The National Basketball Association (NBA) has always been a league relatively free of performance-enhancing scandals. While there have been a few players who have failed drug testing, these players were not big names, and the issue came and went without much notice.
That streak ended abruptly Thursday night with three of the biggest names in the game -- Tim Duncan, Tony Parker and Manu Ginobili (as well as Danny Green) -- being busted for performance-enhancing endeavors. To add fuel to this fire, not only were all four players from the same organization, the San Antonio Spurs, but their head coach freely admits to leading them down this dark path himself. "It's the best thing for our team," Head Coach Gregg Popovich stated. Incredibly, he went on to admit that the team has done it before. As one would imagine, Commissioner David Stern quickly promised "substantial" sanctions, and he delivered in the form of a $250,000 fine. So what steroid injection, doping agent, or banned substance is at the center of this major story?
The answer is sleep.
That's right. As unbelievable as this may sound, the Spurs simply decided to rest their players, and they were punished severely for it. Why would a team decide to do such a thing? Let's take a look at the facts. All teams play an 82-game schedule, and for older players, particularly during the second half of the season, that gets to be an exhausting grind. The Spurs were at the end of a brutal six-game road trip (winning the first five) and currently own the third-best record in the entire league. Why not send your key players home, let them get over their jetlag a little sooner, and get more rest before their next game? What advantage do you gain by subjecting these guys to a physical away game against the defending NBA champion Miami Heat?
To succeed at a high level in any athletic endeavor, you must be able to not only perform at a high level, but also recover at a high level as well. Recovery from intense athletic activity is a multifactorial process. One key to recovery is growth hormone. We all make growth hormone and it helps strengthen our bones, repair muscle tissue, and promote a healthy immune system. Obviously, the use of illegal growth hormone is found within sports as athletes use these types of substances to gain an advantage. What is interesting is that most adult men only secrete natural growth hormone when they are in deep sleep.
The Spurs are an older team. Tim, Tony, and Manu are 36, 30, and 35 respectively (compare that to the ages of the main three of the Oklahoma City Thunder that beat them in four straight games last year in the Western Conference Finals: Kevin Durant -- 24, Russell Westbrook -- 24, and James Harden -- 23). So what does age matter? Consider the fact that as we mature, we tend exhibit less deep sleep as we snooze at night. So by transitive property, if growth hormone helps an athlete recover, and growth hormone is secreted in deep sleep, then deep sleep helps an athlete recover. Furthermore, if deep sleep is harder to come by in an older athlete, then it stands to reason that taking extra care of an older athlete's sleep might help them recover more effectively and be a better athlete -- performance enhancement at its best!
How can we promote deep sleep and better growth hormone secretion? Doing this requires understanding the factors that disrupt deep sleep. Shift work and schedule disruption are huge factors that disturb sleep, which should come as no surprise to anyone. Working unusual hours or traveling across time zones (jetlag) can reduce or disrupt deep sleep, thus affecting growth hormone levels. Imagine how much better 6'11" Tim Duncan sleeps in his own bed, rather than crammed into some hotel bed or trying to catch some essential rest on a charter plane.
I understand that the fans of the Spurs vs. Heat game may have been disappointed not the see the San Antonio stars on the court, but this is not new to sports. Players in the National Football League and Major League Baseball are routinely rested in a strategic fashion. (Don't believe me? Tune into the December 30 game between the Atlanta Falcons and the Tampa Bay Buccaneers. I wouldn't be surprised if the Falcons allowed their more athletic fans to suit up.) Since when do we get guarantees with anything sport-related? On top of that, the game ended up being extremely competitive.
In a world where winning is everything and coaches get fired quickly for not delivering trophies, I could not agree more with Popovich's move (especially since he had to host the Memphis Grizzlies, possibly the best team in the league, two days later). As someone who studies the effects of sleep on elite athletes, I am shocked that more teams do not strategically rest their key players in the midst of these long and compact seasons (this was the Spurs' fourth game in five nights). Commissioner Stern, in my opinion, is wrong for meddling with the right a team has to get the most out of their investments. Earlier this year the Washington Nationals made a similarly bold move to rest their ace pitcher Stephen Strasburg permanently at the end of the season. Instead of a quarter of a million dollar fine, the Nationals manager received something a little different for his decision.
He received the 2012 National League Manager of the Year.
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 Van Cauter E, Kerkhofs M, Caufriez A, Van Onderbergen A, Thorner MO, Copinschi G. J Clin Endocrinol Metab. A quantitative estimation of growth hormone secretion in normal man: reproducibility and relation to sleep and time of day. 1992 Jun;74(6):1441-50.
 Van Cauter E, Leproult R, Plat LJAMA. Age-related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in healthy men. 2000 Aug 16;284(7):861-8.
 Guilleminault C, Czeisler C, Coleman R, Miles L. Circadian rhythm disturbances and sleep disorders in shift workers. Electroencephalogr Clin Neurophysiol Suppl. 1982;36:709-14.
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