In this episode of Precision Medicine Made Simple, we continue our discussion with Dr. Mohammad Jarbou from Episode 33, where we first explored the significance of VO₂ Max testing and its role in personal health optimization. Now, we dive deeper into the importance of sleep health, heart rate variability (HRV), and the insights provided by sleep studies.

Dr. Jarbou breaks down how HRV can be a valuable indicator of overall health and recovery, highlighting its connection to sleep quality and longevity. He also provides a closer look at mild sleep apnea, its effects on well-being, and how lifestyle interventions can help prevent the condition from progressing.

With actionable advice on improving sleep hygiene and the science behind REM sleep rebound, this episode offers valuable insights for those looking to optimize their sleep and overall health through a precision medicine approach.

Key Takeaways:

• HRV reflects the balance between “fight or flight” and “rest and digest”—high HRV = good recovery.
• High REM percentage can signal sleep deprivation, not “better sleep.”
• Mild sleep apnea (AHI 5.6) is common and often doesn’t require CPAP in young, healthy patients.
• Consistent sleep and wake times matter more than “making up sleep” with naps.
• Sleep, fitness, and recovery exist in a cycle—fix one, improve the others.

In This Episode:

• [00:00:00] HRV explained: stress, recovery, and sleep’s role
• [00:02:19] Taylor sets the stage: VO₂ max test and sleep study follow-up
• [00:05:33] Home sleep study setup, devices, and first-night discomfort
• [00:07:59] In-lab sleep studies vs home sleep tests
• [00:10:35] 4–3–2–1 sleep hygiene rule and real-life challenges
• [00:13:18] HRV, alcohol, and what readiness metrics can and can’t tell you
• [00:16:44] Total sleep time: why 5–6 hours is Taylor’s “first problem”
• [00:18:30] High REM percentage and REM rebound from sleep deprivation
• [00:20:00] Deep sleep vs REM: what truly restores your body
• [00:24:33] AHI, 3% vs 4% oxygen drop, and Taylor’s mild sleep apnea
• [00:29:32] Snoring, sleeping on your back, and positional therapy
• [00:35:42] Naps, “social jet lag,” and protecting your sleep drive
• [00:40:28] When to repeat sleep studies and add body composition (DEXA)
• [00:43:05] Taylor’s takeaways and next step: VO₂ max deep dive in a future episode

Notable Quotes:

• “REM sleep isn’t the restorative stage—deep non-REM sleep is where your body really recovers.” – Dr. Jarbou
• “If your HRV is low in the morning, it’s often your body telling you it didn’t get the recovery it needed.” – Dr. Jarbou
• “Most people don’t need fancy tests—they need better sleep structure and consistency.” – Dr. Jarbou
• “Mild sleep apnea doesn’t mean treatment right away. Fix the basics first.” – Dr.

The traditional healthcare system is breaking under the weight of burnout, short appointments, and profit-driven incentives, and Dr. Adam Wheeler has lived it from the inside. After losing a patient and realizing that all his creative energy was going into improving metrics instead of improving lives, he decided to build something radically different.

In this episode of Precision Medicine Made Simple, recorded live at Bigtree Medical in Columbia, Missouri, Dr. Wheeler joins host Taylor Cu and co-host Dr. William Stanford to share how he reimagined primary care from the ground up. His direct primary care network now serves more than 13,000 patients with a model built on unlimited time, transparent pricing, and authentic, patient-centered relationships.

You’ll hear how Dr. Wheeler’s model leverages nurse practitioners to expand access, integrates genetic and metabolic testing to personalize care, and embraces patient-requested treatments such as testosterone therapy, compounded GLP-1s, IV infusions, and preventive protocols. He also discusses how AI and shared decision-making empower patients to take control of their health, creating a system that rewards outcomes instead of volume.

This conversation explores what it truly takes to make healthcare personal again and why the future of medicine belongs to those willing to rebuild it from trust, data, and compassion.

Key Takeaways

• Why Dr. Wheeler walked away from the traditional insurance model
• How the direct primary care (DPC) membership system works and why patients love it
• The role of nurse practitioners in solving the physician shortage
• How Bigtree trains new NPs to lead with empathy and precision
• Why shared decision-making is critical to modern medicine
• What peptides, testosterone therapy, and GLP-1 medications mean for personalized care
• How AI tools are empowering, not replacing, doctors
• Why genetic and metabolic testing helps patients “know the fight they’re fighting”
• The real difference between health span and lifespan and how to extend both
• What the future looks like when healthcare becomes proactive instead of reactive

In This Episode

• [00:00] Turning points in medicine
• [01:17] Intro to Precision Medicine Made Simple
• [02:39] Meet Dr. Adam Wheeler
• [05:49] Membership model explained
• [07:23] Bigtree care models
• [08:19] Scaling intimacy in care
• [08:48] Direct vs. concierge care
• [09:51] Innovative patient care
• [31:34] Genetics and cancer risk
• [33:11] Personalized medicine
• [34:06] Motivational interviewing
• [35:11] Prostate cancer and genetics
• [49:50] AI in healthcare
• [53:01] AI’s role in medicine
• [56:39] Bigtree Medical vision
• [57:48] Final thoughts

Notable Quotes

• [05:43] “It’s really sad that all this creative energy is going to juicing the numbers, as opposed to taking care of people.” — Dr. Adam Wheeler
• [05:24] “We allow our patients to leave our practice at any time. If we do a bad job, they’re supposed to leave, and if we do a good job, they stay.” — Dr. Adam Wheeler
• [14:27] “The direct pay model absolutely changes your incentives as a doctor… it forces you to care about the things patients actually care about.” — Dr. Adam Wheeler
• [38:21] “There’s nothing you can do about the Lp(a), but you need to really optimize all of your other numbers.”— Dr. Adam Wheeler
• [55:19] "I think before we have AI replacing me, we're gonna have me enabled with AI." — Dr. Adam Wheeler

Our Guest

Dr. Adam Wheeler is a

In this episode of Precision Medicine Made Simple, we’re joined by Dr. Mohammad Jarbou, co-founder of the Longevity Clinic. Dr. Jarbou, a board-certified physician in pulmonary medicine, critical care, sleep medicine, and clinical informatics, discusses how his clinic uses a holistic approach to aging and health span. The clinic focuses on prevention and early detection, utilizing personalized medicine, genetic testing, fitness plans, and sleep optimization.

Dr. Jarbou explains how cutting-edge practices, such as VO2 max testing, personalized nutrition, and genetic evaluations, help optimize long-term health. He also highlights the importance of muscle mass and good sleep hygiene for aging well, and how these factors are integral to preventing chronic diseases.

Key Takeaways:

• VO2 max testing is an excellent predictor of longevity and health span.
• Muscle mass is critical for long-term health and quality of life.
• Genetic testing helps guide personalized wellness plans and prevent chronic illness.
• Sleep hygiene plays a significant role in overall health, affecting everything from energy to metabolism.
• Personalized health strategies should incorporate fitness, nutrition, and genetics to achieve optimal wellness.
• Prevention of chronic conditions like diabetes, Alzheimer’s, and sleep apnea can be achieved with early detection and lifestyle modifications.

In This Episode:

• [00:00] – Introduction to Dr. Mohammad Jarbou and the Longevity Clinic
• [05:00] – How the clinic’s focus on prevention and early diagnosis led to personalized care
• [10:00] – The significance of VO2 max testing and wearable technology for tracking fitness
• [15:00] – The importance of muscle mass and weightlifting for longevity
• [20:00] – The role of genetic testing in guiding personalized health strategies
• [25:00] – How sleep quality affects overall health and Dr. Jarbou’s tips for better sleep
• [30:00] – The benefits of personalized nutrition and building sustainable habits
• [35:00] – Addressing chronic conditions with early intervention and prevention
• [40:00] – Hormone replacement therapy and its role in health optimization for longevity
• [45:00] – How genetic testing can help identify risks for chronic diseases like Alzheimer’s

Notable Quotes

• "Longevity is not just how long you live, but the quality of life you have along the way." – Dr. Mohammad Jarbou
• "Muscle mass is critical for both physical function and longevity." – Dr. Mohammad Jarbou
• "Prevention should be the foundation, not an afterthought, when it comes to aging and health." – Dr. Mohammad Jarbou
• "You can't just focus on one area of health. Fitness, nutrition, sleep, and genetics all play an essential role in how you age." – Dr. Mohammad Jarbou
• "Small changes in habits can have a huge impact on your longevity." – Dr. Mohammad Jarbou

Our Guest

Dr. Mohammad Jarbou is a physician with over 20 years of...