How a sleep apnea diagnosis led to a breakout for Astros prospect

Photo: Charlie Blalock

Original Article | THE ATHLETIC | May 9, 2018 | Author Jake Kaplan

Explanations for velocity increases from year to year aren’t always clear. Perhaps a pitcher
adjusted his mechanics. Maybe he used the offseason to work himself into better physical
shape or was simply healthy after previously battling injuries. Often, it’s some combination
of these factors.

The unique story behind Josh James’ velo spike doesn’t neatly fit into any of the above
categories. The 25-year-old Astros minor leaguer didn’t overhaul his delivery or drastically
alter his workouts or his diet. So why does his fastball, which a couple years ago sat 89 to
93 mph, now regularly touch 98?

James, who has quickly risen from an unheralded former 34th-round draft pick to a
legitimate reliever prospect for Houston, attributes his ability to throw harder to better
quality sleep. The 6-foot-3, 220-pound righthander was diagnosed with sleep apnea the
offseason before last, and addressing the disorder, he says, correlates with his breakout.
James, whose fastball now sits 94 to 96 mph, struck out 41 percent of the batters he faced
in Class AA this season before the Astros promoted him Sunday to Class AAA, where he’s
scheduled to debut Thursday in Fresno’s game at Las Vegas. He began throwing harder last
year, his first year sleeping with the assistance of a breathing mask, but his velocity increase
has been even more pronounced early in 2018. On April 29, in his final home outing for
Corpus Christi, the stadium scoreboard radar gun flashed a 100.

“I feel like I’m still brand new to throwing hard,” James said. “It’s like every day I’ll go out
and I’ll throw and I’ll feel sore and I’m like, ‘Man, in this next outing, I don’t think I’ll be
able to hit 95.’ And then I come out and it’s coming out pretty good. It’s definitely
interesting.”

Apparently, this is the new normal for James, an intriguing arm the Astros have developed
as a starter but whose inconsistent delivery will likely result in him being a reliever.

The story of how he discovered he had sleep apnea traces back to 2015, when his roommate
with low-Class A, a pitcher named Ryan Thompson, complained of James’ intolerable
snoring and encouraged him to get it checked out by a doctor.

During his 2016 season in high-Class A , James felt exhausted, his velocity lagged into the
high 80s and he began to gain weight. As a result, James decided to see a sleep specialist in
his offseason hometown of Fort Lauderdale, Fla.

He underwent a sleep study that he said
revealed he was waking up almost 30 times a night when lying on his back and another 15
or so when on his side.

“It wasn’t necessarily eyes open,” James said. “It was just I wasn’t getting into my REM
sleep.”

Though surgery to repair his deviated septum was suggested, James opted to try sleeping
with the assistance of a CPAP machine (Continuous Positive Airway Pressure), a common
means of therapy for sleep apnea that features a mask. He wears the mask to bed every
night, he said, and tried to use it even on the long overnight bus rides in the Texas League.
Vastly improved, mostly uninterrupted sleep has James much more energized and in better
moods, he said, and also has eliminated his previous need to nap during the day. The CPAP
machine is attached to an app that generates a report on his sleeping, and James said now
he wakes up maybe only once or twice a night.

“I just wanted to stop snoring and see if I could get some better sleep and not feel as bad,”
he said.

“(I’m) unbelievably energized. Even sleeping four or five hours with the machine is
10 times better than sleeping 10 hours without it.”

While acknowledging it’s difficult to draw a straight line from treating sleep apnea to
throwing harder, multiple sleep experts vouched for the viability of James’ explanation.
“Particularly if you’re affected during your slow-wave sleep (also known as deep sleep),
that’s when your growth hormone gets released, so your ability to gain strength can be
affected. Your ability to stay focused is going to be affected. Your ability to do things like
repeat mechanics, locate — all of that’s affected because essentially you’re just chronically
sleep deprived,” said Dr. Scott Kutscher of the Stanford Sleep Medicine Center. “So while
there is very little research on the effects of sleep apnea directly on things like performance
(in baseball), we know based off what happens with sleep deprivation that there is certainly
a significant impact on performance.”

Dr. Christopher Winter of Charlottesville Neurology and Sleep Medicine in Virginia
echoed a similar sentiment. “Performance is not only being able to perform and throw
hard,” he said, “but it’s also being able to get your body ready over the next couple days to
throw hard again.” He added he believes sleep apnea is underdiagnosed among baseball
players.

“I’ve seen the reverse several times — I know other doctors have, too — where a young
pitcher is slowly losing velocity and nobody can really figure out why,” Winter said.

“Sleep apnea is one of those things where it kind of slowly creeps up on you.”

James’ velocity spike last year caught him by surprise. His new-found ability to blow a
fastball by hitters has changed everything. When he’s throwing strikes, his mid-80s slider
and his mid-80s changeup are more effective than before. Repeating his delivery has long
been the biggest deficiency for James. His consistency in that area has improved but
remains a work in progress.

Drafted in 2014 out of Western Oklahoma State College, James is an example of what
Astros officials have termed “a Jim Stevenson special.” Stevenson, the team’s amateur scout
for north and west Texas, Oklahoma, Arkansas and Kansas, has advocated for a number of
under-the-radar players at Oklahoma junior colleges the Astros have drafted in recent
years. Outfielder Ramon Laureano and righthander Dean Deetz (Northeast Oklahoma
A&M) and third baseman Abraham Toro (Seminole State College) are among the most
notable in addition to James.

As a 34th-round pick, James received only a $15,000 signing bonus. A native of
Hollywood, Fla. who also spent a lot of his childhood in the Virgin Islands, his parents’
birthplace, James first enrolled at Division II Barry University in Miami. After pitching
only five innings in his year there (he allowed six earned runs), he left to go the JuCo route.
A former summer ball coach of his in the Virgin Islands connected him with Western
Oklahoma State College coach Kurt Russell. Stevenson saw James pitch only a few times
there in his draft year but liked the pitcher’s durable, athletic build and fast arm enough to
encourage the Astros to take a late-round flier.

James has a 3.66 ERA in 364 professional innings dating to June 2014. He spent full
seasons in low-Class A in 2015 and high-Class A in 2016 before last year reaching Class
AA, where he had a 4.38 ERA and was limited by injuries to only 76 innings. He had a
2.49 ERA in 21 2/3 innings for Corpus Christi to begin this season before the Astros
bumped him to Class AAA.

Even though his snoring issue has dissipated, James’ reputation has proved difficult to shed.
Before the start of the minor league season, he had to assure his Class AA teammates it
was okay to room with him on road trips. Eventually, he recruited fellow righthander Brock
Dykxhoorn and later righthander Akeem Bostick.

“It took some convincing,” James said, “to get that done.”

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