another question. This concept of building up resilience, there are a lot of different places that you could build up resilience in your life. You could eat a lot, and store fat, and build up the capacity to fast for a long time or build your fasting muscle and fast for a long time, or you could build up your physical performance and have the ability to go all out physically. When it comes to sleep, since sleep is more on a 24-hour rhythm, can you even build-up for that?

Kirk Parsley: You can. You can build up resiliency. If you sleep from 10:00 PM to 6:00 AM clockwork six months in a row and then you have two weeks of complete chaotic sleep, you're going to be way better off than somebody who gets approximately the right amount of sleep most of the time, and stays up a little too late here and there, drinks little too much now and then. No, I'm not saying that I expect any of these guys to be sleep zealots for six months, but there's ideal and there's reality in between that gap is where we use compensatory things like bright light therapy in the morning, and blocking blue light at night, and taking supplements to help them with their circadian rhythms, and all that type of stuff. So, that's why we have Whoop involved, that's why we have me involved, so that we can fiddle around with people's physiology to help them stay as close to circadian rhythm as possible, but the fact is that every time zone that you change at a minimum takes a day to adjust to. It depends on if you're going east or west, which way's worse and we don't really know which way we're going right now. We might be going east to west the entire time. We might be chasing sunset, which is a little easier than chasing sunrise. So, we'll see. We'll see which way works best. We'll see which way we go. We know which way works best, but mostly which way we go.

Melanie Avalon: Do you think there will be a significant difference from the beginning? Jump one to the N, jump seven? I don't know enough about jumps to even ask this question, but with the physical taxation effects that have happened with the sleep, and the stress, and everything, will it actually affect their experience of the jump?

Kirk Parsley: It will definitely impact-- In fact, you hit on it. That's actually the thing that will be the most impacted is their experience of the jump. Now, skydiving has some technical aspects, but it's not a super technical thing to do it. It is a skill. It's a very perishable skill and it takes a long time to develop a high level of skill in that. But just like anything else, it takes a long time to develop a high level of skill, although the skills are perishable. A lot of the skills are pretty built-in. I wouldn't say it's like riding a bike. It's not that simple. Obviously with the chaotic sleep and the circadian disruption, with the malalignment of their sleep schedule with their circadian rhythm which is inevitable, we're not going to be able to stop that. We're only going to be able to mitigate against it. The most important aspect for this group, because this isn't going to be super physically taxing for them and it's not going to be super stressful for them because they've jumped thousands and thousands of times. It's going to be more stressful because they're going to be in a physiologically stressed state when they jump. But the most dangerous thing in skydiving is landing your parachute. And little mistakes happen all the time with really experienced jumpers. Even at this first training, the training that we did, our first get-together at the beginning of this month, we're working with instructors to help train our guys up on their skills and buff people up. Instructors that do this for a living, they jump 10 times a day, 300 days a year is what they do for a living. 

And so, they were working with our guys and we had one of those guys get injured landing his parachute at the very end. He has thousands and thousands of jumps. It's always possible. My big concern is keeping these guys just cognitively capable as possible, because you don't even have to know anything about skydiving. Just think of it. You're controlling a parachute, which is basically flying a plane to some degree. You're flying one wing and the air is moving you forward. These parachutes go forward at a pretty fast rate. They're not just drifting down like a bubble and they're actually flying forward and they're tilted down, so that they're traveling towards the ground and you can change the angle of that to create more lift or more downward and you can turn it. And so, the mistakes that people can make there, that's the biggest risk. If you just think about that, that's really executive functioning.

I think the best explanation of the prefrontal cortex was given by Robert Sapolsky. He's the grandfather of stress research. He wrote Why Zebras Don't Get Ulcers and other books like that. He's a Stanford researcher. He called it the simulator. It's like a flight simulator for a pilot. And the benefit is, in your prefrontal cortex, you get to come up with dozens of different ideas that you could do right now. There's always a decision tree and usually multiple veins of that, like multiple trees you can go down. If I do this, I could do that, I could do this. There's always a multitude of decisions for going forward in your life. That's what the prefrontal cortex does and that's going to be the area of the brain that's the most impaired as they get more and more tired. And so, depending on how long are we going to be there? Actually, the worst case scenario is what we're hoping for is that we'll actually get seven continents in seven days because we're going to be three, four, five, six time zones away with every jump, then they're going to be day after day after day. So, nobody's going to be close to catching up.

What if we get stuck someplace for three days and then the next one goes like in a day, and then next one, we get stuck there for two days, and then there's a delay here and so, the longer this goes on, the more impaired they're going to be. Landing their parachutes is going to create more and more [unintelligible [00:15:42] in me. Probably not them, because when we get sleep deprived and we begin becoming impaired from our sleep deprivation, one of the biggest things that it does is it interferes with our self-awareness. And so, we don't realize that we're impaired just like being drunk. They're going to be thinking that they're doing great and I'm going to be going to be like, "Nope, they're not. They're in a very dangerous space." So that's the expedition now.

Melanie Avalon: Does it have a title right now? How can people follow it?

Kirk Parsley: I can send you, I guess, if you want to put it in the show notes, but it's legacyexpeditions.net is what it's called. I think that's the only thing that will show up when you go there, but it's Triple 7. It has an icon up at the top for Folds of Honor, which is the name of the organization that raises the money for the fallens' spouses and children. But yeah, legacyexpeditions.net is where you can go read about it and then there're links on there if you want to contribute to it. I think they're even still looking for sponsors if people are interested in that type of stuff. 

Melanie Avalon: Oh, very cool. Okay, well, I will put links to that in the show notes. Will you be documenting this on social media, your experience?

Kirk Parsley: I am going to do my best. We all know that I'm challenged in that area, but I'm going to try really hard to post a lot as we go about this.

Melanie Avalon: Awesome. I have another question about one other topic. Another topic that I have become-- Well, they talk about on the show and I'm very passionate about is the role of mental health and wellness. And in particular, I've been really interested in the role of psychedelics in mental health and wellness. I know you're involved in something specifically with veterans and mental health and wellness, I was wondering what is your involvement in all of that.

Kirk Parsley: My involvement in that goes back probably around a decade. I'm on the advisory board of an organization called VETS and they specifically do that. They specifically fund psychedelics. They have a Stanford professor involved in the research who's running the research. They spend a lot of money on lobbying unfortunately, but that's the way things have to be because they're trying to help legalize things. And then I'm also on the advisory board of another former SEAL advocacy group and SEAL Future Foundation. There're nine physicians involved in that advisory board. One of the things that organization does quite a bit of is work with organizations that do psychedelic treatments. One of our attending physicians is a guy named Bob Kaufman, who's-- I guess, I would say he's the leading psychedelic physician in the country and that he is putting together. There's going to be a psychedelic certification for physicians, I think coming up here in a few months and so, he's heading the board that's organizing that and doing that testing. 

I've known him for years. He's a former military physician as well. He was the initial military equivalent of a CEO. He was the CEO of an organization called NICoE, which is a Traumatic Brain Injury Research Center run by the military. And they did everything there except psychedelics because it was a military thing. Then he's exited the military and now he's working with MAPS, which is the one organization that kept doing research after all the psychedelic research got defunded in, honestly, late 60s. I can't remember exactly when, 1967, 1968. He's heavily involved in that. Doing the research with things like functional MRIs, and serum and salivary testing to try to figure out what exactly the psychedelics do because honestly, we don't know. We know some things that they do, but we don't know how they do what they do. Those are the two main things that I'm doing with psychedelics.

Melanie Avalon: Yeah, I've been so fascinated by it for so long and I've been wanting to do a deep dive episode into the

Kirk Parsley: Well, you should get Dan Engle. Do you know Dan Engle? I will introduce you to Dan Engle. Robert Kaufman is in charge of the certification program. He's the head honcho in there. But I would say, the most experienced physician in America and possibly the world, I don't know how on psychedelics is Dan Engle. He's written several books. He's had a couple of traumatic brain injury centers. He used psychedelics as one of the modalities there. He actually just left Austin few months ago, moved back out to Santa Fe, but he's a good friend of mine and I would be happy to make an introduction. I would think there's no better person you could talk to about psychedelics as far as what they do, and how they work, and what's the truth, what's the reality, and what's the hype about them, and to what degree we know the physiology of them, which isn't an impressive amount, but we do know some physiology about what's happening, it doesn't really explain their action so much, they're still quite a mystery, but he knows as much about that as anyone else and he knows the practical application of mine say better than anyone I've ever known by a longshot, by orders of magnitude. He would love to do your podcast. I'll speak for him.

Melanie Avalon: I would love that.

Kirk Parsley: Your guests can look forward to that. Okay.

Melanie Avalon: Yay. No. And so, specifically, your involvement of it does involve veterans' suicide specifically, right? 

Kirk Parsley: Yeah. We obviously treat people who aren't suicidal, but that's the-- When people are suicidal, it becomes the ultimatum. Because the thing about most of the special forces guys is that they've had years and maybe over a decade of conventional medical treatment by the time they get out of the military. It's very rare that the first symptoms or signs ever showing of, I don't really want to say PTSD, but PTSD-like symptoms, and brain injury symptoms, and all that. It's very rare that those are just coming online when they get out of the military. Most of the time they've had that for 5 or 10 years before they get out of the military. And so, they've gone through all sorts of treatment for it. They've done transcranial magnetic stimulation, and they've done stellate ganglion blocks, and they've done transcranial magnets, and they have done float chambers, and they've done hyperbaric therapy, and they've done all the medications for sure, and talk therapy, and all that kind of stuff. 

When they become suicidal, you can't really go back to something that they've already tried, because if that worked, they wouldn't be suicidal at the moment. I would say the most impressive intervention I've seen in my career working with all sorts of high performers, but the most impressive thing I've ever seen for suicidality is a psychedelic called ibogaine, which comes from an African root called Iboga. It is pharmacologically active ingredient is ibogaine, which they put in capsules. It's done in a very clinical setting with heart rate monitoring and all that stuff, and medical assistants around at all times. All the psychedelics essentially, man we'd be getting into a whole ball of wax, but talking very simplistically about the autonomic nervous system, the stress arousal system, it's called the sympathetic aspect. The primary driver of sympathetic in your brain is something called the amygdala, which is a region of your brain that looks for threat. It kept us alive very well when our world was much more threatening. But the last few hundred years, human life hasn't really been about survival. We perceive a lot of things to stress that shouldn't be perceived as stress. And so, the more sort of amygdala, what we call amygdala tones, it's just like the more amygdala input, more amygdala activity you have, the higher the stress hormones you're producing, the more impaired your brain is, more impaired your decision-making is, more impaired your hormone production is, the more impaired your sleep is, all that stuff. 

All of these psychedelic treatments, what we know they do is they decrease the amygdala activity and we've proven that on functional MRIs. ibogaine can decrease amygdala activity by 90% or so for up to six months. There's nothing on the planet that competes with that. Most suicidal people don't want to die. They just don't want to be alive anymore because they don't see anything in their future. They don't see any way to get out of the mess that they're in and they just see their existence is making everything worse for everybody else. It's usually about getting out of other people's way and not so much about getting out of your own misery, especially veterans. They're people that are very service oriented and so, they're like, "I don't want to be in the way of my family, I don't want to be in the way of my friends, I don't want to be a burden, I don't want to be bringing other people down and my existence is causing someone else pain. It's better if I'm just not here." 

As we talked about a few minutes ago, the prefrontal cortex being your simulator, that's the one that gives you the multiple ideas. It allows you to roleplay multiple versions of yourself and every second of your life to figure out what's the path forward, what should I do, what could I do, what would the most likely outcome be if I said this now or did this now. Well, if that area of your brain is impaired, which is that is the area of your brain that goes offline, the more stress you have, the more that area of your brain doesn't work. And so, if we can decrease the amygdala tone or decreasing the stress in that brain, we're allowing them to make better decisions and we're allowing them to look through the simulator and see lots of different options in their life as opposed to just looking and saying everything's bleak and I don't see any way forward. 

It's just been absolutely amazing and transformative for so many special forces guys. In fact, the founder of the organization, VETS that I'm on the board of, that is a former SEAL named Marcus Capone and his wife, Amber Capone. They started that because he had such a profound experience with ibogaine. It was the typical two, three, four years after the military, where he was retired. He was at home really for the first time in their lives, because SEALs are just gone 75% of the time. That's just the way the job works. And so, he's actually at home and he's gone from being the best in the world to completely insignificant nobody in his mind, and having lots of strife and problems with the wife, because he really just getting to know each other and really living together for the first time, and she has her way of doing things, and he wants to be the man of the house, and she's offended because she wants to do her-- This is very typical. And so, they were having all this strife, and the lives were falling apart, and they were drifting apart, and their relationship was falling apart, and everything was looking really bleak. 

He had an amazing transformation as many people do in a single treatment. She was so happy about it that she was like, "Well, we've got to get this for this guy and this guy." Just their friends that she knew off the top of her head. And so, they got those people treatment and then she's just like, "Well, we've just got to get everybody treatment." And so, they formed a nonprofit to raise money to do this and to do their best to try to make it accessible to everybody by getting researchers and political lobbyists involved to try to legalize it for research purposes, at least because right now everybody who does it has to leave the country to do it because it's not legal anywhere in America.

Melanie Avalon: Well, this is absolutely fascinating and amazing and I would definitely love to learn more about it.

Kirk Parsley: Our intro just turned into a podcast, I think. 

Melanie Avalon: I know. I know. No, but I really would. This is incredible. Well, I will put links to all of this in the show notes. I just think it is so incredible everything that you're doing, not just in the world of sleep, which is what you've been on this show multiple times for, but also the work with the chumps and how that affects everything, and raising the money there for the families and also this work with psychedelics and the veterans. So, super amazing. I'll put links to everything in the show notes. And now, we will jump into part 2 of the listener Q&A with people's sleep questions. For those who are not familiar with Sleep Remedy, how did you decide to develop it and how is it different from pharmaceutical sleep aids? How does it work in the brain? Because I actually have some questions about it. 

Kirk Parsley: I'm sure to some degree, we spoke about the different stages of sleep in the last podcast. As a basic review, I assume most of your audience probably knows this. Every mammal on this planet uses the sun as its guide as to when to be awake, when be asleep. We are highly visually dominant animals and we don't see well at night. Of course, it makes sense that we would preferentially sleep at night, whether which came first, the chicken or the egg who knows, but that's the way things are. There's been enough research to-- To be fair and clear the research, actual sleep research with true scientific rigor, it's only been around about 60 years. But we've pretty well established now that the way that we align our circadian rhythm and that's a job security word. Circadian sounds fancy, but it's just circa means about and dia means a day. So, it's about a day rhythm. If there's no light influence, a male's circadian rhythm is slightly longer than 24 hours and the females is slightly shorter or vice versa. I don't know. I'm pretty sure that's what it is, but it could be the other way around. It's never proven relevant in my career.

Essentially what happens, the blue light goes away because she sun goes down and then we have some nerve cells in the back of our eyeballs that sense blue light. When the blue light goes down that essentially causes us neurons to fire and then they start firing down our optic nerves and into our brain, this kind of circuitous pathway, eventually stimulating the pineal gland to secrete the hormone that most people have heard of called melatonin. When melatonin gets secreted as Matt Walker calls it that starter pistol of the whole event. That's really when the game gets going. There are hundreds of physiologic shifts, and the dominance of neuropeptides and neurotransmitters and neurohormones that are in your brain that led to concentrations of those in different regions of your brain. All shift dramatically and they keep shifting dramatically during the night depending on what stage of sleep you're in. I think most people have probably heard that there are sleep stages. 

One of the other requirements for even feeling sleepy and feeling like you need to go to sleep is for this neuropeptide called GABA, capital G, capital A, capital B, capital A. Gamma amino butyric acid that gets secreted in the brain and that essentially slows down the brain, what we call the neocortex, which is what you think of when you think of a human brain that shape underneath and embedded in that shape is the primal brain, or the lizard brain, or all of that and the brainstem. So, not that part of your brain. But the part that we think of as a human brain, GABA really slows that down. The reason that's important is that really the definition of sleep simply means that that area of your brain is off. It's dissociated. William Dement, the grandfather of sleep medicine and America defined sleep as, there is a barrier between you and your environment and you can be awakened past that barrier. 

What he means by that is that the barrier essentially means that you're not paying attention to your environment. Your eyes work, your ears work, all of your senses are still working, you're just not paying attention. Your brain is actually still perceiving it, just not processing it and thinking about it and using it for anything. That's why you can wake people up who are sleeping with subtle things like turning on a light or an odd noise. If you sleep in a noisy environment, but it's consistently noisy, people who work on ships say and they sleep near the engine, and there's a loud rumble the whole night, they can sleep through that. But some weird noise happens, which may or may not be any louder than the other noises around it, that wakeup. So, your senses are still working. You're not really processing them. 

The other thing that would happen when the sun went down and what we know from studying hunter-gatherers that still exists today who have never experienced electricity and most people who have been camping will know the same thing that once the sun goes down, it takes about three hours to three and a half hours to really feel overwhelming desire to sleep. That's how hunter-gatherers that exist today. It's important that they decrease the blue light in their eyes and it's important that a bunch of neurochemical changes happen in your brain and you secrete melatonin and then you secrete GABA. Your brain secretes all of this and that slows your brain down. The other thing that happens when the sun goes down after about three hours is your body temperature starts to get a little lower. And so, those are the three prerequisites. Pretty much anything that you've ever heard of as far as setting up your sleep environment, or your bedtime sleep ritual, or sleep hygiene, they're all really based around those three things. Shutting off your brain, secreting melatonin, decreasing your body temperature. That's the foundation of it. 

As we talked about in the last episode, I never really set out to be a sleep guy and I wasn't dealing with people who have sleep disease. To be clear, I'm not a board-certified sleep physician, which is somebody who works with people who have sleep diseases. I am a physician that works with people to optimize their performance and sleep is one of the major issues and that's what I do and that's what I've been doing for the past 11 years. But in working with the SEALs, when they came to me, they didn't have any diseases, but they weren't performing as well as they wanted to perform. As I said in the last episode after a while is determinable, maybe it's the sleep drugs. In order to get them off of sleep drugs, I had to come up with something to replace it with. I couldn't just take away the drug that they had been using to sleep for the past three or four years, and give them nothing, and expect them to sleep, and still like, me and still listen to me. With the help, they were great patients, they were very motivated, they were great at taking notes, they're great at keeping journals, they're great at giving me feedback as you can probably guess. Nobody was shy about sharing their experience. Nobody was yesmanning me or stroking my ego. It was all very serious and I just got a lot of great feedback. 

This was 2009. It really started with the vitamin D3 and that was the beginning of that Robb Wolf, D3 calculator that got added to the internet or something. That was the beginning of the awareness of this epidemic of vitamin D3 deficiency that we had in America. I read a lot about that and I heard a lot about that, and I found out that it's a big player, and people being able to sleep well. Vitamin D3 deficiency is associated with poor sleep and I'm like, "All right." The SEALs work at night and they sleep during the day. When they do go outside during the day to train, they're covered with camouflage, and goggles, and gloves, and helmets, and all this stuff." And so, it's probably just a vitamin D3 deficiency. I knew they all had vitamin D3 deficiencies because I had all their labs. And so, I knew that to be the case. I thought that would solve it. And of course, that was naive. It improved some people's life and performance, but nothing amazing.

Further study led me to understand that magnesium is required for all vitamin D3 reactions. I think it is the most common mineral deficiency, it's magnesium. I started giving them magnesium, where we're giving them Natural Calm in those days. No, actually, it started with milk of magnesia. [laughs] How disgusting is that? They were doing it and they're taking that and vitamin D3 drops, and then we said, "Well, it's our little melatonin." Everybody knows about that. And then I learned about GABA and started adding GABA and then I thought, "Well, let's see how's melatonin made." Actually, another guy's been in the sleep space, maybe even longer than me. His name is Dan Pardi. He was a neuroscience PhD student specializing in sleep when I met him about a year into this project. I told him what I was giving and he was like, "Well, I think it's probably a little too much melatonin." We had a really long conversation about that and that changed my melatonin. Then I thought, "Well, let me make sure that they're making plenty of melatonin." So, what did they need to make it? And that's tryptophan and L-5-hydroxytryptophan. 

That's really it. There's no trick in there. There's nothing in there that tricks your brain into dissociating or not paying attention to where you feel like you're asleep. That's what sleep drugs do. After, I don't know, I want to say a year, year and a half after I got out of the SEAL teams, and the entire time that I was the doctor there, but the pressure really started on me after I got out. The SEALs just really wanted me to make a product for them, so that they didn't have to go buy all this stuff piecemeal. This is well before Amazon was a big thing. They were having to drive all over town to get their supplements. And so, really peer pressure led me to making this supplement. I put it in the foil pack that it's animated a drink, so that they could grab a handful of them and throw them in their pockets unlike pills and so forth. You can crush it, smash it, get it wet, whatever. It doesn't make any difference. Very durable. It has a very long shelf life that way. And that's where the product came from.

Then I'd say shortly after I finalized what I was giving guys, I learned about the ability of phosphatidylserine decreasing cortisol which is the primary stress hormone and high cortisol levels will prevent you from sleeping or preventing from sleeping well. It can interfere with sleep. Let's put it that way. I started giving guys phosphatidylserine. When I started making my product, this is just something Robb Wolf and I chipped in on, Peter Attia chipped in on, and we did on a really small budget and said, "Let's just try and see if it goes." And we really couldn't afford to put phosphatidylserine in it. After a couple of years, we came out with a new formulation where we added some phosphatidylserine. But that's it. There's no trick, there're no gadgets, there's no magic to it. If you think about evolutionarily taking about three hours for your brain to build up the right chemistry to make you feel really sleepy and very few people are ever going to spend three hours getting ready for bed in modern society. The idea is to see if we can cause a lot of those similar changes by super concentrating some supplements. 

The reason there is a very small amount of melatonin and there's just in case you haven't really started secreting melatonin. But there's not enough melatonin in there to keep you asleep all night. Your brain still has to do the work. And then we're putting in the nutrients to make sure that your brain doesn't run into any deficiencies when it's doing the work. We're just trying to be realistic and say, the ideal would be to spend three hours getting ready for bed. But if you're only going to spend an hour getting ready for bed or some people only 30 minutes, drink this, it's a liquid, it absorbs super quickly, we can get all these ingredients into your brain really quickly, do a little bedtime ritual, see if it helps you get to sleep. If you can go into a high-quality sleep pattern immediately right when you fall asleep, you start going through the sleep cycles very, very appropriately, let's say. And it's a high quality, what we call histogram like our measurements we would like, this would be a very high-quality sleep. 

Then you usually sleep really well all night. It's very rare that somebody starts out with really high-quality sleep and then has poor-quality sleep later. It's very rare that somebody starts out with poor quality of sleep and their sleep gets better through the night. It's an all or nothing game. If you start sleeping poorly, the sleep cycle right before you wake up is probably going to be a pretty poor sleep cycle as well. If you start sleeping really well, then the last one is going to be pretty good cycle. And so, that's it.

Melanie Avalon: Okay, so many things you touched on already and I'm trying not to go on tangents, but I have to ask you one question. You said at the beginning, the fun fact that we're not sure about the accuracy of, but the average circadian rhythm of females versus males, which I'm definitely going to have to look into. Do you subscribe to the idea that part of the reason that people are night owls or early birds has to do with their natural circadian rhythm and that those with naturally longer rhythms are more likely to be night owls such as myself?

Kirk Parsley: Yes, I think that's fairly non-controversial. That's the good thing about sleep research. A lot of my colleagues in the health and wellness space, they all spar a lot about nutrition, and exercise, and training techniques, and all that type of stuff. This a lot of conflicting research and it's hard to know what's right. The good news about sleep research is that there's a very, very, very few conflicts. Pretty much everybody agrees on most things with the more geeky you get, the more nuances people would argue over. But the general concept that some people are just wired in this genetics in the sense that it's a gene that's passed down, or is it something that's occurring when your brain's forming in the womb, or is it something that's occurring as your brain's developing when you're a child? We don't really know the answer to that. But there are definitely well-documented owls and larks. 

Of course, it's very well documented that when the brain and body's hormones change drastically during puberty, adolescence, there is a very, very market shift towards being in an owl. And so, if your kids are already an owl, already has a hard time maybe going to sleep by 10 o'clock, and then they get to be 12, 13, 14 years old, and they have the shift, they might have a really hard time falling asleep before midnight or maybe 1:00 AM. And then most places in this country school starts around 7:30 AM. So, you can imagine how sleep-deprived kids are and they're way more sleep deprived than adults, not only because of that adolescent shift, but also because kids need more sleep. An adolescent should be getting 9, 10, maybe 11 hours of sleep. They're averaging about six in America. Adults are averaging slightly under 6, but adults only need 8. So, kids are worse off.

Melanie Avalon: Okay, that's really good to hear. 

Kirk Parsley: Total tangent, but-- 

Melanie Avalon: Yeah. Well that actually surprised me to hear you say there's not much controversy around that just because so many people, especially I think a lot of people who are naturally early birds and if they're in the biohacking health world, I don't know, there's a lot of pressure that-- [giggles] I know it's maybe , but-- 

Kirk Parsley: If you want to talk about social values and social pressure that's a different question and physiology of will somebody given the same circumstances of you controlled for the environment and you randomize people, would there be a dispersion across that cohort that would be predominantly people who prefer to fall asleep an hour, hour and a half later, wake up an hour, hour and a half later in the earlier group. That has always happened. Every time that's been studied that's happened. So, I don't know that there's any controversy over whether that they exist as I've started that with though. 

As far as I know, I don't think that anybody has established essentially what the cause of that is. And to the best of my knowledge, I've never read or heard anything about being able to alter that. It's like slower-fast twitch muscle fibers. You have your distribution, and some people are built to be really fast and really strong, and some people are built to be really endearing, and those two don't cross over. They just are what they are. One is not better than the other, but you're never going to find a world's strongest man competitor also being competitive at marathons. It's a completely different type of muscle-- neurological and muscle fuel energy sources, they're just wired different, and now [unintelligible [00:46:40] are just wired different. 

Melanie Avalon: Oh, that works for me. Okay, so, you touched on a lot of things. We have a lot of questions about already. Melatonin, for example, figuring out the right dose of melatonin to put into your supplement. So, is too much melatonin or long-term melatonin a problem? For example, Margaret says, "Are there any negative long-term effects from supplementing melatonin? I'm curious because I have been taking it for years and also because some functional medicine providers are suggesting pretty high doses of melatonin as prevention for COVID. So, also, I would like to know more about--" Oh, this is another question about it. She wants to know how the high doses of melatonin are thought to help fight COVID. 

Kirk Parsley: Melatonin, I think most people understand is actually a hormone. The FDA is a very strange organization and there's not a lot of logic behind a lot of what they do. And so, you can buy melatonin over the counter here, but you can't buy estrogen or testosterone over the counter here, but they're all hormones. Vitamin D3 is a hormone. In the UK and Australia, you need a prescription for melatonin. Again, totally aside, but melatonin is a hormone as I said that is-- To be clear, melatonin isn't just made in your brain. Your entire body sees more melatonin during sleep. It is an immune modulator. It has high antioxidant effects, one of the original postulates behind people supplementing that. I want to say that the dose was recommended. This was maybe in the 80s or early 90s, the recommended dosage was like 15 milligrams a day or something. That was going to prevent cancer because it was an antioxidant. Antioxidants were all the rage. So, anything that's an antioxidant is doing its anti-oxidation through modulating the immune system some way like how specifically the virus is related to the immune system's response to SARS-CoV-2 and how melatonin impacts that I don't have the slightest idea, but I can just say that it's an immune modulator. 

Now, because it's a hormone that's much different than it being say a vitamin or an essential nutrient or an essential mineral. Our bodies are very intelligent machines. Our brains are constantly, constantly literally every millisecond measuring what's in our blood. Not only what's in our blood, but just what is in the interstitium, which is the link to fluid in between the cells. It may not have blood supply in there and it's responding to that, and that's part of the determination of whether you make more or less of something. Because our bodies are smart, if you put something into your body that your body ordinarily makes and your body sees that and it works, well then the sensing mechanisms in your brain are going to say, "Well, that's already there." So, then they trigger to make it isn't going to happen. This is well understood with something like testosterone therapy in men.

If you give men testosterone therapy for approximately a year or two, they essentially won't make much testosterone anymore. You need to be pretty sure that you're committed to that and it's going to be really hard for them to start making testosterone again. They'll probably never make as much testosterone as they were making the year or two before when you started them on the hormone. We know this to be true with hormones. It's a downregulation of hormones because hormones are constantly being adjusted. Like I said, every millisecond, your brain is measuring, "Oh, we need more of this. We need less of that." It's always being controlled. All of the cortisol, stress hormone, that's being constantly modulated. That's changing as I'm talking. As I get more or less excited about topics like my cortisol is changing. This stuff's always in flux. 

Melatonin is made in very small doses, very small amounts. It's a very powerful hormone in the brain. Now, unfortunately, in order to measure it in the brain, you would have to have some way of sticking like measuring fluid in the brain and the interstitium in the blood. And so, you'd have to bore needles into people's brains to figure out how much melatonin is in the brain. You can do salivary assays where you're getting it through the saliva. But like I said, melatonin is made in your viscera like around your organs and so that's not the greatest measure. But actually, when Dan Pardi and I had that conversation, he said that the human brain only makes about 6 micrograms between the time the sun goes down and the sun comes up. So, that's over an 8-to-12-hour period the brains can make 6 micrograms. 

Well, if you take a 5 milligrams tablet or even a 1 milligram tablet, why would your brain make any melatonin? Has no need to. Not that 100% of its going to your brain, but there's a real chance of this. We've never been able to prove that melatonin quantities decrease in the brain if you supplement. However, if that's not true, it would be the only hormone that anyone is aware of that didn't downregulate when you gave it to somebody, what we call exogenously so from the outside in. You put it into somebody's body that decreases every hormone we know of like everything we've ever tested, every hormone we're aware of in humans that happens. So, we haven't been able to prove with melatonin for the reasons I discussed. However, what has been proven in mouse studies, mice and rats is that the receptors in the brain that receive and catch and hold on to and then produce the functions of melatonin, those receptors will decrease if you take melatonin on a regular basis.

Let's just say that your brain-- We will just make it simple. I'm just going to choose arbitrary numbers with no units to it. Let's say in an ordinary night, if you live like your ancestors, you didn't have electricity, the sun went down, your brain would start producing melatonin. By the time you woke up in the morning, your brain would produce melatonin level of 5, right? So, let's say that's how you're wired. You make 5 every night and the we give you exogenously, however we get it into your body, inject it, swallow it, whatever, so we put melatonin into your body and let's say we put in 10, or 15, or 20, or 30, or something, or even maybe just put in 5, but we are putting melatonin in your body. It's getting into your brain. Your brain is going to quit making as much melatonin almost certainly. But even if it doesn't, follow me here, say we give you 5 or 10 every night, we have measured that your receptors are going to decrease.

Now, if we quit giving you that melatonin, your brain goes back to making 5, but it only has half of the number of receptors, then this it's the same as your brain making 2.5 because there's not enough receptors for the system to be balanced anymore and it's going to take weeks for that to come back. So, that's the downside of taking exogenous melatonin on a chronic basis, is that you're almost certainly decreasing your own melatonin production, which is something that tends to go down over your lifetime anyway, because the pineal gland in the back of the brain that secretes it actually calcifies on the ducts feed it calcify, just meaning that it gets built up with calcium around it like atherosclerosis or calcified tendon injuries or whatever the people know about. So, it's a similar process.

Taking in exogenously, definitely going to decrease receptors. Most likely you're going to decrease melatonin production if you stay on the same dose every night, let's say, you take 5 every night and keep in mind, I'm saying 5 is an arbitrary number, nobody go take 5 milligrams, that's too much. But let's say, you're taking the amounts that your brain would ordinarily make every night and you do that every day for the rest of your life, is that going to cause any problems? Probably not. But who knows? We would have to study people over their whole lives, but I would say almost certainly that if you took 50 milligrams per night, it wouldn't just be your brain that would be affected, all sorts of regions of your body that would downregulate melatonin receptors and you would definitely run into some poor physiologic changes because you had so few receptors, especially if you ever quit taking that melatonin. 

It's a slippery slope. If you're just going to take it for a few days like you want to take it for jetlag, something like that, yeah, sure go for it. Short term, it's not going to do anything. It takes weeks to downregulate receptors, it takes weeks for them to come back. That's the reason antidepressants take-- They say, they'll take anywhere from four to eight weeks to start working well. That's because it's downregulating receptors. It's changing the receptor densities in your brain. This is primary effect. And so, it takes a long time for them to change. And then if you quit taking an antidepressant, then it takes a long time for them to change back and the melatonin is just like that. 

Melanie Avalon: Gotcha. What about something else that people often find knocks them out like a dose of melatonin and that would be Benadryl? I know for me-- So, I don't take Benadryl on a regular basis or anything. But if there's ever a night that I just have to sleep and sleep is not going to happen, if I take a Benadryl, I'm good, I sleep. We have two questions about Benadryl. Jennifer says, "I also use Benadryl to help with sleep and I'm freaking out that this would cause negative health effects." What Sophie said. "My mom's doctor said a similar thing." She said, "I'd like to know the long-term effect of over-the-counter sleep aids. I read Why We Sleep and the author talks about the side effects of prescriptions for sleep, but not over the counter which my doctor said is "basically Benadryl" and should not have negative health effects." And I have heard that from doctors that like Benadryl is fine, antihistamines like Benadryl for sleep.

Kirk Parsley: Yeah, right. You may have guessed that I am going to disagree with that statement. But first, I'd just like to give a little clarification as to why Benadryl is a different type of sleep drug. When you think about prescription, sleep aids, for various reasons, they're starting to use a lot of things as sleep aids now including antidepressants, and pain medications, and things like that. But let's stick with the on-label use and the intended use. There's a category of drugs called Z-drugs, which would include Ambien and Lunesta and then there's a category of drugs called benzodiazepines, which includes things like Valium and Xanax. So, both of those drugs bind GABA receptors. If you'll remember earlier, I said, that's one of the main neuropeptides used to slow your brain down. 

Now, the most common reason that people have initiation insomnia, meaning that they can't fall asleep, it's some sort of stress. It's some sort of active mind. I'm being overly simplistic, but that's a fair way to say that I think. You have this chemical and the reason I don't like the term biohack is because I feel the original biohackers were the pharmaceutical industry. Everybody hates the pharmaceutical industry, but now, they want to do biohacks. And so, with the pharmaceutical industry says is like, "Hey, scientists have determined that when GABA binds this receptor in sufficient quantities that slows the brain down enough for people to go to sleep. So, let's see if we can make a molecule that will bind that GABA receptor and we'll do the job of GABA better than GABA," so that when people can't sleep, they can take this drug and it'll be more of a GABAergic effect than their brain could produce, and so it's going to help them fall asleep. Benzodiazepines were the first version of those. 

Now, it turns out there's a high risk of developing dependencies on these, they suppress your respiration, your breathing, so you can overdose pretty easily on them. It's a slippery category. And then of course, the pharmaceutical industry decided what we can make something better and they made the Z-drugs and the Z-drugs supposedly don't have the same type of dependency to them but they act the same way. Now, the difference is, let's say that when GABA binds a receptor, we'll call GABA binding the receptor and the receptor reacting to that GABA molecule and changing the chemistry of the cell and changing the neuron functions in the brain. Let's say that we'll give GABA the baseline of 1. When GABA binds, it has a GABAergic effect or will say GABA effect of 1. When benzodiazepine binds, it has a GABA effect of a 1,000. When a Z-drug binds, it has a GABA effect of 10,000. So, I've already told you what happens when your body doesn't need as many receptors to get the effect, you downregulate GABA receptors in the brain. It becomes a big deal because now you can't ever get off of these drugs. If it's having a 1,000 times more effects, then it's conceivable that you could decrease the receptors for GABA a 1,000 times. And then how long is that going to take to come back, if you ever quit taking the drug and how are you possibly going to get to sleep before that? 

Now, as I said, what GABA does is it slows down your brain and it really takes your neocortex offline, so that just simply means that you aren't paying attention and processing your sensory, but your lizard brain, your old brain, reptilian brain underneath that that causes your body to function and is primarily concerned with reproduction and survival, that region of your brain keeps working all night. That doesn't slow down. And in fact, that can actually increase in a lot of instances. If I have 1,000 or 10,000 times the GABA effect in my brain, it might completely shut down my neocortex, but that doesn't mean the rest of the chemistry in my brain has changed enough for me to go into what we call a normal sleep cycle. If it's not a normal sleep cycle, then it's not a quality sleep cycle. So, I say all of that to distinguish that from antihistamines, and alcohol, and other things that people may use for falling asleep. I could talk for hours about the strange effects of the Z-drugs and benzodiazepines, not just around sleep, but around all sorts of behaviors. But I don't think that's the point of this and I won't bore anybody with that. 

Now, the other thing that goes on, as I said when melatonin switches on, it starts being produced a cascade hundreds, thousands of chemical concentrations throughout the brain shift. And they're shifting constantly, and they're constantly being sensed in different stages of sleep. They shift again. And this is like a very, very highly active process. It's a symphony. Think of this as like the biggest symphony you've ever seen. There is a conductor, the conductor the part of your brain that's sensing all of this and it is adapting throughout the night. One of the things that happens is when your brain is getting ready for sleep, it decreases the production of certain neuropeptides, or neurotransmitters, or neurohormones or kind of same thing that's a relevant distinction and one of the primary, what we call wake-promoting.

I think it's an important aside to address here. The most complete definition truly of being asleep is a lack of wakefulness. We have chemicals in our brain and body and hormones in our brain and body that make us awake and alert. The maximum of that is the fight or flight. When you are in fight or flight, you are maximally awake and alert. So, you have a lot of wake-promoting neurotransmitters and hormones in your brain and throughout your body. These are very wake-promoting. They make you feel like being awake. So, one of the first thing your brain does at night is decrease those wake-promoting neurotransmitters and then starts increasing the sleep-promoting neurotransmitters such as GABA like I listed earlier. All an antihistamine is doing is it's binding the receptors that histamine would ordinarily bind to and therefore you don't have to decrease the amount of histamine in the brain, which is a wake-promoting neurotransmitter. You don't have to decrease it as much because you're binding all the receptors and it's having no effect. That's how the drug works.

Again, you're messing with the normal physiology. If you take an antihistamine to decrease the wake-promoting neurotransmitters in your brain and then we measure your sleep throughout the night, it doesn't look the same. The sleep quality, the sleep architecture of that histogram, where we're measuring all the different stages, and how long you're in each stage, and how you're cycling through that, that doesn't look normal. You have a diminished amount of deep sleep and a diminished amount of REM sleep. The Z-drugs and the benzodiazepines do the same thing. Alcohol does the same thing. They all have their own pattern for how they mess with sleep. But essentially, what you're doing with Z-drugs and benzodiazepines is you're just turning your brain off, which doesn't mean that you're asleep at all, like it doesn't mean you have any of the normal neurological patterns that we would expect to see during sleep, it doesn't mean you have any of them. Very often I've seen almost every SEAL, I had a sleep study done on, they had 99% stage 2 sleep, which means they weren't getting any deep sleep and they weren't getting any REM sleep, so they really weren't getting any sleep, they were just unconscious because they're using sleep drugs.

Alcohol really, really, really messes with deep sleep, that's the anabolic phase that we talk about, that's when you're rebuilding, getting stronger, smarter, clearing out waste, increasing your anabolic hormones like testosterone, and growth hormone, and thyroid, and all of your hormones. And then even your appetite regulation, the hormones that control appetite regulation, now that's being reset during this anabolic phase. REM sleeps when you're dealing with a lot of emotional categorization and memories, and rehearsing things, and catching new information to pathways associated with old information, so that you can access this in different ways. All sorts of things are going on during sleep that are really important. If you're diminishing REM sleep or you're diminishing deep sleep, you're diminishing the quality of your sleep. 

Now, taking an antihistamine and getting rid of the primary wake-promoting neurotransmitter might make you feel not awake at all, but that doesn't mean that you're asleep. If I hit you in the head with a baseball bat, you'd go to sleep too, but it wouldn't really be asleep, like your brain-- you wouldn't have that normal pattern. Alcohol's the same way. So, I think I answered the histamine question. But I just felt it was important to talk about how they all do it. They all do it differently, but they're all a trick. They're all a biohack.

Melanie Avalon: Quick question about the antihistamines. Because you're saying that it might instigate a state of seemingly being asleep, but it's not necessarily the good form of being asleep. But if a person is chronically sleep deprived, so they need sleep, and it's time to sleep, and they take an antihistamine, and that shuts off their brain, since they were needing sleep anyway would that sleep then be fruitful?

Kirk Parsley: It's always going to be true that some sleep is better than no sleep. However, as an example, when the pharmaceutical industry's first started getting successfully sued for the Z-drugs, because they were essentially dissociating people's brains, people were still awake to any outside observer, they could still have conversations, they could still drive their car, they could still work, they could still do all sorts of things, but they would essentially have no memory of it because it'd really shut down, it dissociated their brain from all the normal pathways and circuitry that should be going on. And so, when pharmaceutical industry makes a drug, they do their own research, they own the research, and then they turn in the research they want to the FDA, and then the FDA approves it or doesn't approve it, and there's some expectation obviously of honesty and morality within the pharmaceutical industry, there's some trust being put in there. 

When they started getting sued, then more research came out and the FDA was nearer to government. I don't know if it's the FDA, but it started demanding more, well, let's see all of the research. It turns out that taking a sleep drug like Ambien or Lunesta, I might not be exact on these numbers, but I'm close, I'm within a couple of percent on this. I want to say it led to people falling asleep about 13 minutes earlier than they would have if they didn't take it and they slept for about 38 minutes longer total than they would have if they didn't take it. However, it also completely erased about 80% of REM sleep and about 20% to 40% of deep sleep. In that instance, sleeping 40 minutes less but having good quality of sleep would have been exponentially better, way more effective for you. 

As you know, when I work with clients and my whole shtick about sleep, nutrition, exercise, and stress mitigation, it's all the same. It's all lifestyle. The reason I work with people for a year is because it's really a behavioral change program. I'm a physician, so I can do all sorts of things. I can do labs, and we can test things, and measure things, and do prescriptions. We all of those things as well, but it's primarily a behavioral change. What we want to do is idealize your life to where you can get the best possible sleep you could possibly get. Now, there's an ideal way to live your life. We could measure that out and do all sorts of metrics with-- You can go on forever, do the things that you could address to be what you consider to be ideal with the client's goals. But then there's a reality like how much can you actually change your life. 

Ideally, we would all shut off electricity three hours before we went to bed. We wouldn't put any light in our eyes, our houses would cooler and we would live like our ancestors. That would be ideal. Now, is that possible in modern life? Not for very many people. There're other obligations. There're realities to life. And so, we build the lifestyle to be as close to the ideal as possible. And then in between that there's a gap there. There's the ideal, there's what's really possible, and then there's some gap in between there and that's what we supplement. The supplements might be nutritional supplements, it might be gadgets that you wear, it might be behavioral tricks, and mantras, and things that we can do to narrow that gap, so that you get the best possible sleep you could possibly get. That's the approach to getting better sleep. 

Taking anything as a substitute of the lifestyle modification is a terrible idea. I don't care what the supplement is. You can't say, "Well, I'm going to live 50% of the lifestyle. I'm going to do 50% of the behaviors I know I should do and then I'm going to take this drug and fall asleep anyway and expect to get good sleep." It's just not possible. It doesn't make any sense that that would work. That would be like saying, "I'm going to eat terrible food all the time, and take this drug, and I'm going to be as healthy as I would be if I ate a perfect diet." Of course, you're not going to. There's no possible way that's going to work. While I'm not saying that Benadryl is going to kill somebody or cause some catastrophic illness in their life, I am saying that it is suboptimal. It is something that you could use piecemeal, like you could use it here and there. When I was SEAL, that was well before the Z-drugs, one of the things we did when we got on these really long transit flights, flying from California to the South Pacific or whatever, we'd be on these really long flights and essentially a cargo plane, and we would take Benadryl because who the hell wants to sit in a cargo plane for 18 hours.

Intermittently doing things like that and even intermittently taking Z-drugs or benzodiazepines, I don't have any problems with that. If there's a functional use for it, and there's a plan and there's an end game, and there's a point where you're going to get off of it, and it's episodic-- When a SEAL's wife was widowed, I would very often give them benzodiazepines and a lot of doctor stuff that was way too risky. Yeah, that's way too risky for them, because they could become suicidal and that's an easy drug to overdose on and they can get dependent on and all this other stuff. But in that instance to me, it made a lot of sense. She's not going to have the same grief a year from now or even two months from now that she's going to have for these first couple of weeks and there's a lot to process. Some sleep of some quality is going to be better than no sleep at all. That's going to make her way worse emotional wreck than she's already going to be. 

Same thing, if you're flying across a dozen time zones. If you fly across 12 time zones, it's at least 12 days to get your circadian rhythm realigned and it could be up to 24 days depending upon which way you're flying and how you're wired. Is it okay to take some sleep drugs to help you get on the same time tracking like take some sleep drugs at night, take some stimulants in the morning to help you get ready to do whatever you're doing to where you travel to? Yeah, that all makes sense, but there has to be an exit plan. If this is something that she's doing as a preferred technique over anything what we call chronic administration, which is something that you do more than six months. I would advise against it. It doesn't lead to normal sleep. I forget the exact pattern. I want to say Benadryl decreases REM and deep sleep about the same amount and I think it's 30% to 40%. So, you're essentially losing 30% to 40% of your sleep.

Melanie Avalon: For those who are currently taking prescription sleep meds, how can they get off them? Because we have questions about that. Tonya says, "What steps would you take to wean yourself off prescription sleep meds such as Xanax? And then Mellie, "I'm smiling because my dad calls me Mellie." Mellie says-- Oh, this is not me. She says, "How to wean off sleeping aids and maintain it long-term for those with chronic insomnia?"

Kirk Parsley: The first thing I always tell anyone is when you're going to make a big behavioral change in your life, you need a very strong why. All behavioral change is hard. People think about alcoholism and cigarette smoking, but literally every behavioral change is a really hard change to make, especially the older you get. First, really motivate yourself. Have a long list of very powerful whys. Why you're going to get off this drug? I can give you a couple right off the top of my head. There have been studies that show chronic insomniacs, people who have insomnia for more than six months or more than six months out of the year I'll say, and people who take sleep drugs chronically more than six months out of the year, they die on average 12 years younger than people who don't have insomnia or don't use the sleep drugs. Now, I don't think to sleep drugs are causing anything. I think that is just the insomnia that's leading to poor recovery, more catabolic activity, less anabolic activity, and leading to an earlier death. 

Essentially, aging is kind of a disease in that aging predisposes you to-- makes it more likely for you to die from anything and it makes you-- the older you get, the more likely you are to have any disease. I would submit to you that the deficit between how much you can repair during your sleep before tomorrow comes is essentially aging, so that delta is aging. If you could stay awake for 16 hours, and then go to sleep, and recover 100% then you wouldn't age. You wake up the next day being exactly the same. As you get older, it gets harder and harder to recover over the full night and that accelerates. And so, you're getting older essentially. I think that's the reason that it's associated with an earlier death is because you're just physiologically older.

Now, with that said, how do you get off of that? That's just a why. I'm just giving somebody a why. The other thing is, I would put insomnia and anything you value in a Google Scholar search or a PubMed search, and just read till your heart's content about how chronic insomnia is ruining everything you value. Give yourself a lot of whys. I spent way too long explaining you that, but that's what I did. So, we're just going to keep rolling with it. What I did with the SEALs, again, I can't just take it away because they have downregulated receptors now and they have decreased GABA receptors. Even if their brain is making plenty of GABA, they don't have enough receptors. They essentially have a GABA deficiency now and we need those receptors to come back before they're going to be able to get normal sleep physiology occurring from their brains.

What I did is I would put them of course on the supplement because the idea of the supplement again is to concentrate all the nutrients in your brain and to give you a little bit of melatonin and to give you some GABA, so that we're getting your brain in a good state to be able to fall asleep. And then I had them titrate off of their sleep drug. So, anybody who's on a sleep drug or has been on a sleep drug chronically, of course, work with your physician, this isn't meant to be specific medical advice for anybody. But what I did is I would have a compounding pharmacy make their sleep drug into a serum and 10 drops would be-- I'm saying an example, 10 drops would be a full dose. They would do 10 drops every night for a week and they would take the supplement at the same time and then the next week they would do 9 drops, and then the next week they would do 8 drops, and then the next week-- You can see it. Now, it takes 10 weeks to get down to zero. So, there's plenty of time for their receptors to come back. So, that's how I did it. 

You could chop up your pill, you could cut your pill as long as it's not a sustained release pill. You could chop your pill into maybe four or five pieces and do something similar to that. But again, especially if you're on a benzodiazepine, I'd recommend working with your physician in a way, but I'll just point out that coming off of benzodiazepines if you have formed a dependency can be very dangerous to include dying from it. 

Melanie Avalon: Actually, also to that point, regarding long-term use of Sleep Remedy, Jennifer and Tammy both want to know, "Does the Sleep Remedy effectiveness lesson with prolonged use?

Kirk Parsley: It shouldn't. No. I don't see any reason why it would. This is a nutritional supplement. All of these are normal nutrients that your body is used to seeing. We're simply making sure that it's there with most nutrients that you take in. Now, we do have vitamin D3, which is technically a hormone. We've brought the dosage of that down just to make sure that we don't cause people to go too high and that does get stored in fat. When you take this supplement chronically, then you're going to be boosting your overall vitamin D3 levels. If you took the labs at the beginning and you took them six months later, you would have higher vitamin D3 levels. Now, it's not going to keep increasing and keep getting higher and higher as you take it because you're going to use your vitamin D3. 

Then of course, I am putting some melatonin in there, but it's a very, very, very, very tiny dusting of it and it's meant to just be the initiator in case your brain hasn't started initiating the production of melatonin already, but it would all be consumed within a couple of hours. And then everything else in that essentially if you don't need it, it's just something that's going to washout. It's going to end up being processed by your liver and chopped into pieces or it's going to be processed by your kidneys and end up in your bladder, it could end up in your colon. But within three to four hours, everything that's in the product is essentially going to be used or disposed of. There's nothing in there that really keeps you asleep. All it does is something to help initiate sleep. There should be no long-term decline. If there's a decline in your sleep quality, I would look first to your behaviors, have you changed your behavior?

Melanie Avalon: "Do you have plans for expanding beyond the US?" Jolene wants to know, "Can you make your supplement available in the UK and Ireland? Please, desperate Insomniac over here." And Julie said as well, "When will I be able to get Sleep Remedy in the UK please?"

Kirk Parsley: Yes. We are working on, I mean, it's on the list of things to do and you know how business goes. It could happen in two months. It might take two years. I don't know. Our intention is to make a melatonin-free version of it and then we could get it into Australia, and the UK, New Zealand, and Canada. Right now, though all of those require melatonin to be a prescription. We can't do that if we have any melatonin at all. But of course, we would have to be sure that the production cost would justify itself and there'd be enough people buying it. 

Now, there is a way to buy the product. There is something called third-party shippers, Borderlinx, L-I-N-X. Borderlinx is one of them. I can't remember the names of them. But there are people who buy our products through a third-party shipper. So, somebody like Borderlinx, essentially you order it through them, and then they ship it to you in your country. I, as a business I don't have the legal authority to ship things overseas, but a third-party shipper does. It ends up on the recipient. If your customs seized it for some reason or something, I think you just lose out. But I don't know the laws of all that. So, I'm not encouraging you don't want to break the laws, but I just saying that I know there are significant number of people doing that.

Melanie Avalon: This is a question for me. There are different forms of it. You have the drink form, there's the pill form, and you were talking about the benefits of having it in a drink for absorption earlier. Is the pill form still pretty absorbable? And also, a lot of my listeners eat like a one-meal-a-day-type pattern and they eat like a lot in the evening. If that's the case, because of absorption and having food in your stomach and things like that, would you recommend, like having it before they eat or after they eat, if people are eating which might not be ideal for sleep, but if people are eating in the evening?

Kirk Parsley: Yeah. Well, again, I would start with lifestyle. Again, this is a supplement. It's meant to supplement the gap between ideal and reality. But my best lifestyle advice to you, which is scientifically validated through sleep research is that you should go to bed on an empty stomach. That doesn't mean that you're starving yourself. It just means that whatever you've eaten has had time to leave the stomach. It can still be getting digested in the small intestine. But an empty stomach is the best way to go to sleep. If you have an empty stomach when you go to bed, then it really shouldn't matter. The capsules are going to be absorbed in your stomach. Now, whether the capsules are as effective as the liquid or not that's up for debate. I'd have to do extensive randomized, double-blind, placebo-controlled test to figure that out. I haven't done that. 

By customer report, there are people that claim that the capsules work a lot better for them. There are some people that claim that the capsules don't work as well for them. Definitely, if you're drinking a liquid, it's just going to absorb more quickly. How much more quickly? I can't say. That's going to vary from person to person. The formulation isn't exactly the same between the capsules and the drink just because of the quantities of ingredients in there. I think it was going to take six pills or something to just make our regular drink formulation into pills. And so, we used a different form of magnesium. We changed the volume by changing the sources of several things and got it down to three capsules, which I think is reasonable. I just don't feel like people would be excited about taking six capsules a night. 

The other advantage to the capsules is that it's easy to titrate. You can take three and if you're a 90-pound woman and you take three and then really just knocks you out and you feel too groggy in the morning or something because you essentially just bottomed your cortisol out and got a ton of really great deep sleep that was really regenerative and restoring, but your cortisol hadn't come back up to a normal level. By the time you woke up in the morning, you might feel a little tired and you might prefer to take two, if two works enough. If you're a bigger guy or you have difficulty, you can go to four, you can go to five, you can do whatever you want with the capsules. So, it's a little easier to do that than with the liquid. 

Melanie Avalon: For my listeners who are following an early eating window and are in the "fasted state" in the evening, the unflavored capsules have nothing that in Gin Stephens and I's opinion would break the fast. 

Kirk Parsley: Interestingly, we actually have capsules because of a collaboration with Whole30. Melissa Hartwig is a friend of mine and she liked the product. Actually, I think there were some women who are working with her who really liked the product. And so, she and I started talking about it. But then as part of The Whole30, you can't have any sweeteners and you can't have any flavorings in your food. It is really strict. Of course, we have natural flavorings in there, but we have stevia in there and we have some xylitol in there. And so, neither one of those were allowed. We said, "Well, let's see if we can make it into a capsule formulation." And that was really the motivation behind doing that. And now ironically, I think that capsules are actually upselling the tea which really bums me out because I think the tea is such a good idea because of the fast absorption, but also because it's part of a sleep ritual and it reminds you that you need to take time to get ready.

Melanie Avalon: I use the capsule as part of my ritual. 

Kirk Parsley: Well, that's fine, but you're somebody who's very disciplined around sleep. If somebody's not really disciplined around sleep, but they have to take the time. I make my sleep tea with boiling water, because then it just seems more like tea and it tastes better to me. The warmer the water, the sweeter it tastes, I don't think it ever really gets overly sweet. I've been keto for several years and I have high sensitivity to sweetness. So, it's not overly sweet even with boiling water. I do that. I put my teakettle on, and I start boiling the water, and I get my cup on and my little satchel, satch it out and it's part of the process of getting ready to go to bed and slowing your brain down being aware that there's something about to change that you're consciously making a choice to shift your behavior to get ready for bed. It's just my fear that people are going to sit down, work at their computer until 9:59 PM, and then go jump in their bed, and pop their capsules, and lay down to be in bed by 10:00 PM, 15 minutes later, they're going to be going, "Why am I not asleep yet?" The stress hormones are going to start climbing up. That's my concern with it. But if people like them, then they like them. 

Again, it's the difference between ideal-- Some people, they don't want to have the drink because they have to get up and pee more. But I don't think that's a super strong argument, because you don't have to mix it with 8 ounces. You can mix it with 3 ounces or 4 ounces. Just have a hard time believing that 4 ounces of water is going to make a big difference in your bladder. But there are people who take capsules for that reason. So, they just don't want to take by habit. That's usually men, if their prostate gets larger, they pee more frequently. And so, they just don't drink liquid after a certain time in the night to prevent them having to get up. So, yeah, there are reasons to do it.

Melanie Avalon: We have two questions about that. Joanne says, "She started needing to wake up to pee every night the last few months. What causes this?" She says, "She's eliminated caffeine and alcohol and limits liquids after 2:00 PM." And then Alyssa said, "I need this answer too. This has been happening to me the last year and I'm early 30s. So, it's not perimenopause related."

Kirk Parsley: My first guess would simply be a higher stress load in life. You have some significant change that's changed the basal amount of stress that you're carrying around. As I said, the absolute lowest point of stress hormones in your body is during deep sleep. And then when you first go to sleep, that first sleep cycle and a sleep cycle is 90 to 120 minutes, that first sleep cycle is like 90% deep sleep. So, you have really, really low stress hormones. And then your cortisol, your stress hormones gradually creep up over the course of the night and they get to a point in the morning, where if you didn't have an alarm clock, they would be high enough to wake you up, because cortisol is one of the wake-promoting hormones and epinephrine and norepinephrine that come out simultaneously, those are wake-promoting. And so, that's all part of the normal rhythm. 

Now, what's happening when you have the really low levels of cortisol in your deep sleep, and say the first half of the night, you have super, super minimal levels of stress hormones. One of the things that happens when you're in sleep is that your kidneys actually slow down. The production of urine decreases, so that you can sleep for 10 hours and most people don't go 10 hours during the day without having to go to the bathroom. That's a normal built-in mechanism. But if you have higher stress hormones, then you're not quite as deep sleeps. You aren't having quite the same physiologic changes. Your kidneys might not be slowing down as much as they usually do. Now, again, the one woman said, she didn't think it was perimenopausal which is possible. There could be some hormonal shifts that are somewhat similar to that. I'd be getting way off on tangent with zero estrogens, different supplements, and things like that. I think that's too far to go. 

My first guess would be just an increased stress load and for that I would recommend a completely free PDF on my website that is called Stress Free Sleep guide. You can download it and it gives you an entire program on how to create less stress in your body while you're sleeping. 

Melanie Avalon: For listeners, the show notes for this episode will be at melanieavalon.com/sleepquestions2, the number 2. We'll put links to all of that there. We talked about this on the last episode, but you do have a new formulation for children, which is really exciting. Would you like to briefly hyst say what the differences for the kid's formula?

Kirk Parsley: There's a lot less of everything in there. There are a couple of categories that are taboo with clinical researches. We try very hard not to do research on children. We try very hard not to do any research on pregnant women just because it could have such long-lasting consequences. This would be an unethical. However, there is literature on children who have diseases that are related to poor sleep quality, or short sleep duration, or initiation insomnia, difficulty falling asleep. And going through the research on that and the different supplements that have been used for kids with down syndrome sometimes have sleep disorders. Obviously, kids with ADHD, whether they're on stimulus or not can have-- There has been some nutritional research. We basically extrapolated out of that like what's proven in the literature to be about the right dose for a child to help them sleep. And so, we just extrapolated from that data and tried to build the most robust product we could while still being on the careful side of things. Although there's nothing risky or dangerous and there's just like I don't want to overload anything. I don't want to overload you with vitamin C or vitamin B. There's nothing I want to overload you with.

We basically designed it to be right in the middle of the childhood. If younger kids are taking it, it shouldn't be super physiologic meaning more than your body would ordinarily see. If older and larger kids are taking, it should still be adequate. The flavoring is different. When we very first started, actually, before I even started this company, when I first took on the project of doing this, it wasn't even sleep cocktail yet. It didn't have its name yet. This is what led to the sleep cocktail. I was figuring all of this as I went. I was a doctor. Obviously, I didn't have any training and how to get supplements produced or whatever. And so, we'd get all the sample flavors from these production houses and I would just line up my family and everybody tasted.

Melanie Avalon: How many different flavors would you try? Was watermelon one of them?

Kirk Parsley: We probably went through eight different samples or something.

Melanie Avalon: Can I vote for watermelon?

Kirk Parsley: You can vote for watermelon. [laughs] I'm not sure they will make it, but you can vote for it. I must say my daughter is the youngest and I want to say she was probably around 10 years old when this was happening. So, then they would have been like 10, 12, and 14. But all three of them loved the berry. I just wanted everybody to take a sip because I knew [laughs] this could make them sleepy in the middle of the day, is like 1 o'clock, 2 o'clock in the afternoon or something. And then we did this several times. And the kids, all just loved the berry. It was so good. They like, "Oh--" My daughter was like, "This is so good. You should call it berry bedtime and I love it." The funny thing was we had all the sample glasses out. My wife, and my kids, and I, sometimes some people I was working with, my friends whatever, we'd all be tasting them, have them all lined up on the counter. And the kids would just fight over the berry when they wanted to-- They'd all fight over the berry one and that one would go away. Every time we did the taste test, that one was gone immediately. 

Then the funny thing is that they were all good at-- [laughs] I was like, "All right, note to self. Kids really like berry flavor" and it obviously works. That was a full adult dose in one class to three kids, all drink out of and then they still all took a nap. So, it turned out to be okay. And then really, Shayla, number two in my company, my COO, she was really the push to actually get the child's formulation out. She just had her first baby 18 months ago and you know that mother nesting instinct has been strong with her since she got pregnant. She's always really been passionate about a good project. And so, I said, "Well, I don't really have time to do it, but if you want to push it, you can push it." And so, she pushed it. That's how I hit the market. We just started selling it, I think 10 days ago, two weeks ago something like that.

Melanie Avalon: Well, congratulations. It's really exciting. For listeners who want to get their own, you can go to melanieavalon.com/sleepremedy and you can use the coupon code, MELANIEAVALON to get 10% off anything, which is very exciting and I did confirm by the way that it'll work on that.

Kirk Parsley: Good for you. [laughs] We know what would have happened if you would have left that to me. So, it was a wise choice.

Melanie Avalon: One last question about the Sleep Remedy specifically and then it leads into another topic that we have a lot of questions about. So, Carrie would like to know, "Does Sleep Remedy work for nightshift workers since their circadian rhythm is disrupted?" And then I have quite a few questions about shiftwork. So, everybody knows that they're getting represented. Carrie says, "I hardly ever get more than five hours of sleep due to working full-time overnight. I do get an hour or two nap before going to work and on the weekends, I try to sleep normally overnight, which half the time doesn't work. I've been doing this for over a year now. My question is how much damage am I doing to my body doing this?" Maryland wants to know, "How to deal with irregular work schedule, disrupting sleep?" Ashley says, "She works seven days of 12-hour nightshifts? Do you have any tips for quality sleep during the day and adjusting back to a dayshift?" Leilani wants to know, "If you have any ideas to help shiftworkers who need to sleep during the day?" And Beth wants to know, "Ways to help bounce back between nighttime and daytime sleeping." People who are shift working and are all over the place. Can they use Sleep Remedy? And just in general, what can they do to support their sleep with that type of schedule?

Kirk Parsley: That is by far the most common question that I get with most of the audiences that I lecture to, nonprofessional sports teams because they usually have controller. Although, baseball, they have night games. And so, they have some issues around the night as well. Definitely law enforcement, first responders, and healthcare providers who work in hospitals and emergency rooms and such, by far the most common. No, I will preface this with-- my very unpopular answer is that 2 plus 2 is always going to be 4 and I cannot make it anything different than that. The World Health Organization has classified shiftwork as a type 2A carcinogen, which is the same category that cigarettes are in. Meaning that almost certain it increases your risk for cancer. However, it would be unethical to do research on it. So, we'll never have the proof that there's cause and effect, but we're sure as we can be without doing unethical research to find out. 

With that said, I would tie that to what I said earlier about people who take sleep drugs or have chronic insomnia, they have a higher risk of all diseases and they die younger. The same is true for shiftworkers. I think cancer stands out more than anything else because it's often protracted and tragic. There's a long narrative associated with the life after the cancer diagnosis, obviously, which may or may not kill them. But anyway, I think it scares people and stands out more. But it's actually true for cardiovascular disease as well. If you look at firefighters and law enforcement, these people tend to die of heart attacks, not only more frequently, but also much younger. Again, the shiftworker number is around the insomnia number. It's on average you're going to die 10 to 12 years younger than people who don't do shiftwork. 

Now, you could have great genetics and you're going to live to 90 or maybe you're going to live to 100, and you do shiftwork, and now you live to 90. I'm not saying that you can't have a long life. I'm just saying that it's almost certain that it's going to decrease your lifespan if you do that for a very protracted period of time. For the reasons that I said earlier, you essentially aren't recovering. You're physiologically aging faster. And so, while you have fewer chronological years, your physiology looks like somebody 10 to 12 years older. And so, on average, you would die 10 to 12 years older. You would get diseases, end-of-life diseases more likely more earlier in your life and you'd be more likely to have this. And then of course, there're other things associated with that. So, it's not 100% the sleep. That's horrible news. I don't want to be Debbie Downer. 

With that said, my advice is to knowing that is to make sleep your primary concern, like your top priority. I say this all the time when I'm talking about people optimizing their lifestyle for performance. But for the shiftworker out there, yes, performance. Any type of performance like how good of a spouse you are, how good of a parent you are, how good you are at your job, your physical performance, your strength, your endurance, all of these things. All of this performance, yes, tied into there. So, yeah, performance issues. However, you are doing something that has a high risk of decreasing your lifespan or increasing your disease risk. So, make your lifestyle as perfect as you can possibly make it. Sleep again the priority, but also eat the very best diet. You can possibly figure out a way to eat consistently, exercise in a very smart way, in a very regular way, stay fit, control your stress at all costs. You are running around higher stress hormones all the time if you're a shift-worker, not just while you're working, but because you're sleeping outside of your circadian rhythms and you're very unlikely to be shiftworker and be getting enough quality sleep to repair, you're going to use your stress hormones as a compensatory technique to have enough energy to get through your day. 

A couple of things to do. There's more than one physiologic system going on when we talk about circadian rhythm. But circadian rhythm is usually the broad term that we're using to describe the sleep-wake cycle and basically adjusting your sleep-wake cycle to be aligned with the time zone that you're in. But there's a lot more to it than that. And so, as an example, the cells in your liver, kidney, heart, lungs, muscles, everything, those cells all behave slightly differently during the daytime than they do while you're asleep during the nighttime. Now, this is true whether you're working at night and sleeping during the day, or sleeping at night working during the day or however you do it. There are overarching rhythms. Every cell in your body has its own clock and there are physiologic shifts throughout. There are cycles and this is sometimes called the ultradian rhythm, which is broader than the circadian rhythm. But if you are going to shiftwork, my glib answer, which isn't meant to be disrespectful is the first thing I would do is try to figure out a way not to do shiftwork or to get out of it as soon as possible. That's not always possible. 

Obviously, there are professions that just need to be working at night in society depends on them, and there's nothing we can do about it, and it has to happen. That doesn't mean that one person-- I see this very commonly in law enforcement as people work nightshift their entire career. That's definitely worse than cycling on and off of shiftwork. I've consulted with things like emergency room staff and they have a rotating schedule, so that they basically break the day up into eight-hour shifts, and then you cycle through these shifts, and they have all sorts of ways of doing it. I don't know where or why they do it the way they do. But as I said earlier, if you fly across 12-time zones, it takes a minimum of 12 days to align up to 24 days to align, to recapture your circadian rhythm to be aligned with where you have flown to. The same is true for shiftwork.

If you have completely inverted your schedule to where you're working at the exact time you would ordinarily be sleeping, then you're 12 hours out of phase. If you start working this nightshift, it's going to take you 12 hours or it's going to take you 12 days at a minimum to get the best possible alignment of your circadian rhythm, the closest to your normal physiology that you can possibly get is going to take at least 12 days and up to 24 days. However, the longer you do this, obviously it's suboptimal sleep, which is leading to less anabolic activity, more catabolic activity. It's going to be harder on you physiologically and that's always going to be true. There's just no way around it. Again, 2 plus 2 is always going to be 4. However, the mitigating things that you can do. It's like if you can talk your leadership into saying, "I want to do a month of the shift and then a month of the opposite shift, then I get to at least get a month of recovery before I go back on that."

The places that had the eight-hour shifts the way they cycled through them, they're going to be out of phase, they need at least a week on those schedules to align and oftentimes, two weeks. I usually recommend a two-week phase of shifts. You're working nights for two weeks and you're working the midday shift for two weeks, you're working mornings for two weeks and the early shift or whatever. And then that's at least giving you some recovery time and then ideally, you have the most recovery right before you go back onto nightshift. This is something that's counterintuitive to people, which for the lack of-- I mean, I can't understand why, but I've asked the question enough to know that it is counterintuitive to people. But if I told you that I was going to starve you next month, and I somehow have control over what you eat, and then just like next month, you're going to cut your calories into a third, and that's what you're going to do for the whole month. 

The smart thing to do this month would be to eat a lot. Just store as store as many calories as you possibly could, not practice starving. And the same thing is true for sleep. Same thing is true for exercise. If I said next month, you're going to have to run 10 miles a day, well, what would you do this month? Start building up your mileage, where it doesn't kill you to run 10 miles a day. But when I tell people next month I'm going to sleep deprive you every day of the month, they think they should practice sleep deprivation, no, be as healthy and robust as you possibly can. When you're getting good quality sleep and especially when you're combining it out with good nutrition, and good exercise practices, and good stress control mitigation practices, you're the most resilient. So, now you can handle the insult of the sleep deprivation much better. It is why younger people can handle sleep deprivation better than older people because they're more resilient, they're more robust, they're more hormonally robust, they're more anabolic, they're less catabolic, they can recover a lot faster from anything including sleep deprivation. So, that's one piece. 

Practical application of that, again, I would talk to the leadership and see if you could get some smart scheduling rotations, if that's not possible, it's just not possible, that's the way things are. Now the second most unpopular thing that I say is that the best thing for you after working your nightshift is to get to sleep as soon as you possibly can after your shift. The reason that's so unpopular is because most or not most, but a lot of shiftworkers, their lives are set up to where they're coming home as their family starting their day and that's like their time with their family, but if they just came home and went to sleep, then they would miss that, and then they would get up later, and get ready in the evening, and go to work, and never really see their family. So, they don't like that idea. Find a work around that if you can. If you can't, you just can't. 

The third thing is, again, you're just going to idealize everything. Just take it to an absurd extreme. You need to be sleeping in a cold dark cave that is as quiet as it could possibly be in the bed as comfortable as it could possibly be. Don't have a crappy mattress. Anything that's going to interfere with your sleep, go ahead, spend $10,000, $15,000 on a great mattress, so that you have the ability to get great sleep. If your house isn't cool enough or if you sleep hot, get a ChiliPad, get an OOLER, put the investment into there, wear earplugs if you have to if you live in a noisy environment, make your windows Kentucky trailer park dark, I mean like aluminum foil if you have to. Whatever you do build the perfect sleep environment, decrease the blue light in your eyes at least three hours before you're going to go to bed. Let's say, if you are going to go home and go to sleep right after your shiftwork, start wearing blue blocking glasses three hours before you go home or a couple of hours before you go home if you're going to be home for about an hour, before you go to sleep or something like that. 

Then I would recommend, actually, to these people to take supplementation because your body is simply more taxed. It has some physiologic limitations. It's not as anabolic. It's more catabolic. It's going to have a harder time recovering, and absorbing nutrients, and all sorts of things. I would recommend supplementation across the board, but definitely anything that's going to improve the quality of your sleep. If you're only going to get five or six hours and there's just no way around that, well, then the difference between getting a perfect five hours of sleep and a mediocre five hours of sleep that's going to be night and day. That's going to be a huge difference in your performance, and your longevity, and your disease risk. So, all of those things, I would put equal importance on. But again, it all hinges on the very first thing that I said is that you have to realize how critical this is and make it your top priority and realize that this isn't a luxury, this isn't something you're doing because you've heard some guy on a podcast talking about like, "This is your life, this is everything about you, this is your performance, this is your longevity, this is your disease risk, this is everything that you value is hinging on this. You're starting behind. You've already set yourself up to be deficient in this. So, do everything you can."

The other thing that I always recommend is take as many naps as you possibly can. I don't care if they're five-minute naps, 20-minute naps, taking an hour nap, great. It depends on what your job is and how things are set up, take as many naps as you possibly can. Again, if you sleep five hours and you take three hours' worth of naps over the course of the 16 hours you're awake, it's not the same as sleeping eight hours. It's not ideal, but it's closer. It's much better. And that's my advice for shiftworkers.

Melanie Avalon: Oh, my goodness, so many things you touched on. Okay, well, really quickly that blew my mind that it took 12 days to fix things that's really upsetting and that was with jetlag or traveling, completely changing--

Kirk Parsley: Yeah. So, essentially, every time zone to be honest, I'm being on the dramatic end of it. It can be as fast as half a day. But most of the research agrees on a day to slightly more than a day for every time zone you cross. If you change one time zone in the US, it's at least a day to get back on schedule possibly up to two days. If you go from California to New York it's a minimum of three days up to six days.

Melanie Avalon: Crazy. Well, you talked about a lot of the "biohacking things" that we can do to help with fixing the whole sleep situation. I often wonder if I am like the craziest person out there when it comes to using all the things to try to regulate my circadian rhythm, but I think it's pretty valuable because I can definitely speak to what I do find really effective and you touched on a lot of them, so I wanted to provide some resources for listeners, like the mattress, the ChiliPad, I actually had on Tara Youngblood on the show. She's the founder of ChiliPad and they make a-- She was really great. She also said that early birds and night owls are things. So, [laughs] that was a good moment. But if listeners would like to get their own ChiliPad, it's basically a mattress that cools you down and I use mine every single night of my life.

Kirk Parsley: A mattress topper.

Melanie Avalon: Yeah, it goes on top of your mattress. It's amazing. Which one do you have?

Kirk Parsley: I have both, but I prefer the OOLER. The OOLER is quieter and I'm a bit sensitive around noise with sleep.

Melanie Avalon: I have the ChiliPad.

Kirk Parsley: That's a little bit louder. It's not drastic. I think it's about 10% louder or something.

Melanie Avalon: It might be time for me to try it either away.

Kirk Parsley: The OOLER is sleeker looking too and my bedroom is very minimalistic. So, it blends in, so either one is great. I find almost everybody who tracks their sleep can point to a very beneficial change from using the ChiliPad.

Melanie Avalon: I can't imagine not using it now.

Kirk Parsley: I think Peter Attia on a podcast said that it doubled his-

Melanie Avalon: Oh, wow.

Kirk Parsley: -his deep sleep as measured by the Oura Ring. So, that's significant. Maybe I made that up. Maybe he said it increased it by 50%. But I remember it just being drastic and me going, "Wow, that's a huge--" I don't get that big of a change, but I get a big change.

Melanie Avalon: It was one of the things that I started using it and I was like, "How was I ever not using this?" And the codes for it are really confusing. They're not my normal like MELANIEAVALON code. So, listeners, in the show notes, I'll put the codes. Because I think you can get between 15% and 20% off. So, I'll put links to that in the show notes. And then the blue light blocking glasses are huge. I can't imagine my life not using them. I think I told you this the first time we recorded that I use three different--

Kirk Parsley: Yes, you did tell me that, you progress throughout the day with them.

Melanie Avalon: Every night, I progress through three different versions. I thought it was being really special. I thought I come up with this whole concept of starting with clear ones, and then progressing to yellow ones, and then progressing to red ones. And then I met Andy Mant, the founder of BLUblox and his company actually makes all three options. So, that was really exciting. I have mine on right now.

Kirk Parsley: Here's an interesting, aside, at least I think it's interesting, so I'm going to interrupt you. When I first started doing this, when I first started lecturing about all of this stuff, there wasn't a single company out there making blue blocking glasses yet. What I was recommending to people to do is buy gaming glasses, because that's how gaming glasses work. It's the same thing, because they're trying to reduce eye fatigue and blue light's the most refractive. And so, it distorts your vision the most by making glasses that block out the blue light. It sharpens your vision and decreases the fatigue of your eye muscles. I just think that's really neat. And now, there's a company is all over the place doing and there're lots of great products.

Melanie Avalon: Well, the funny thing is, so when I started doing it, I was using the Uvex brand and they were not advertised for blue light blocking. They're people in some industry where they need these glasses. I don't know what they're for.

Kirk Parsley: Shooting glasses often are the same thing. I used to use something called Eagle Eyes, which is a shooting glass, but it had the same argon coating on the lens that the gaming glasses did. Blocked blue light to what degree I don't know. It definitely wasn't engineered for the products are now engineered for. They're much better.

Melanie Avalon: Exactly. That's the point. The funny thing is with the Uvex, when I first started using them, because I've been using them for years. Well, I've started using them years and years ago. Now, the exact same glasses, they're on Amazon. They advertise them as being for blue light blocking for this reason. They change their branding. That said when I had Andy Mant on the podcast, I think I've had him on two or three times. He actually started that company because he found such a benefit from blue light blocking glasses. But then he actually went and tested all different glasses that were available with some sort of light tester thing and realized they weren't actually blocking the wavelengths completely or what they need to be blocking, so that's when he founded the company.

Kirk Parsley: There is a mutual friend of ours who has an entire video on blue blocking glasses, where he has a blue light and white light and he measures how much they all block. That's Anthony Beck. I don't know how to find it. I guess, YouTube, Anthony Beck and blue blocking glasses or something. I'm not sure if he gets into name brands that much, but he shows the differences between-- there're always going to be unscrupulous people and there are definitely glasses out there that really don't block blue light at all that are sold as blue blocking glasses. So, it's one of those things like mattresses you just have to go with quality. It's not like you need to buy them a hundred times. You're just going to buy them once and they are not really expensive. 

Melanie Avalon: Exactly. Because I get so many questions saying can people use off brand, really cheap ones? I'm like, "Well, you can, but I don't know what it's doing." I just know from working with Andy that they do what they say. And I agree. I wanted to touch on that. So, I'm glad you brought it up again, the mattress, you spend a third of your life on it. So, if you're going to invest-- What else do you spend a third of your life on?

Kirk Parsley: My grandfather, the only positive male role model in my life as a child and lot of really wise great sayings and one of the things he told me, I have no idea why he would tell his seven year old this when-- He was telling it to me, he said, "Never go cheap on mattresses or shoes because if you're not in one, you're in the other."

Melanie Avalon: Well, that's really great. Haven't heard that before.

Kirk Parsley: Comfortable shoes and a comfortable mattress, you're always in one of those.

Melanie Avalon: I go barefoot a lot though. In any case, listeners, you can get 15% off BLUblox. It's at their website. I wish they would spell it different, because it's hard to remember, but it's B-L-U-B-L-O-X dotcom and the coupon code, MELANIEAVALON. I think, yeah, it gets you 15% off. And another really cool thing they do is they donate a pair of glasses to somebody in need for every pair that you buy. So, that's really exciting. As far as the most effective things, for me, it's the blue light blocking, the ChiliPad, Joovv red lights at night to light everything. And again, the code for that is MELANIEAVALON and then the Sleep Remedy. It's pretty much mainly four things.

Kirk Parsley: That's an expensive light source. [laughs] 

Melanie Avalon: I know, but [laughs] it has so many other uses as well. 

Kirk Parsley: To be clear, red light is the only light that has no blue light in it. If you can just get red lights, you don't-- Submarines and ship, if you go to the bridge of a ship at night, it's always red light, because it maintains your light vision or your nighttime vision.

Melanie Avalon: This is true, but then Joovv comes with all the benefits of red and near infrared light therapy. 

Kirk Parsley: Joovvs are really cool. I'm not saying they're not. They're really cool. They could be prohibitively expensive, especially if the people are going to go out and buy a $10,000 mattress now and ChiliPad and everything else.

Melanie Avalon: I didn't even talk about the canopy.

Kirk Parsley: Right. Your EMF canopy.

Melanie Avalon: Start with Sleep Remedy, blue light blocking glasses, and a good quality mattress, and ChiliPad. 

Kirk Parsley: Yes.

Melanie Avalon: That's a lot.

Kirk Parsley: That's actually not terrible. ChiliPads aren't very expensive, blue block glasses aren't very expensive, sleep supplements are not very expensive.

Melanie Avalon: I would say, if you have to start with two things, start with the blue light blocking glasses and the Sleep Remedy.

Kirk Parsley: That would be my advice as well. 

Melanie Avalon: And then ChiliPad.

Kirk Parsley: Yeah. 

Melanie Avalon: And then Joovv.

Kirk Parsley: I would say then mattress.

Melanie Avalon: Oh, I forgot mattress. This is complicated. Oh, wait, and we forgot blackout curtains.

Kirk Parsley: Yeah. Like I said, you can use aluminum foil if you have to for your windows, anything to block out the light if you can't afford blackout curtains.

Melanie Avalon: I will put a link in the show notes to the curtains that I bought. They're not that expensive. They're on Amazon. Friends, you will get these curtains and they will change your life. They're luxurious hotel curtains, and they come in different colors, and they're so amazing that my cohost, Gin Stephens of The Intermittent Fasting Podcast was on the fence about how important-- And that's actually a question for you. Even if it's just like a tiny little bit of light at night, does that make a difference? Because for me, it makes a huge difference and then she attested to that after she got blackout curtains.

Kirk Parsley: There's definitely individual sensitivity to that. However, I would say that it all depends on whether or not it's enough light for you to sense with your eyes closed because if your eyes are closed, presumably, you cannot tell when you close your eyes that the light's there. And you would only know that by being able to remove it. When I traveled a lot, I would go to these hotel rooms and obviously for years I've had the ideal setup with 100% blackout and all of that. I would go to the hotels and the light would come under the door, and there would be a light on the smoke alarm, and there would be a light on climate control, and some other-- They have a phone would have a light, because I'd made myself so sensitive to it by being so pedantic about my sleep environment that I really didn't have a choice. And so, I had to turn off all the lights and then walk around the room and figure out what I was covered and I actually traveled with the roll of aluminum foil, because that's the easiest thing to cover a light completely. You just put a wad of aluminum foil or things. 

Melanie Avalon: What about black electric tape? That's what I use. 

Kirk Parsley: That seems like that would work in a lot of situations. Sure. Yeah.

Melanie Avalon: And it sticks. 

Kirk Parsley: It does.

Melanie Avalon: Brilliant. On the flipside of things, a topic that I meant to touch on earlier when we were talking about compounds, but caffeine. We have some questions about caffeine.

Kirk Parsley: I almost covered that when I was talking about wake-promoting neurotransmitters, but go ahead.

Melanie Avalon: Well, the interesting thing is the questions that came in about it are actually about it supporting sleep. Yeah, so, Ashley says, "I know some people who have caffeine to help them fall asleep." Alyssa says, "I wish I could remember where, but I've read that several people drink coffee right before bed and it's improving or neutral to their sleep as long as they go to bed quickly within 30 minutes to one hour from consuming the caffeine. I'm curious how this actually works physiologically. I would think it would just wake you up again once it kicks in." And then Damon says, "My question is, if someone falls asleep while highly caffeinated does that mean they are immune to caffeine?" And then my, Melanie's question is caffeine-- Because I went through a period where I was like, "I'm going to get rid of every single thing that's possibly influencing my sleep and it's just going to be all natural." So, I got rid of caffeine, I got rid of alcohol, I got rid of every single factor. But now, I feel having caffeine in the morning gets you started and it makes you more energetic early and so then you are more tired at night. So, caffeine, what's the deal?

Kirk Parsley: Interestingly, the most difficult sleep patient that I've ever encountered was in the SEAL teams. And ironically, he now works for me in this company. He's been out of the SEAL team for a long time and he still to this day is exactly what you just described. Robb Wolf would just say, there's paradoxical responders in the world and that's just the way it is. That just means some people will take a stimulant to make them tired and some people take a depressant and it makes them energized. I hate to be that simplistic with it, but I don't know the mechanisms. So, I have to be that simplistic with it. But there definitely are people who drink coffee at night and it makes him fall asleep. 

Now, the reason this is so confusing is because of how caffeine works. We talked about ATP last time. Didn't we talk about this just the podcast before this? Anyway, we're going to cover it again if we didn't. Every cell in your body uses a form of energy called ATP. Just think of it like every cell in your body is its own little organism, and it has its own fuel tank, and it has a fuel tank full of something called ATP. This is the energy. It uses to do whatever work that cell does depending upon what cell it is. Now, ATP stands for adenosine triphosphate which means there are three phosphate groups on it. Every time you cleave a phosphate group off, it releases a bunch of energy that can be used to do cellular functions. And so, you break down ATP into ADP, adenosine diphosphate and then AMP, adenosine monophosphate, and then eventually you break it down to just A, just adenosine. Adenosine builds up in that respect is almost a waste product inside of your cells. And then it gets out of the cells, and it's in your interstitium and the fluid and spaces between the cells, and your brain senses that you have receptors in your brain to sense adenosine.

The reason for that is because if you've taxed your brain, if you've taxed your body and your brain, you've produced this glut of adenosine, that's one mechanism for your body in your brain to say, "We need to recover. We need to stop what we're doing. We need to sleep, recover, restore, regenerate, replenish fuel sources, get rid of waste products, all these sorts of things. Get ready to do this again tomorrow. But right now, we're exhausted." Adenosine builds up throughout the day. What caffeine does is it blocks adenosine receptors. It binds the adenosine receptors and it doesn't allow the adenosine to bind the receptors, but it doesn't have any effect on the adenosine receptors like adenosine does. Maybe on these people, their receptors are having some activity to the caffeine molecule itself. I don't know. Again, total speculation. I don't know the mechanism of that.

Melanie Avalon: I have a theory that I've heard. The Ray Peat people say that it supports metabolism and so, then you're able to-- It supports your liver and it helps with blood sugar issues during the night.

Kirk Parsley: I don't know how that would explain initiation in sleep. Let me finish my thought. As the adenosine builds up, that's what we call sleep pressure. Adenosine under that definition as we talked about earlier that would be a sleep-promoting neuropeptide, a protein structure in your brain that promotes sleeping behavior. That's actually what causes the sleep pressure. Sleep pressure is the desire and the physiologic need, perception that you need to go to sleep and recover. The more adenosine you have, the more that builds up. If you're awake for 18 hours, it should really make you feel like sleeping. If it's 24 hours it should definitely make you feel like sleeping. If you go up to like 72 hours, the pressure is so high that you literally can't stay awake. You could be at work sitting in your chair in a meeting doing something really important and you'll still fall asleep because the sleep pressure is just too high.

Now, men tend to have more muscle mass than women. Muscle mass has a much higher metabolic consumption of ATP, because obviously muscles are moving all the time. The more muscle mass you have, the more adenosine you build up. However, although an average size female and average size male, there might be a 30% difference in muscle mass, but there's probably only a 5% to maybe 10% difference in their brain sizes. How much adenosine is in their brain, how much sleep pressure are they getting by having this extra muscle mass, which is why I think that men tend to have what we call maintenance insomnia and females tend to have what we call initiation insomnia. Men often have so much adenosine. They have so much sleep pressure that they can go to sleep no matter how stressed out they are because they're just tired. They're just exhausted and their brains are saying, "You got to sleep." And so, they go to sleep. They have their first deep sleep cycle that clears out a bunch of the waste products, gets rid of a lot of the adenosine, gets rid of other things, starts replenishing the brain, the neurons a little bit, and other cells in your body start recovering a little bit. And then once you come out of that sleep cycle and you're going up towards REM, which is almost you have to pass through wakefulness to get from deep sleep to REM because REM is a little higher brain frequency than being awake. 

If your stress hormones are high enough, once you go through that wakeful period on your way to your REM, you actually just wake up. And so, men tend to be able to fall asleep really well, if they're really stressed, but then they do one sleep cycle, and then that's enough to clear out all the waste products, and then they wake up, and then they have a hard time going back to sleep. That's very characteristic of male insomnia. Females tend to lay in bed and not be able to fall asleep. These are generalizations. Of course, anybody can have all three types of insomnia-- any of the three types I should say. The answer is, I just explained how caffeine works and why it's so counterintuitive that it could ever make anybody sleep, but I don't know the answer. I have no idea how that happens. But I do know that to be true. It's very rare. It's a very small subset of the population. My guess is that it's under 5% of the population and that's true for-- just in my experience with working with clients, it's probably under 5%.

Melanie Avalon: Back to the Ray Peat people, maybe that's why people-- because some people have a big dinner and then they have an espresso after and then they can fall asleep. I don't know.

Kirk Parsley: I'm sorry. I don't have all the answers, but that one, I don't know the answer too.

Melanie Avalon: That's okay. That's okay. You touched on something else. That's a huge topic that I have a lot of questions about females, hormones. I'm just going to let you know some of the questions and then maybe you can speak to the whole hormonal aspect. So, Cheryl says, "Hormones and insomnia." Oh boy, that's all she says. Valerie says, "Any advice on sleeping issues due to perimenopause/menopause?" Christina says, "How to Improve insomnia and get better sleep once you hit menopause?" Moving beyond that, Joanne says, "Does he think this will help for postmenopausal women?" She's talking about your Sleep Remedy supplement. She says, "I just started taking Sleep Remedy, for the first night, I slept great. The second night, I slept awful. That is my normal routine good than bad. It's a vicious cycle." Then I have two more specific questions about menopause, but do you want to talk about hormones?

Kirk Parsley: Sure. There are a couple of factors, perimenopausal and menopausal. One thing to know is that the male's testicle and the female's ovary is exactly the same organ, okay? During embryogenesis, when you're in the womb, while you're forming the human, the testicles and the ovaries forming the same place and they form in a very, very similar fashion with one exception. In the males obviously, eventually descend and fall out of the pelvic internal area, and they fall into this ugly wrinkly sack, and then that's the male testicle. And the female, of course, the ovary stays inside. They don't have that. Now, both of those organs, again they are the same organs, they both produce testosterone. The primary sex hormone in men as most people know is testosterone. The primary sexual hormone in women which most people don't know is also testosterone. What happens is an ovary has a lot of tissue around the outside of it that is high in this enzyme called aromatase. What aromatase does is it converts testosterone to estrogen. Men have aromatase in their body fat. Not their internal around their organs, but their subcutaneous body fat. The body fat you would see you around, whatever-- they have their shirt off like whatever body fat you would see like that's the type of fat in a male that has aromatase in it. 

You can see why like a 16-year-old boy is very likely to have almost no body fat while going through puberty, and have these high testosterone levels, and have almost no conversion of that testosterone into estrogen to these really high testosterone levels, which leads to a lot of growth. Estrogen is almost nonexistent in them, so they tend to keep growing taller and more muscular. Testosterone is a very anabolic hormone. Females have a lot of estrogen because they're their ovaries are producing testosterone, but as it's leaving the ovary and getting out into the bloodstream, it has to go through this tissue that has aromatase and it converts into estrogen. Now the ovary is producing more testosterone than the aromatase can convert, some of that testosterone slips by and that's where women get their basal testosterone levels from. Now, as I said, primary sex hormone in both male and female is testosterone. Men have 10 times more testosterone than women. Women have 10 times more estrogen than men, but women also have 10 times more testosterone than they have estrogen. 

The first thing that you lose-- Perimenopausal, when your ovaries start slowing down, the first thing that you lose is testosterone and in fact this starts happening pretty early. I worked with one of my mentors when I was in the SEAL teams and learning in alternative medicine. He's 40 to 50 years in obstetrics and gynecology, researcher, professor, very smart, and he did a lot of alternative things. I learned a lot from him. One of the things that he always said was that cellulite in women is primarily caused by a lack of testosterone. That's a complex thing in there because what testosterone does is it says something called neuromuscular tension, which like your muscles aren't ever completely flaccid and it can be as early as about 35 years old that the ovarian production of testosterone starts being inadequate to get past the aromatase and provide a woman with testosterone.

Like I said, your muscles are never completely relaxed. They always have some tension in them and that's caused by however much signal your nerves that are innervating those muscles are producing. And so, the resting muscle potential has a lot to do with your nervous system, which is why when you're stressed, you are tense, you're holding more muscle tension. You have little muscles that attach your skin to the fascia, which is the layer of material that covers up your muscles, and blood vessels, and organs, and all sorts of other stuff. The skin is held in by these muscles. Then if you release the muscle tension, if you release the neuromuscular tension by decreasing the testosterone, then those get a little bit longer. If they get a little bit longer, they let this can go up. But some places, the skin is actually attached to the fascia, so that stays there and then that causes these odd little dimple shapes that we call cellulite. All aside, but I find that super interesting.

Melanie Avalon: Actually, I'm going to insert one little thing. For those interested in fascia, I had a whole episode partly on it. Do you know Dr. Dana Cohen? She wrote a book called Quench-

Kirk Parsley: No, I don't think I know her.

Melanie Avalon: -about hydration. But we talked about the fascia. So, for listeners, I'll put a link in the show notes to that if they want to learn more. I'm really fascinated by it. It's fascinating. 

Kirk Parsley: The point of all that is that one of the things that we found out when I was working at the SEAL teams, there was an organization in the Navy called the Navy Health Research Center. It's just full of researchers. PhDs are looking for something to do all the time and they came over to the SEAL teams and started doing a lot of research around sleep and hormones when I started talking about that. We were actually the first people to ever document this, which I think was intuitive to a lot of physicians, but nobody ever published it for some reason but there is almost a direct correlation. A perfect correlation is a correlation of 1 and that would be, if this then that always right. If every time this happens, that happens that's a perfect correlation of one move. If it happens 50% of the time, then that would be a correlation of 0.5. So, there's about a 0.8 correlation between your total testosterone level and your duration of sleep. This is true in men and women. Again, we're the first ones to document that. So, I believe that female sleep can start getting worse well before menopause simply because the ovaries are slowing down. So, the total testosterone level in a female impacts her ability to get good quality and good duration of sleep. 

Now, the other thing that happens around menopause-- Man we could go down so many rabbit holes and I'm trying not to get too complex with us. But as I was saying earlier, the brain is always sensing the hormone levels. Always, always, always. It's happening all the time. Most of its highly regulated during the night, during deep sleep primarily. Ironically, there aren't a whole lot of testosterone receptors in the brain. The primary sensing area that-- This area of the brain called the thalamus, which senses a lot of what's in the blood, and then it transfers that to the hypothalamus, and then that stimulates the pituitary to produce these signals to make more hormones or make less hormones. But there aren't a lot of testosterone receptors. There are a lot of estrogen receptors. When a female's estrogen starts getting low--

This is now much further along the perimenopausal. Perimenopausal, they think is technically defined as within five years. It could be as much as ten, but it's like within five years of menopause or something. It doesn't really mean a whole lot. Nobody knows exactly when you're going to go through menopause. But as the ovaries are slowing down in their production, you're getting less and less testosterone. Very likely, when you first start, you're still having plenty of estrogen. But over time, as the estrogen levels get lower and lower, the brain senses it. And then when your brain senses it, it stimulates the pituitary gland to secrete a hormone called luteinizing hormone. When that hormone gets secreted, it causes an increase of ovarian production of testosterone and estrogen essentially. So, it's like trying to raise the estrogen level. However, we call that a luteal surge, luteinizing hormone. So, it's a luteal surge also what comes with that is some stimulation of other activities. One of the things that it causes is immune-modulated flush and that's what we call the hot flashes. Hormones like every cell in your body is affected by every hormone. We categorize things into systems and stuff artificially because it's easier to talk about that. But every hormone matters to every cell in the body at all times and it affects the DNA expression. 

It's a super complex issue, but the point is the two things that will keep women from being able to sleep well is a low testosterone levels and a low enough estrogen level to cause a luteal surge that causes hormonal hot flashes. The hot flashes are going to happen during your first phase of sleep, your second phase of sleep, maybe 90 plus percent of all your sex hormones are made while you're in deep sleep at the first half of the night. So, women do get hot flashes during the day, but they're much more rare and they primarily get them when they're trying to sleep. Progesterone can protect against that. DIM is a supplement that people can take that females can take that would essentially increase their testosterone levels by decreasing their conversion to estrogen. Zinc would do the same thing. There are some supplemental things you can do around that. However, I would just encourage you to do your own research and probably work with a physician if you think that it's hormonal. 

I could talk for three or four hours about the Women's Health Care Initiative that led to all the women getting off of hormones and what a terrible idea that is. The easiest thing, if you're perimenopausal is just to get on bioidentical hormones and replace all your hormones to a physiologically younger level and you'll sleep better, you'll feel better, and you'll have more muscle and less fat, and you'll have more energy and higher sex drive, and all sorts of great things, but I digress as this is a sleep talk. So, we'll talk about that. [laughs] But that's my answer to that.

Melanie Avalon: A really quick question about that. Especially something like progesterone, is there a big difference between taking that as--? Well, I don't know how when it's prescribed. Do you take it as a pill when it's prescribed?

Kirk Parsley: Yeah, that's the one hormone that you can take as a pill.

Melanie Avalon: Okay. Compared to topically and also, speaking of Ray Peat people, they're a big fan of progesterone. So, I've been playing around with progesterone cream for a long time. I don't know if that's a problem being younger.

Kirk Parsley: Progesterone is a pretty safe hormone. It's involved in the whole complex pathway. But again, that'd be multi-hour conversation on its own. They've done research where they give men 200 milligrams of progesterone in the middle of the day and they fall asleep for 15 minutes. That's about the only measurable effect. Women, if they are on progesterone should take it before they go to bed. It tends to help women fall asleep, whether or not it's going to reduce the luteal surge that leads to the hot flashes is a very complex and nuanced conversation, but that goes well beyond the scope of anything we should try to talk about on here.

Melanie Avalon: So many questions I want to ask, but the nice thing is you answered a lot of other questions. I said I had more questions about the hormones. Yeah, like Sherry wanted to know, "What causes women to sweat at night? Is it hormone related? Would sweating be related to the hot flashes?" 

Kirk Parsley: That's the luteal surge. Yeah.

Melanie Avalon: Okay. Yeah, because Susie as well says, "I still sweat and it's been two years since I've had my period. So, I'm clearly done with menopause."

Kirk Parsley: No. So, she's done with menstruating, which is not the same thing as being done with menopause. That's the definition of menopause is that you're done with menstruating, meno-pause. But as far as the hormonal aspect of that, there're multiple years of consequences for that. As soon as you quit menstruating, it doesn't stop it. It's not that simple. Your brain and physiology have to change over multiple years. There're three different types of estrogen in a female's body and you start producing a lot more of another kind of estrogen that is really minor unless you're menopausal. There's one that's really minor unless you're pregnant and then there's one that's the primary one that drives all sorts of the estrogenic effects. And so, when you go through menopause, eventually this other form of estrogen increases significantly, receptor density changes, all sorts of things happen. After a while, a lot of the luteal surge stuff goes away, but the lack of estrogenic effects, things like bone density and so forth, that obviously still continues. And so, you can have your own opinion about that stuff. But the hormonal changes associated with menopause are not as simple as stopping menstruation.

Melanie Avalon: Rapid fire questions about dreams. There was a consistent theme that was coming around and that was whether or not you could remember dreams and what that might mean about your sleep. For example, Rose says, "Why can't I recall any dreams? If I don't dream, I've heard that we are always dreaming, does this mean I'm a light or heavy sleeper?" And then Caroline says, "Is being able to remember your dreams affect your quality of sleep. I feel on nights I remember my dreams, I am half lucid while dreaming, and I don't sleep as well as compared to when I don't remember my dreams?" And then Rene just wants to know about "Crazy dreaming and what that might mean?"

Kirk Parsley: Well, crazy is a very loose term. I'm not sure it's even politically correct to say. So, I don't [laughs] know. I'm going to sidestep that and I'll explain what I do know about dreams.

Melanie Avalon: It wakes her up and disturbs her so much that she can't fall back to sleep.

Kirk Parsley: I would love to have a histogram to put on your screen and I could point to things and describe this, but I'll do my best to describe it. Basically, you go through a deep sleep cycle as you go from stage 1 and 2 down to 3 down to 4, travel across the floor for like you're in the basement and then you start climbing the steps back out of the basement, and you're from 4 to 3 to 2 to 1, but you don't do 1. After that you actually go to REM, if you remember stage 1 is that pre-sleep groggy phase. You go from stage 2, which is what we call transitional sleep. There are some characteristic brainwave changes that we can see on the screen when we know you're in stage 2 sleep. The spindles can fire and then that's firing you into REM sleep. What we know through research is that is actually a trigger to rehearse or think about something that is important to you or that you've worked with that day or something. We know if we have people study list and try to memorize the list and we can measure their brainwaves and we can tell-- 

When they're trying to memorize this word, their brain looks this way. When they're trying to memorize that word, the brain looks that way. When they're trying to memorize this other word, the brain looks this way. And then we can put electrodes on their head and we can fire. When they're in deep sleep, we can fire a little energy into their brain to cause the spindle to look a certain way and we can cause them to remember certain words better than other words. We know that there's this rehearsal aspect to it. How far back does it go? Obviously, you can dream about your childhood, you can have all esoteric nonsensical dreams that everything blends together. There's a subconscious component to it. There's a conscious component to it. It's still up to debate whether the dreams actually mean anything, but one of the people who asked this question who was absolutely correct is that we all are dreaming all the time while we are asleep. Meaning that our brain is producing some sort of stimulus-response to a stimulus that doesn't actually exist. We're seeing, or thinking, or feeling about something that's not actually happening. 

Now, I talked about deep sleep and REM sleep. Deep sleep, the super anabolic phase, you're not actually paralyzed during this bit. Obviously, your movement is significantly diminished, but you're not paralyzed. And so, when you're in deep sleep, it's really anabolic, it's really restorative, there's a lot of repairing going on. You are dreaming. If you wake people up during deep sleep-- They've done the research, which if you've wake people up and you were studying them, we know where they're at, we know where their brainwaves are at, and we know they're in deep sleep, and then we go wake them up and we say, "Are you are you dreaming?" They'll be like, "Yeah." But they can't really remember the dream or if they do, it's not super vivid. There's not a lot of activity to-- "Yeah, there was some processing going on that I can remember, but it's all foggy and not really specific." 

Now, like I said, you go across the basement floor in stage 4 and then you climb up to 3, and then 2, you get this little firing. It causes this rehearsal and REM and you think about something really intensely and then we wake up somebody in REM sleep and we say, "Are you dreaming?" They say, "Yeah." "What are you dreaming about?" "Well, let me tell you. Sit down. I have all sorts of detail and it's very vivid, and it has a lot of color, and it has a lot of action" and we can remember it very well. We believe that that's where emotional categorization happens. For example, something glib, little flip into but just playful to say, you have an argument with your spouse about doing the dishes, or leaving socks on the floor or something like that. It gets a little more heated than it should because you're both tired, and irritable, and whatever the case. And you have this suboptimal experience with that. If you get a good night's sleep, and you do all your REM, and at some point that's going to fire, and you're going to rehearse it, and it'll likely happen three or four times during the night. Then you process it, and then you put it in a little file, a file to think of it like a hierarchical file system of like, "This is something really important and significant. This is not so much, not so much" This is really insignificant. 

Now, if you get good quality sleep all the time or after these events, then it's very likely you will categorize the right state. This is one of the beliefs around PTSD, is that PTSD is very frequently associated with sleep deprivation and chaotic sleep. And so, they don't categorize things well. If you don't categorize the dirty socks on the floor conversation, you might wake up tomorrow hypersensitive to that. And then the next time your spouse does that just like 10 times as irritating and now this is like, we're getting a divorce over the socks, which is obviously ridiculous. But again, that's a glib example of it, but we know this to be true. Yes, you're dreaming all night. REM sleep is much more vivid, much more memorable. As I said earlier in this podcast and the one we've done before, the beginning of the night is primarily deep sleep. 90% deep sleep, 10% REM sleep, that transitions and progresses throughout the night to your last sleep cycle, 90% REM sleep, 10% deep sleep. 

The odds are if you get a full night's sleep, if you have good sleep quality, good sleep architecture, and you're transitioning through all of the stages well, and you have enough anabolic hormones, and everything is repairing and restored and you're progressing through a good night's sleep, and your histogram looks great when we plot it all out, it looks perfect. Because your last sleep cycle is 90% REM sleep, the odds are you're going to wake up in REM. If you wake up in REM, you're going to remember what you're dreaming about. If you wake up in deep sleep, you're not going to remember what you're dreaming about. Also, when you wake up in deep sleep, as I told you, the lowest your cortisol will ever be as well you're in deep sleep. So, if you wake up in deep sleep, you're going to have lower cortisol and cortisol is the hormone that keeps us alert in proportion to our environment. You don't have a high enough cortisol level to be awake, but the alarm clock went off anyway and now you wake up, and you feel tired, and you don't remember your dreams, and you think you had a bad night's sleep, but you could have had a great night's sleep, and it just happened transition into a deep sleep cycle right before you woke up. An hour later, you're going to feel fine, you're going to have a great day and full of energy, and all that other stuff. 

Melanie Avalon: That is really fascinating. The timing of the wakeup is really key. People who would almost be better sometimes to have less sleep or wake up at the end of a sleep cycle, then a little bit more sleep and wake up in the middle? 

Kirk Parsley: No, the ideal is to get the sleep you need. If you get all the sleep you need, you will wake up in REM. If you don't get enough sleep and you wake up in a REM cycle, you'll feel better when you wake up than you would feel if you woke up in a deep sleep cycle. However, you didn't restore as much. You are still increasing your risk of disease and shortening your lifespan essentially. It's still ideal to get that extra 30 minutes of sleep, or extra hour of sleep, or whatever that delta is. It's still better to actually get that. But you might subjectively feel better waking up from a REM sleep because as I said, that's a higher brainwave state than even being awake is. And so, you're going to wake up with just more neurostimulation and a more active brain and a higher cortisol level, and you're going to feel more like being awake that doesn't take away from the fact that you got inadequate sleep. It's just that you woke up at a more opportune time to not feel as tired from your sleep deprivation. 

Melanie Avalon: Oh, my goodness, I have so many more questions, but I feel we cannot ask all of them. I do want to ask one question that I personally had and two people asked about. So, I am going to ask it really quickly and it has to do with breathing, because I recently had an episode with James Nestor, who wrote the book Breath, which was an incredible book. And for listeners, I'll put a link to in the show notes. But how do you think breathing affects sleep. For example, Susan says, "I'd love to get his insight on open-mouth sleeping and its long-term impact on sleep quality. My daughter does it and is perpetually tired, but just can't break the habit." And then Sophia says, "Mouth taping, what does he think of that?" And for listeners, that's where you put tape over your mouth to force you to breathe through your nose at night.

Kirk Parsley: I know you've read the book and you realize there are some receptors in the nasopharyngeal pathway that can change some neurological functions. That's a pretty deep complex conversation to have. But to simplify it, at the end of the day and I don't mean to poo-poo. There definitely is some significance. But at the end of the day, as you know that the CO2 levels is what makes us feel like breathing that drives the urge to breathe. There's plenty of oxygen in the air for us to go for a really long time without reoxygenating. But CO2 buildup causes us to want to force that out and to breathe more. If you have something say, a deviated septum or chronic inflammation, maybe you're in a mold toxicity situation, or maybe you have allergies to the flora in the area that you live in, you have a restricted nasal passage to be able to pull air through, it might be harder. Well, it would be harder to get adequate ventilation through your nose alone.

That's not the same as saying that you aren't using your nose at all. It's just saying that because of whatever restrictions in there, you might not be able to get an adequate amount of ventilation to where you don't have a high CO2 buildup that's acidic, and that's a physiological stressor, and that leads to increased stress hormones, and that will wake you up. It's not something to be overlooked. You can't simply say, "Well, I'm going to tape my mouth shut because I've read that this helps people breathe because of these receptors in the nose and how that changes myriad physiologic and neurologic functions. And so, I'm just going to tape my mouth shut and suffer through it." Well, that's not a smart idea. If you're building up CO2, then that's going to lead to all sorts of negative effects on your sleep. The mouth taping is, I would just call that controversial. I'm not going to take a side on it. I don't think there's enough information to know. I haven't read every research paper on it. I can't say I'm the world's expert in that, but from what I've seen it's controversial. There's a lot of theory and speculation and a lot of the stuff.

Basically, in order for you to get good sleep, you can't be hypercapnic. You can't have too high of CO2 levels. There's no chance that you're going to have too high of oxygenation issues, the soft palate, so the area in the back of your throat, where your nose and your tonsils meet that soft palate area. There's a lot of flexibility and pliability to that and that can occlude your breathing area. That's what causes snoring. Snoring is simply so much diaphragmatic pressure that is pulling past a tissue that's obstructing the airway and it's causing a pulsatile flapping event. That's the snoring noise. Are you going to sleep better by taping your mouth shut, are you're going to sleep better if you don't have your mouth open, and you aren't taping your mouth shut? Do people who breathe through their mouth have lower quality of sleep? There's no research I'm aware of to suggest that any of that is true. 

By and large, breathing through your mouth is associated with hypersensitivity in your brain to CO2. You have a set point in your brain where CO2 levels get to a certain height and then you go, "Oh, I have to breathe right now. I have to take another breath." That can be trained. That's what Wim Hof type training is doing. It's training you pass those limitations to where your receptors are less sensitive and now you can handle higher CO2 levels without having this overwhelming urge to take a deep breath. All of that could be tied into an overall stress response. However, if you're properly oxygenating and blowing off CO2 during the night, I don't think it matters to a large degree whether it's happening through your mouth or your nose.

Melanie Avalon: For listeners, I will put a link in the show notes to the interview with James because we do dive in deeper to that. But to clarify, you don't have to literally put duct tape of your mouth. We talk about that in the interview. He does this a little piece of tape. It's really interesting to hear different perspectives on all of it. I still have more questions, but I feel we got to wrap this up. In any case, thank you so much. This has been absolutely incredible. Again, for listeners, get Sleep Remedy, don't think twice, definitely try it. The link for that is melanieavalon.com/sleepremedy. The coupon code, MELANIEAVALON will get you 10% off and I can't let you go without asking the last question I ask every guest on this podcast. What is that question?

Kirk Parsley: What am I grateful for?

Melanie Avalon: What is something you're grateful for?

Kirk Parsley: What is something that I'm grateful for? I'm grateful to have a lot of meaningful loving relationships in my life.

Melanie Avalon: That's a good thing to be grateful for. For listeners, where can they best follow your work? Any links that you want to put out there?

Kirk Parsley: If you want information-- Oh, I meant to mention this in one of the questions. I actually have a blog with a video about menopause and sleep. That's on my website. So, that's Doc D-O-C Parsley, like the herb, P-A-R-S-L-E-Y, docparsley.com. You can play around with that. There's the kids' guide and Stress-Free Sleep Guide. But if you just go to that website, you should be able to find everything. The sleep supplement is also on that site. But if you want to go directly to this supplement page to learn more about the supplement, that's sleepremedy.com and then there's sleepremedykids.com. And then I think in your show notes, you're going to list out a few of the links to the PDFs for helping decrease stress while you sleep or sleep being limited by stress, and building a bedtime routine for your kids, and all those other things. So, yeah, actually if you go to sleepremedykids.com that's built-in. docparsley.com is the safest thing. Dude, docparsley.com.

Melanie Avalon: I'll put direct links to everything. Again, that'll be at melanieavalon.com/sleepquestions2, the number 2. Thank you so much. This was absolutely incredible. I cannot express enough how grateful I am for everything that you're doing for the world in the whole sleep atmosphere, your sleep supplement, all of the education that you're doing. It's really, really valuable. I know I am forever grateful and I think my audience really benefits as well. So, thank you so much.

Kirk Parsley: I think it's fascinating that anybody cares and wants to listen. I'm very grateful to have the opportunity to answer your audience's questions. It's always a good time to talk to people who actually have any interest in the stuff I geek out on all day.

Melanie Avalon: Agreed. Well, maybe when people have finally forgotten these episodes, we can bring you back in the future now.

Kirk Parsley: [laughs] I think this might traumatize people for years. It might be a decade before I come back.

Melanie Avalon: If they're still listening right now, I think they're fans. So, I think they're already sold if they're still listening. [laughs] All right, well, I will talk to you again soon.

Kirk Parsley: Okay.

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